One problem is that usually one entire side of the chest is at risk for tumor and has to be treated. It may be difficult to administer a dose of radiation high enough to control tumor growth without risking toxic effects to adjacent structures including the heart, the stomach, intestines, liver and kidneys.
The radiation therapy physician must also be careful in giving radiation to the heart. This is even more of a problem after surgery to remove the left lung, with the resulting shift of the heart toward the left side of the chest. Sophisticated radiation methods have to be used with this cancer, which may involve electron beam treatments as well as the usual external radiation therapy.
Combined Therapy There has been a lot of interest in combined treatments, especially with radiation therapy being used as an adjuvant to surgery. This has also included the use of adjuvant intraoperative radiotherapy (IORT). New cooperative studies are evaluating various chemotherapeutic agents such as radiation sensitizers, especially doxorubicin .
Very recent research has also involved the preliminary use of chemotherapy , followed by surgery if the disease responded.
