Optimization of Treatment of Advanced Nonsmall Cell Lung Cancer Using Radiotherapy and Chemotherapy

Study A Inclusion Criteria:

* Histologically or cytologically confirmed NSCLC
* Stage IIIA/IIIB staged with
* CT chest and upper abdomen
* Liver, renal, hematological reserve appropriate (according to "standard" institutional values)
* Brain CT and/or bone scan only if clinical symptoms request such investigation
* Performance status KPS 60-90
* No second cancer except skin non-melanoma
* No previous treatment
* Patient must be contactable for follow-up
* Patient to be able to start treatment within 2 weeks from randomization (institutional confirmation needed)
* Life expectancy \> 3 months
* Patient must be able and willing to give informed consent, and fill in questionnaires

Study A Exclusion Criteria:

* Stage III B "wet" (existing pleural effusion , but not necessarily cytologically verified)
* RT field \> 200 cm2
* Pregnancy

Study B Inclusion Criteria:

* KPS 60-90
* Stage IV and Stage III B (existing pleural effusions , but not necessarily cytologically verified)
* Histologically or cytologically confirmed
* CT staged disease (thorax and possible upper abdomen)
* No second cancer except skin non-melanoma
* Liver, renal, haematological reserve appropriate (according to "standard" institutional values)
* No previous treatment
* Patient must be contactable for follow-up
* Patient must be able and willing to give informed consent and fill in questionnaires
* Patient to be able to start treatment within 2 weeks from randomization (institutional confirmation needed)
* Life expectancy \> 3 months

Study B Exclusion Criteria:

* Brain metastasis (brain CT and/or MRI not needed, unless symptoms exist - clinically indicated)
* RT field \> 200 cm2
* Pregnancy
* A-P separation too large to be adequately treated with 60-Co (?)