Radiofrequency Ablation and External-Beam Radiation Therapy in Treating Patients With Stage I Non-Small Cell Lung Cancer That Cannot Be Removed by Surgery

OBJECTIVES: Primary * To determine progession free survivial rates in patients with inoperable stage IA and select stage IB non-small cell lung cancer treated with external-beam radiation therapy and radiofrequency ablation (RFA). Secondary * To determine the acute and late toxicity of combining RFA with external-beam radiation therapy. * To determine the patterns of failure at time of first relapse. * To determine the rate of overall survival at 1 and 2 years after treatment. * To evaluate the ability of peak standard uptake value (SUV) and max SUV obtained prior to RFA to predict local control and time to progression. * To measure post RFA/simulation (treatment planning) PET max and peak SUV's and correlate this data with local control at 1 and 2 years. * To evaluate the ability of peak and max SUV's for fludeoxyglucose F 18 obtained shortly after radiotherapy (post-treatment) to predict local control and time to progression. * To evaluate PET-CT data and its utility in guiding radiation therapy treatment planning. * To explore the use of dual time point imaging PET data obtained to predict local control and also to differentiate between recurrence versus inflammation when applicable. * To assess physical function as a prognostic measure, and to determine the impact of treatment on physical function. * To evaluate the impact of treatment on generic and disease-specific quality of life. OUTLINE: Patients undergo fludeoxyglucose F18 positron emission tomography (FDG-PET) and CT scan at baseline. Patients then undergo radiofrequency ablation (RFA). Beginning within 5 weeks after completion of RFA, patients undergo external-beam radiation therapy once daily, 5 days a week, for 5-6 weeks. FDG-PET/CT scan is repeated 3-4 weeks after RFA and 12-16 weeks after completion of external-beam radiation therapy. Quality of life is assessed at baseline, during treatment, and at 16 weeks and at 1 year after completion of treatment. After completion of study treatment, patients are followed periodically for 2 years.