Cisplatin, Pemetrexed Disodium, and Radiation Therapy Followed by Docetaxel in Treating Patients With Stage III Non-Small Cell Lung Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologic or cytologic diagnosis of non-small cell lung cancer (NSCLC), meeting 1 of the following staging criteria:
• •* Stage IIIA disease, meeting all of the following criteria:
• •* Mediastinal lymph node involvement
• •* Greater than one mediastinal lymph node enlarged on CT scan, confirmed by positron emission tomography (PET) scan
• •* Paralyzed left vocal cord with separate lung primary distinct from the aorto-pulmonary lymph nodes on the CT scan
• •* Stage IIIB disease, meeting all of the following criteria:
• •* N3 lymph node involvement
• •* Enlarged N3 lymph nodes on CT scan confirmed by PET scan
• •* Lymph node involvement may not extend to cervical lymph nodes other than supraclavicular lymph nodes
• •* Right-sided primary tumor with left vocal cord paralysis
• •* Evidence of tumor extension into the mediastinum and/or mediastinal structures by mediastinoscopy, bronchoscopy, or CT scan
• •* No evidence of malignant pleural effusion unless effusion is only evident on CT scan
• •* No more than 1 parenchymal lesions on the same or opposite sides of the lung
• •No brain metastases by CT scan or MRI
• •PATIENT CHARACTERISTICS:
• •SWOG performance status 0 or 1
• •Platelet count ≥ 100,000/mm³
• •Absolute neutrophil count ≥ 1,500/mm³
• •Creatinine ≤ 1.5 times upper limit of normal (ULN)
• •Creatinine clearance ≥ 45 mL/min
• •Bilirubin normal
• •Transaminases (SGOT and/or SGPT) ≤ 1.5 times ULN
• •Alkaline phosphatase ≤ 2.5 times ULN
• •Total lung volume (i.e., right and left lung minus the gross tumor volume) receiving greater than 20 Gy of radiation ≤ 40%
• •FEV\_1 ≥ 70% of predicted
• •DLCO ≥ 50 mL/min
• •No other concurrent malignancy
• •* Prior malignancy allowed provided it is in clinical control and is not likely to impact clinical outcome in the opinion of the treating physician
• •No peripheral neuropathy ≥ grade 2
• •No serious medical illness, including, but not limited to, any of the following:
• •* Uncontrolled congestive heart failure
• •* Uncontrolled angina
• •* Myocardial infarction
• •* Cerebrovascular event within the past 6 months
• •* History of chronic active hepatitis
• •* History of HIV infection
• •* Active bacterial infection
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •Must be willing and able to take folic acid, cyanocobalamin (vitamin B12), or dexamethasone
• •PRIOR CONCURRENT THERAPY:
• •No prior chemotherapy or radiotherapy for NSCLC
• •No concurrent participation in another therapeutic investigational study
• •Concurrent ibuprofen (400 mg four times daily) allowed during pemetrexed disodium administration provided the patient has normal renal function
• •No concurrent aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs) 2 days before, during, and for 2 days after pemetrexed disodium administration
• •* Patients on long-acting NSAIDs (e.g. naproxen sodium, diflunisal, nabumetone, or celecoxib) must be willing or able to discontinue usage 5 days prior to, during, and for 2 days after pemetrexed disodium administration