Stereotactic Body Radiation for Consolidation After Standard Chemoradiation for Stage 3 Lung Cancer

This protocol will investigate the potential role of SBRT for patients with stage 3 NSCLC. Eligible patients will first have received standard 50.4 Gy chemoradiation. Patients entering the study will have the opportunity to receive SBRT as a noninvasive option as compared to surgical resection. For patients who are not surgical candidates, SBRT after 50.4 Gy chemoradiation represents a technique of radiation consolidation that may be more effective and less toxic than standard conventional fractionated radiation

PATIENT ELIGIBILITY Conditions for Patient Eligibility (Inclusion)

• Pathologically or cytologically confirmed NSCLC
• Stage III NSCLC according to the AJCC 7th edition staging criteria. Stage II (T1-3N1) patient that are deemed medically inoperable are also eligible.
• Concurrent chemoradiation to a radiation dose of 50.4 Gy.
• residual tumor volume after concurrent chemoradiation that is appropriate for SBRT:

• Primary tumor <120cc (approximately 6cm diameter).
• Mediastinal/Hilar disease: 1-2 involved regions <60cc (approximately 5cmx3cmx3cm)
• Absolute neutrophil count ≥ 1,000/uL, platelet ≥ 60,000/uL.
• Total bilirubin ≤ 2x upper institutional limit of normal (ULN), and AST or ALT ≤5x ULN.
• ECOG performance status 0 to 2
• Minimum life expectancy of 12 weeks.
• Age older than 18 years.
• Voluntary, signed written informed consent.
• Women of childbearing potential must have a negative pregnancy test
• Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 1 months thereafter.

Conditions for Patient Ineligibility (Exclusion)

• Disease progression during or after standard chemoradiation to 50.4 Gy
• Prior thoracic radiation other than the pre-operative radiation not greater than 50.4
• Metastatic disease
• Uncontrolled severe, intercurrent illness.
• Women who are breast-feeding.
• No chemotherapy within 2 weeks from the first SBRT treatment.
• Concurrent anticancer therapy.
• Prior complete resection of all NSCLC.