Radiation Therapy or Observation After Chemotherapy in Treating Patients With Stage IV Non-Small Cell Lung Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
• •* Mixed histology allowed if all components are consistent with NSCLC
• •* Squamous cell histology allowed
• •Stage IV disease
• •* Oligometastatic disease (M1 with 1-3 metastases)
• •* Patients with M1 disease that involves intrapulmonary metastases are eligible provided ≤ 40% of the total lung volume receives ≥ 20 Gy of radiotherapy
• •Previously untreated disease OR achieved stable disease or partial response within 8 weeks after completion of 2-6 courses of standard platinum-based chemotherapy (administered every 3-4 weeks)
• •Pleural effusion allowed provided it is minimal
• •No history of or current brain metastases
• •* Patients who have had up to 3 brain metastases allowed provided they have been treated with not signs of progression
• •PATIENT CHARACTERISTICS:
• •ECOG performance status 0-1
• •Life expectancy ≥ 12 weeks
• •Platelet count ≥ 100,00/mm\^3
• •Hemoglobin ≥ 9 g/dL
• •WBC ≥ 2,000/mm\^3
• •Creatinine ≤ 2 times upper limit of normal
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •Able to undergo radiotherapy, based on radiation oncology consultation
• •Willing and able to comply with study treatment
• •FEV\_1 ≥ 1 L
• •No requirement for daily supplemental oxygen
• •No second primary malignancy, except for any of the following:
• •* Carcinoma in situ of the cervix
• •* Nonmelanoma skin cancer
• •* History of low-grade (Gleason score ≤ 6) localized prostate cancer, even if diagnosed within the past 5 years
• •* Stage I breast cancer that was treated within the past 5 years
• •* Other malignancy that was diagnosed and definitely treated ≥ 5 years ago with no subsequent evidence of recurrence
• •No concurrent severe and/or uncontrolled medical condition, including any of the following:
• •* Angina pectoris
• •* Congestive heart failure within the past 3 months, unless LVEF \> 40%
• •* Myocardial infarction within the past 6 months
• •* Cardiac arrhythmia
• •No clinically significant infection
• •No psychiatric illness or social situation that would limit compliance with study requirements
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics
• •No prior therapy for this cancer other than 2-6 courses of standard platinum-based chemotherapy with or without bevacizumab
• •No prior radiotherapy to the treatment sites (e.g., primary lesion, clinically involved nodes, or metastatic lesions)
• •No bevacizumab during and for 4 weeks after completion of radiotherapy
• •No concurrent systemic chemotherapy
• •No other maintenance systemic therapy during radiotherapy
• •No other concurrent investigational agents for the primary neoplasm
• •No concurrent intensity modulated radiotherapy
• •No concurrent prophylactic nodal radiotherapy