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

You may be eligible if

• 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