Radiation Therapy in Treating Patients With Stage I Non-Small Cell Lung Cancer And Lung Dysfunction
Lung Cancer

About this trial
This is an interventional treatment trial for Lung Cancer focused on measuring stage I non-small cell lung cancer, squamous cell lung cancer, large cell lung cancer, adenocarcinoma of the lung, adenosquamous cell lung cancer, bronchoalveolar cell lung cancer
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed stage I (T1-2, N0) non-small cell lung cancer (NSCLC) Squamous cell carcinoma Basaloid carcinoma Adenocarcinoma Bronchoalveolar carcinoma Adenosquamous carcinoma Large cell carcinoma Large cell neuroendocrine carcinoma Giant cell carcinoma Sarcomatoid carcinoma Non-small cell carcinoma not otherwise specified Tridimensionally measurable solitary parenchymal lung lesion no greater than 4 cm in diameter by chest CT scan (lung windows) No metastatic disease or hilar or mediastinal lymphadenopathy Must have mediastinoscopy* (anterior, cervical, or both) if mediastinal lymph nodes are greater than 1.0 cm in diameter by chest CT scan No positive lymph nodes on mediastinoscopy* NOTE: *Patients may have positron-emission tomography in lieu of mediastinoscopy provided there is no fludeoxyglucose F 18 uptake in the mediastinum and hilum Poor surgical risk, as defined by 1 of the following: High risk due to nonpulmonary reasons, such as renal failure, cardiac failure, or hepatic dysfunction and deemed by thoracic surgeon to be unsuitable for lobectomy Pulmonary dysfunction indicated by one or more of the following: FEV_1 less than 40% of predicted DLCO less than 50% of predicted Oxygen dependent Chronic PaCO_2 greater than 45 mm Hg VO_2 less than 15 mL/kg/min PATIENT CHARACTERISTICS: Age: 18 and over Performance status: 0-2 Other: Not pregnant or nursing Fertile patients must use effective contraception No weight loss of more than 10% within the past 6 months No other active (less than 30% risk of relapse after completion of prior therapy) malignancy except nonmelanoma skin cancer Chemotherapy: No prior chemotherapy for NSCLC Radiotherapy: No prior chest radiotherapy
Sites / Locations
- Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
- Memorial Cancer Institute at Memorial Regional Hospital
- Ella Milbank Foshay Cancer Center at Jupiter Medical Center
- CCOP - Mount Sinai Medical Center
- University of Chicago Cancer Research Center
- Fairview University Medical Center - University Campus
- Saint Luke's Hospital
- Saint Francis Cancer Treatment Center at Saint Francis Memorial Health Center
- Great Plains Regional Medical Center
- UNMC Eppley Cancer Center at the University of Nebraska Medical Center
- Veterans Affairs Medical Center - Buffalo
- Oswego Hospital
- CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
- St. Joseph's Hospital Health Center - Syracuse
- SUNY Upstate Medical University Hospital
- Blumenthal Cancer Center at Carolinas Medical Center
- Wayne Memorial Hospital, Incorporated
- Comprehensive Cancer Center at Wake Forest University
- Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University
- Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
Arms of the Study
Arm 1
Experimental
Radiotherapy
Patients receive accelerated 3-dimensional (3-D) conformal radiotherapy daily 5 days a week for 3.5-6 weeks. Cohorts of 8 patients receive escalating fractions of accelerated 3-D conformal radiotherapy until the maximum tolerated course is determined. The maximum tolerated course is defined as the course at which no more than 2 patients develop at least grade 3 dose-limiting toxicity and no more than 1 patient develops at least grade 4 dose-limiting toxicity. Patients are followed at 3 weeks, 6 weeks, 3 months, every 3 months for 2 years, and then every 6 months for 3 years.