Combination Chemotherapy and Computer-Planned Radiation Therapy in Treating Patients With Unresectable Stage III Non-Small Cell Lung Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
• * Squamous cell carcinoma
• * Adenocarcinoma, including bronchoalveolar cell carcinoma
• * Large cell anaplastic carcinoma, including giant and clear cell carcinoma
• Inoperable stage IIIA or IIIB disease
• No direct invasion of vertebral body
• * Tumors adjacent to a vertebral body without bone invasion allowed if all gross disease can be encompassed in radiotherapy boost field
• Contralateral mediastinal disease (N3) allowed if all gross disease can be encompassed in radiotherapy boost field
• No scalene, supraclavicular, or contralateral hilar node involvement
• Transudate, cytologically negative, non-bloody pleural effusion allowed if it can be encompassed in radiotherapy field
• * No exudative, bloody, or cytologically malignant pleural effusion
• * Evidence of pleural effusion by chest CT scan but not chest x-ray that is too small to tap allowed
• At least 1 unidimensionally measurable lesion
• * At least 20 mm by conventional techniques OR
• * At least 10 mm by spiral CT scan
• * The following are not considered measurable disease:
• * Bone lesions
• * Leptomeningeal disease
• * Ascites
• * Pleural/pericardial effusion
• * Abdominal masses that are not confirmed and followed by imaging techniques
• * Cystic lesions
• * Tumor lesions in a previously irradiated field
• PATIENT CHARACTERISTICS:
• Age:
• 18 and over
• Performance status:
• ECOG 0-1
• Life expectancy:
• Not specified
• Hematopoietic:
• Granulocyte count at least 1,500/mm3
• Platelet count at least 100,000/mm3
• Hepatic:
• Bilirubin less than 1.5 mg/dL
• AST less than 2 times upper limit of normal
• Renal:
• Creatinine clearance 20-130 mL/min for females
• Creatinine clearance 20-150 mL/min for males
• Pulmonary:
• FEV1 at least 1.2 L
• Other:
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No other currently active malignancy (defined as completed prior therapy and considered to be at less than 30% risk of relapse) except non-melanoma skin cancer
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• Not specified
• Chemotherapy:
• No prior chemotherapy for NSCLC
• No other concurrent chemotherapy
• Endocrine therapy:
• No concurrent hormonal therapy except steroids for adrenal failure or septic shock, hormones for non-disease-related conditions (e.g., insulin for diabetes), or glucocorticosteroids as antiemetics
• Radiotherapy:
• See Disease Characteristics
• No prior radiotherapy for NSCLC
• Surgery:
• At least 2 weeks since prior exploratory thoracotomy