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Radiation therapy for neuroendocrine tumours (NETs)

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is not usually used to treat neuroendocrine tumours (NETs). If used, it is usually when the cancer has spread (metastasized). Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. Most people receive other treatments before radiation therapy.


  • destroy cancer cells in the body
  • destroy cancer cells left behindafter surgery or other therapies
  • relieve pain or control the symptoms of advanced neuroendocrine cancer (called palliative therapy)

The following types of radiation therapy are used to treat NETs.

Radionuclide therapy

Radionuclide therapy (also called internal radiation therapy) uses a radioactive material called a radioisotope that travels through the body. Cancer cells take up the radioactive material, and the radioactive material destroys the cancer cells. For NETs, the radioactive material is usually combined with a substance (a radiopharmaceutical) that targets specific molecules on the surface of cancer cells. Using the radiopharmaceutical allows the radiation to be delivered directly to the cancer cells and limits the effects of radiation on normal cells. Radionuclide therapy may be called targeted radiation therapy or systemic radiation therapy.

Peptide receptor radionuclide therapy (PRRT)

PRRT is a type of radionuclide therapy used to treat NETs. It uses a radioactive material, usually lutetium-177 (Lu-177), combined with a somatostatin analogue (octreotide or octreotate). This radiopharmaceutical is given through a needle into a vein (intravenously).

PRRT may be used for well-differentiated NETs when:

  • surgery can’t be done
  • some cancer remains after surgery or radiofrequency ablation (RFA)
  • the cancer has continued to grow (progressed) and spread (metastasized)

PRRT doesn’t work for all NETs because octreotide may not attach to the tumour cells. Most people need an octreotide scan before being considered for PRRT. This scan shows if octreotide attaches to NET cells.

PRRT is only available at a few cancer centres in Canada. It can only be used with special approval from Health Canada or by taking part in a clinical trial. Talk to your doctor about whether PRRT is right for you.

External beam radiation therapy

During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it. It is not usually used to treat NETs, but it may be given to relieve pain and manage symptoms from bone metastases or brain metastases.

Find out more about bone metastases and brain metastases.

Side effects

Side effects can happen with any type of treatment for NETs, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

During radiation therapy, the healthcare team tries to protect healthy cells in the treatment area as much as possible. For example, an amino acid mixture is given before PRRT to protect the kidneys from the effects of the radioactive material. But damage to healthy cells can happen and may cause side effects.


Side effects of radiation therapy will depend mainly on the type of radiation used and the treatment schedule. Radionuclide therapy doesn’t usually cause many side effects.

Some common side effects of radiation therapy used for NETs are:


Questions to ask about radiation therapy



A procedure that removes or destroys cells, tissues or organs.

Ablation may be done by surgery, radiation, chemicals, heat, high-frequency electrical current, radiofrequency waves, lasers or other methods.



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