Combination Chemotherapy and Computer-Planned Radiation Therapy in Treating Patients With Unresectable Stage III Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

  * Squamous cell carcinoma
  * Adenocarcinoma, including bronchoalveolar cell carcinoma
  * Large cell anaplastic carcinoma, including giant and clear cell carcinoma
* Inoperable stage IIIA or IIIB disease
* No direct invasion of vertebral body

  * Tumors adjacent to a vertebral body without bone invasion allowed if all gross disease can be encompassed in radiotherapy boost field
* Contralateral mediastinal disease (N3) allowed if all gross disease can be encompassed in radiotherapy boost field
* No scalene, supraclavicular, or contralateral hilar node involvement
* Transudate, cytologically negative, non-bloody pleural effusion allowed if it can be encompassed in radiotherapy field

  * No exudative, bloody, or cytologically malignant pleural effusion
  * Evidence of pleural effusion by chest CT scan but not chest x-ray that is too small to tap allowed
* At least 1 unidimensionally measurable lesion

  * At least 20 mm by conventional techniques OR
  * At least 10 mm by spiral CT scan
  * The following are not considered measurable disease:

    * Bone lesions
    * Leptomeningeal disease
    * Ascites
    * Pleural/pericardial effusion
    * Abdominal masses that are not confirmed and followed by imaging techniques
    * Cystic lesions
    * Tumor lesions in a previously irradiated field

PATIENT CHARACTERISTICS:

Age:

* 18 and over

Performance status:

* ECOG 0-1

Life expectancy:

* Not specified

Hematopoietic:

* Granulocyte count at least 1,500/mm3
* Platelet count at least 100,000/mm3

Hepatic:

* Bilirubin less than 1.5 mg/dL
* AST less than 2 times upper limit of normal

Renal:

* Creatinine clearance 20-130 mL/min for females
* Creatinine clearance 20-150 mL/min for males

Pulmonary:

* FEV1 at least 1.2 L

Other:

* Not pregnant or nursing
* Fertile patients must use effective contraception
* No other currently active malignancy (defined as completed prior therapy and considered to be at less than 30% risk of relapse) except non-melanoma skin cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* Not specified

Chemotherapy:

* No prior chemotherapy for NSCLC
* No other concurrent chemotherapy

Endocrine therapy:

* No concurrent hormonal therapy except steroids for adrenal failure or septic shock, hormones for non-disease-related conditions (e.g., insulin for diabetes), or glucocorticosteroids as antiemetics

Radiotherapy:

* See Disease Characteristics
* No prior radiotherapy for NSCLC

Surgery:

* At least 2 weeks since prior exploratory thoracotomy