Radiation Therapy for Lung Neuroendocrine Tumors

Radiation therapy uses high-energy rays, such as x-rays or radioactive particles, to kill cancer cells.

Although surgery is the main treatment for most neuroendocrine tumors (NETs), radiation therapy may be an option for those who can’t have surgery. It may also be given to reduce the size of the tumor or improve certain symptoms, sometimes along with chemotherapy.

External beam radiation therapy (EBRT)

EBRT uses a machine that delivers a beam of radiation to a specific part of the body. This is the type of radiation used most often for lung NETs. Proton beam therapy and stereotactic body radiation therapy (SBRT) are types of EBRT that sometimes are used.

Before your treatments start, the radiation team will determine the correct angles for aiming the radiation beams and the proper dose of radiation. Each treatment lasts only a few minutes, but the setup time – getting you into place for treatment – usually takes longer.

Treatment is much like getting an x-ray, but the radiation dose is stronger. The procedure itself is painless. Most often, radiation treatments are given 5 days a week for several weeks, but this can vary based on why it’s being given.

Possible side effects

Some common side effects of radiation therapy include:

• Skin changes in areas getting radiation, ranging from redness to blistering and peeling
• Nausea and vomiting
• Diarrhea
• Fatigue
• Loss of appetite
• Weight loss
• Low blood counts, which can increase the risk of serious infection

Usually, these side effects go away within a few weeks after the treatment is complete. Ask your doctor what side effects to expect and how to prevent or relieve them.

Peptide receptor radionuclide therapy (PRRT)

People with somatostatin receptor (SSTR)-positive NETs who already have been treated with octreotide or lanreotide may be candidates for PRRT. Up to half of patients with lung NETs may not be suitable candidates for PRRT because their NETs do not all express SSTR.

In PRRT, a radioactive element is linked to a somatostatin analog to form a drug called Lu-177 dotatate. It is injected into a vein in the arm.

This drug travels throughout the body, attaches to cancer cells, and gives off radiation to kill them. The radiation is delivered directly to the tumor, so there is less effect on healthy tissues.

Possible side effects

Side effects of PRRT include low levels of blood cells, nausea, and fatigue. There is a small risk of developing bone marrow cancers and a small risk of significant kidney dysfunction. 

Tell your cancer care team if you are or might become pregnant, because Lu-177 dotatate can harm the fetus. There is not enough information about the effect of yttrium-90 on pregnant women, so you should discuss this with your doctor.

Since these drugs expose you to radiation, people who come into contact with you need to follow certain radiation safety practices to limit their exposure. See Systemic Radiation Therapy for more information.