Lung cancer is the leading cause of cancer‑related death in the United States. We treat both non‑small cell lung cancer and small cell lung cancer at all stages—from I to IV. Thanks to modern technology, we offer curative treatment even to patients who have been told they are not surgical candidates.
For medically inoperable stage I NSCLC (<3-4 cm), the gold standard is stereotactic ablative radiation therapy (SABR). We deliver an ablative dose in 1‑5 sessions directly into the tumor. At ROC, we use 4D‑CT to track breathing motion, a robotic couch for precise positioning, and abdominal compression to reduce tumor movement. Each treatment takes 20‑30 minutes, is completely painless, and requires no anesthesia. The 3‑year local control rate is 90‑95%, comparable to surgical lobectomy. For patients with poor lung function or advanced age, SABR is the only curative option.
The standard of care for medically inoperable stage III NSCLC is concurrent chemoradiation (carboplatin/paclitaxel plus radiotherapy to 60‑66 Gy in 30‑33 fractions). We typically use intensity‑modulated radiation therapy (IMRT) to treat the gross tumor and involved lymph nodes. Daily cone‑beam CT adjusts for stomach filling and breathing motion.
After chemoradiation, if there is no progression, durvalumab immunotherapy is typically given for 12 months. This consolidation immunotherapy increases 5‑year overall survival from approximately 33% to 43%, based on the PACIFIC trial.
Up to 30% of stage IV patients have oligometastatic disease (usually <5 sites of metastases). For some of these patients, we can perform SABR to all metastatic sites with the goal of long‑term remission and delaying the need for systemic chemotherapy. Even when widespread disease is present, palliative radiation can be used to control symptoms: hemoptysis (coughing up blood) in 80‑90%, bronchial obstruction, superior vena cava syndrome, and painful bone metastases.
For limited‑stage SCLC, fractionated radiation therapy typically over 6-6.5 weeks is given concurrently with etoposide/cisplatin with curative intent. For extensive-stage SCLC, we use palliative radiation to symptomatic sites.
Common temporary side effects of thoracic radiation include sore throat, trouble swallowing, fatigue, and dry cough. The symptoms can be managed with medications and typically resolve within 2‑4 weeks after treatment ends.
Call us at 847-698-0600 ext. 112 to schedule a consultation. Our team works closely with thoracic surgeons and medical oncologists to help you achieve the best possible outcome.
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