Video-Assisted Surgery Followed by Radiation Therapy in Treating Patients With Stage I Non-small Cell Lung Cancer and Poor Heart and Lung Function

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Known or suspected, single, peripheral, stage T1 N0 M0 lung tumor
• •* Tumor must not be identifiable by bronchoscopy
• •* Bronchoscopically visible cancer or bronchial distortions considered related to tumor
• •* Positive cytology by bronchoscopy allowed if no gross abnormality visible
• •* Mediastinoscopy required for nodes greater than 1 cm
• •* No pleural effusions
• •* No metastatic or N2 disease on CT scan
• •* Lesion must be accessible for video-assisted thoracoscopic wedge resection
• •High cardiopulmonary risk for thoracotomy with at least 1 of the following criteria:
• •* FEV1 less than 40% predicted
• •* DLCO less than 50% predicted
• •* Supplemental oxygen requirement
• •* Chronic PaCO2 greater than 45 mm Hg
• •* Maximum oxygen consumption (VO2 max) less than 15 mL/kg/min
• •Patients who appear at high risk for non-pulmonary reasons (e.g., patients who are elderly or with renal or cardiac failure) may be eligible only if VO2 max or other criteria above are met
• •Eligible for radiotherapy after completion of wedge resection if histologic documentation of non-small cell lung cancer, including any of the following subtypes:
• •* Squamous cell carcinoma
• •* Adenocarcinoma
• •* Bronchoalveolar cell
• •* Large cell anaplastic carcinoma
• •Cytology from bronchial washings and transthoracic needle aspiration not acceptable
• •PATIENT CHARACTERISTICS:
• •Age:
• •18 and over
• •Performance status:
• •0-2
• •Other:
• •No other malignancy within the past 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix
• •Weight loss no greater than 10% within the past 6 months
• •PRIOR CONCURRENT THERAPY:
• •Radiotherapy
• •No prior thoracic irradiation