Imaging Markers in Targeting Radiation Therapy in Patients With Stage I, Stage II, Stage IIIA, or Stage IIIB Non-Small Cell Lung Cancer

OBJECTIVES:

- To acquire experience in the marker implantation process for mediastinal lymph nodes
and primary lung tumors in patients with stage I-IIIB non-small cell lung cancer.

- To characterize the potential side effects involved in the use of markers in these
patients.

- To analyze the positional stability of lung markers in these patients over a
radiotherapy series.

- To acquire experience in the use of markers for treatment planning and radiotherapy in
these patients.

OUTLINE: Patients undergo implantation of ≥ 1 small radio-opaque Visicoil™ marker into or
close to the primary lesion and affected lymph nodes by bronchoscopy. Patients then undergo
x-rays to document marker location, detect potentially dropped markers, and diagnose
operation-related side effects (i.e., pneumothorax). After marker implantation, patients
undergo stereotactic or conventionally fractionated radiotherapy for 30-33 daily fractions.

DISEASE CHARACTERISTICS:

- Diagnosis of non-small cell lung cancer

- Stage I-IIIB disease

- No prior surgical tumor resection

- Respiration-induced tumor motion > 5 mm

- Recruited by attending physician or research nurse at the Medical College of Virginia
Hospitals

PATIENT CHARACTERISTICS:

- Not pregnant

- No insufficient lung function or other parameters prohibiting a bronchoscopy

- Not a prisoner or institutionalized

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Concurrent chemotherapy allowed