If lymph nodes are involved, the margins of the surgical resection are very close to the tumor or involved by tumor, or extensive tumor is found at surgery, radiation therapy with or without chemotherapy may be recommend postoperatively. As a result, cancers in the lung will frequently spread to these areas. CT scans and chest x-rays before surgery are often, but not always, successful in identifying this type of spread. Radiation therapy is usually given once or twice per day, five days a week, for approximately 6 to 8 weeks. Each treatment session lasts only several minutes, although setup times and treatment planning may occasionally cause some sessions to last longer.
Chemotherapy can also improve the survival rates in some instances over radiation therapy alone.
Carcinomas Small cell carcinomas have a tendency to spread early and are very sensitive to chemotherapy and radiation therapy. For these reasons, surgery is not routinely used in their treatment. Radiation treatments are usually given once or twice per day, five days a week, for approximately 4 to 6 weeks. In general, to prevent growth of any small, undetectable cancer sites in the brain, a lower dose of radiation is given than would be used to treat actual known sites of metastatic disease. By Devine JW, Mendenhall WM, Million RR, Carmichael MJ Cancer.