G-CSF and Pegfilgrastim in Treating Neutropenia in Patients Undergoing Radiation Therapy and Chemotherapy for Limited Stage Small Cell Lung Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically or cytologically confirmed small cell carcinoma of the lung
• * Limited stage disease, defined as any of the following:
• * Tumor confined to one hemithorax
• * T4 tumor not based on malignant pleural effusion
• * N3 disease not based on contralateral supraclavicular involvement
• No complete tumor resection
• Measurable or evaluable disease
• Pleural effusion allowed provided the following conditions are present:
• * Effusion is too small to tap under CT guidance and is not evident on chest x-ray
• * Effusion appears only after a thoracotomy or other invasive procedure
• Must have certification by a Radiation Oncologist that the tumor can be encompassed by limited radiotherapy fields without significantly compromising pulmonary function
• No distant metastases
• PATIENT CHARACTERISTICS:
• Zubrod performance status 0-1
• ANC (absolute neutrophil count) ≥ 1,800 cells/mm³
• Platelet count ≥ 100,000 cells/mm³
• Hemoglobin ≥ 10.0 g/dL (transfusion or other intervention to achieve hemoglobin ≥ 8.0 g/dL allowed)
• Total bilirubin ≤ 1.5 mg/dL
• AST (aspartate aminotransferase) or ALT (alanine amino transferase ) ≤ 2 times the upper limit of normal (ULN)
• Alkaline phosphatase \< 2.5 times ULN (\< 5 times ULN if judged by the investigator to be related to liver metastases)
• Serum creatinine ≤ 1.5 mg/dL
• Creatinine clearance ≥ 50 mL/min
• FEV1 (Forced Expiratory Volume) obtained pre- or post-bronchodilator must be ≥ 1.5 liters/second
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for ≥ 60 days after the last study treatment
• No prior invasive malignancy, except non-melanomatous skin cancer or other micro-invasive malignancy, or carcinoma in situ of the breast, oral cavity, or cervix, unless the patient has been disease-free for a minimum of 3 years
• No weight loss \> 5% for any reason within the past 3 months
• No severe, active comorbidity, defined as follows:
• * Unstable angina and/or congestive heart failure requiring hospitalization within the past 6 months
• * Transmural myocardial infarction within the past 6 months
• * Acute bacterial or fungal infection requiring intravenous antibiotics
• * Chronic Obstructive Pulmonary Disease exacerbation with FEV1 (forced expiratory volume) \< 1.5 liters/second or other respiratory illness requiring hospitalization or precluding study therapy within the past 30 days
• * Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects
• * AIDS (HIV testing not required for entry into this protocol)
• No prior allergic reaction to the study drugs
• PRIOR CONCURRENT THERAPY:
• No prior systemic chemotherapy for lung cancer
• * Prior chemotherapy for a different cancer is allowed, provided it was completed ≥ 5 years prior to registration
• No prior radiotherapy to the region of the study cancer that would result in overlap of radiotherapy fields
• No concurrent intensity-modulated radiotherapy
• No concurrent amifostine