Stereotactic Body Radiation Therapy in Treating Patients With Inoperable Stage I or Stage II Non-Small Cell Lung Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
• •* The following primary cancer subtypes are eligible:
• •* Squamous cell carcinoma
• •* Adenocarcinoma
• •* Large cell carcinoma
• •* Bronchoalveolar cell carcinoma
• •* Non-small cell carcinoma not otherwise specified
• •Stage I or II disease based on 1 of the following tumor node metastasis (TNM) stage criteria:
• •* T1, N0, M0
• •* T2 (≤ 5 cm), N0, M0
• •* T3 (≤ 5 cm), N0, M0 (chest wall primary tumors only)
• •No primary tumor of any T-stage within or touching the zone of the proximal bronchial tree\* NOTE: \*Defined as a volume 2 cm in all directions around the proximal bronchial tree (carina, right and left main bronchi, right and left upper lobe bronchi, intermedius bronchus, right middle lobe bronchus, lingular bronchus, and right and left lower lobe bronchi)
• •No primary T3 tumors involving the central chest (≤ 2 cm toward carina invasion) or structures of the mediastinum
• •Any hilar or mediastinal lymph nodes \> 1 cm on CT scan OR demonstrating suspicious uptake on positron-emission tomography scan must be biopsied and confirmed negative for NSCLC
• •The primary tumor must be deemed technically resectable with a reasonable possibility of obtaining a gross total resection with negative margins (defined as a potentially curative resection (PCR))
• •Deemed medically inoperable based on pulmonary function for surgical resection of NSCLC secondary to an underlying physiological problem, including any of the following medical conditions\*:
• •* Baseline forced expiratory volume (FEV)\_1\< 40% of predicted
• •* Postoperative predicted FEV\_1 \< 30% of predicted
• •* Severely reduced diffusion capacity
• •* Baseline hypoxemia and/or hypercapnia
• •* Exercise oxygen consumption \< 50% of predicted
• •* Severe pulmonary hypertension
• •* Diabetes mellitus with severe end organ damage
• •* Severe cerebral, cardiac, or peripheral vascular disease