VIDEO ASSISTED WEDGE RESECTION (VAR) AND RADIOTHERAPY FOR HIGH RISK T1 NON-SMALL CELL LUNG CANCER: A PHASE II STUDY

Study start date: December 1, 1994

DISEASE CHARACTERISTICS: Known or suspected, single, peripheral, stage T1 N0 M0 lung tumor Tumor must not be identifiable by bronchoscopy Bronchoscopically visible cancer or bronchial distortions considered related to tumor Positive cytology by bronchoscopy allowed if no gross abnormality visible Mediastinoscopy required for nodes greater than 1 cm No pleural effusions No metastatic or N2 disease on CT scan Lesion must be accessible for video-assisted thoracoscopic wedge resection High cardiopulmonary risk for thoracotomy with at least 1 of the following criteria: FEV1 less than 40% predicted DLCO less than 50% predicted Supplemental oxygen requirement Chronic PaCO2 greater than 45 mm Hg Maximum oxygen consumption (VO2 max) less than 15 mL/kg/min Patients who appear at high risk for non-pulmonary reasons (e.g., patients who are elderly or with renal or cardiac failure) may be eligible only if VO2 max or other criteria above are met Eligible for radiotherapy after completion of wedge resection if histologic documentation of non-small cell lung cancer, including any of the following subtypes: Squamous cell carcinoma Adenocarcinoma Bronchoalveolar cell Large cell anaplastic carcinoma Cytology from bronchial washings and transthoracic needle aspiration not acceptable PATIENT CHARACTERISTICS: Age: 18 and over Performance status: 0-2 Other: No other malignancy within the past 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix Weight loss no greater than 10% within the past 6 months PRIOR CONCURRENT THERAPY: Radiotherapy No prior thoracic irradiation