Radiation Therapy in Treating Patients With Extensive Stage Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed extensive stage small cell lung cancer (SCLC) diagnosed within the past 6 months*

  • Has 1-4 extracranial metastatic lesions NOTE: *Diagnosis made before treatment with chemotherapy

• Has completed 4-6 courses of platinum-based chemotherapy within the past 8 weeks AND meets the following criteria:

  • Radiographic partial or complete response to chemotherapy in ≥ 1 site of disease according to RECIST criteria (if radiotherapy has been delivered to primary disease with chemotherapy, there must be complete or partial response in ≥ 1 of the sites that has not been treated with radiotherapy)
  • No progression in any site
• No limited stage SCLC, even if disease progressed
• No brain or CNS metastases

PATIENT CHARACTERISTICS:

• Zubrod performance status 0-2
• ANC ≥ 1,000/mm^3
• Platelets ≥ 75,000/mm^3
• Hemoglobin ≥ 8.0 g/dL (the use of transfusion or other intervention is allowed)
• Serum ALT and AST ≤ 2.5 times upper limit of normal (ULN) (for patients who will receive radiotherapy to the liver)
• Serum bilirubin < 1.5 times ULN (for patients who will receive radiotherapy to the liver)
• Serum creatinine < 1.5 times ULN (for patients who will receive radiotherapy to the kidneys)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

• No severe, active co-morbidity, defined as any of the following:

  • Acute bacterial or fungal infection requiring IV antibiotics at the time of study registration
  • Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of study registration

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• Recovered from prior chemotherapy (i.e., toxicities ≤ grade 1 [except for neuropathy and alopecia])
• Thoracic radiotherapy administered concurrently with or before chemotherapy for the current diagnosis allowed (these patients will not receive mediastinal radiotherapy per protocol)
• No prior radiotherapy to the region of this cancer that would result in overlap of radiotherapy fields
• No concurrent chemotherapy