High-Dose or Standard-Dose Radiation Therapy and Chemotherapy With or Without Cetuximab in Treating Patients With Newly Diagnosed Stage III Non-Small Cell Lung Cancer That Cannot Be Removed by Surgery

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed newly diagnosed non-small cell lung cancer (NSCLC)

  • Stage IIIA or IIIB disease

    • N3 supraclavicular disease or contralateral hilar lymph node involvement (i.e. greater than 1.5 cm on short axis or positive on PET scan) not allowed
    • N2 or N3 disease and an undetectable NSCLC primary tumor allowed
  • Unresectable or inoperable disease
• No distant metastases

• Pleural effusion allowed provided effusion is minimal and none of the following conditions are present:

  • Cytologically positive pleural effusion detectable by CT scan and chest x-ray (pleuracentesis required to confirm negative cytology of pleural fluid)
  • Greater than minimal pleural effusions (minimal effusions not detectable by chest x-ray and too small to tap safely are allowed)
  • Exudative pleural effusions, regardless of cytology
  • Malignant pleural effusion (T4 incurable disease)
• Measurable or evaluable disease

PATIENT CHARACTERISTICS:

• Zubrod performance status 0-1
• Absolute neutrophil (ANC) ≥ 1,800 cells/mm³
• Platelet count ≥ 100,000 cells/mm³
• Hemoglobin ≥ 10.0 g/dL (transfusion or other intervention allowed)
• Creatinine normal OR creatinine clearance ≥ 60 mL/min
• Bilirubin normal
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.5 times upper limit of normal
• Pulmonary Function Test (PFTs) including forced expiratory volume at 1 sec. (FEV1) ≥ 1.2 L/sec or ≥ 50% predicted (best value obtained prior to or after use of bronchodilator)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective protection
• No uncontrolled neuropathy ≥ grade 2
• Patients with post-obstructive pneumonia allowed
• No prior invasive malignancy, except nonmelanoma skin cancer, carcinoma in situ of the breast, oral cavity, or cervix, unless the patient has been disease-free for the past 3 years
• No prior severe infusion reaction to a monoclonal antibody
• No weight loss of ≥ 10% within the past 4 weeks
• No history of allergic reaction to paclitaxel or other taxanes, or to carboplatin

• No severe, active comorbidity, including any of the following:

  • 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 IV antibiotics at the time of study entry
  • Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or within past 30 days precluding study therapy
  • Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects
  • AIDS

• No significant history of uncontrolled cardiac disease, including any of the following:

  • Uncontrolled hypertension
  • unstable angina
  • Myocardial infarction within the past 6 months
  • Uncontrolled congestive heart failure
  • Cardiomyopathy with decreased ejection fraction

PRIOR CONCURRENT THERAPY:

• At least 3 weeks since prior exploratory thoracotomy (if performed)
• Prior systemic chemotherapy allowed, provided it was not given for NSCLC
• No prior therapy that specifically and directly targets the EGFR pathway
• No prior radiotherapy to the region of NSCLC that would result in overlap of radiotherapy fields
• No concurrent white blood cell (WBC) growth factors (i.e., filgrastim [G-CSF] or sargramostim [GM-CSF]) given during radiotherapy or prophylactically during consolidation chemotherapy