S9900: Surgery With or Without Combination Chemotherapy in Treating Patients With Non-small Cell Lung Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically or cytologically proven non-small cell lung cancer (NSCLC), meeting 1 of the following staging criteria:
• •* Stage IB (T2, N0)
• •* Stage II
• •* T1-2, N1 with negative mediastinoscopy OR
• •* T3, N0
• •* Selected stage IIIA with negative mediastinoscopies
• •* T3, N1, excluding superior sulcus
• •* Positive level 10 hilar nodes allowed if mediastinoscopy negative
• •Apical tumors with no clinical symptoms allowed
• •No symptomatic tumors (T3, N0 or T3, N1) involving the superior sulcus
• •* No Pancoast's tumors
• •Negative mediastinoscopy required in all patients with clinically positive mediastinal or hilar lymph nodes to ensure no N2 disease
• •Bidimensionally measurable or evaluable disease by chest x-ray or contrast-enhanced CT scan
• •* T3, N0 disease assessable only by bronchoscopy must be affirmed by 2 observers and documented by photograph that includes main carina
• •PATIENT CHARACTERISTICS:
• •Age:
• •18 and over
• •Performance status:
• •Zubrod 0 or 1
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •Granulocyte count at least 1,500/mm\^3
• •Platelet count at least 100,000/mm\^3
• •WBC at least 4,000/mm\^3
• •Hepatic:
• •Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• •SGOT or SGPT no greater than 2 times ULN
• •Alkaline phosphatase no greater than 2 times ULN
• •Renal:
• •Creatinine no greater than 1.5 times ULN
• •Creatinine clearance at least 50 mL/min
• •Pulmonary:
• •See Disease Characteristics
• •Preresection FEV\_1 greater than 2.0 L OR
• •Predicted postresection FEV\_1 greater than 1.0 L
• •No postobstructive pneumonia
• •Other:
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •No serious infection
• •No other serious medical condition that would preclude study compliance
• •No prior allergic reactions to drugs containing Cremophor
• •No prior malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •No prior systemic chemotherapy for NSCLC
• •No other concurrent chemotherapy
• •Endocrine therapy:
• •Not specified
• •Radiotherapy:
• •No prior systemic radiotherapy for NSCLC
• •No concurrent radiotherapy
• •Surgery:
• •At least 5 years since prior resection of lung disease
• •Other:
• •No other concurrent investigational therapy
• •No other concurrent anticancer therapy