Comparing Photon Therapy To Proton Therapy To Treat Patients With Lung Cancer

Inclusion Criteria

• •Histologically or cytologically proven diagnosis of non-small cell lung cancer
• •Clinical American Joint Committee on Cancer (AJCC) (AJCC, 7th ed.) II, IIIA or IIIB (with non-operable disease; non-operable disease will be determined by a multi-disciplinary treatment team within 60 days prior to registration; note: for patients who are clearly nonresectable, the case can be determined by the treating radiation oncologist and/or a medical oncologist or pulmonologist
• •* Patients who present with N2 or N3 disease and an undetectable NSCLC primary tumor are eligible
• •* Patients who refuse surgery are eligible
• •* Patients who develop local recurrence after surgery and rendered candidate for definitive concurrent chemoradiation are also eligible
• •* Patients who have received systemic treatment (up to 4 cycles of induction chemotherapy, or up to 6 months of targeted therapy) are eligible
• •Appropriate stage for protocol entry, including no distant metastases, based upon the following minimum diagnostic workup:
• •* History/physical examination within 30 days prior to registration including resting heart rate;
• •* Fludeoxyglucose F 18 (FDG)-positron emission tomography (PET)/computed tomography (CT) scan for staging within 60 days prior to registration
• •* Magnetic resonance imaging (MRI) scan with contrast of the brain (preferred) or CT scan of the brain with contrast within 60 days prior to registration;
• •* Forced expiratory volume in one second (FEV1) \>= 0.8 liter or \>= 35% predicted with or without bronchodilator within 90 days prior to registration;
• •* Patients who meet the criterion above without oxygen (O2), but who need acute (started within 10 days prior to registration) supplemental oxygen due to tumor-caused obstruction/hypoxia are eligible, provided the amount of the O2 needed has been stable
• •Zubrod performance status 0-1 within 30 days prior to registration
• •Absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3 obtained within 30 days prior to registration
• •Platelets \>= 100,000 cells/mm\^3 obtained within 30 days prior to registration
• •Hemoglobin \>= 9.0 g/dl (note: the use of transfusion or other intervention to achieve hemoglobin \[Hgb\] \>= 9.0 g/dl is acceptable), obtained within 30 days prior to registration
• •Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamate pyruvate transaminase (SGPT) within 30 days prior to registration
• •* It is highly recommended but not required that SGOT or SGPT be =\< 1.5 upper limit of normal
• •Total bilirubin =\< 1.5 within 30 days prior to registration
• •* It is highly recommended but not required that total bilirubin be =\< 1.5 upper limit of normal
• •Serum creatinine \< 1.5 mg/dL or calculated creatinine clearance \>= 50 mL/min within 30 days prior to registration estimated by the Cockcroft-Gault formula
• •Peripheral neuropathy =\< grade 1 at the time of registration
• •Patients with non-malignant pleural effusion are eligible
• •* If a pleural effusion is present, the following criteria must be met to exclude malignant involvement:
• •* When pleural fluid is visible on both the CT scan and on a chest x-ray, a pleuracentesis is required to confirm that the pleural fluid is cytologically negative
• •* Exudative pleural effusions are excluded, regardless of cytology
• •* Effusions that are minimal (i.e, not visible on chest x-ray) that are too small to safely tap are eligible
• •Patients must have measurable or evaluable disease
• •Women of childbearing potential must have a negative serum pregnancy test within 14 days prior to registration
• •Women of childbearing potential and male participants must practice adequate contraception
• •Patient must provide study-specific informed consent prior to study entry