Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Stage IIIA Non-small Cell Lung Cancer

OBJECTIVES: I. Compare the overall survival of surgically resected patients with limited
stage IIIA non-small cell lung cancer who are treated by postoperative chemotherapy with or
without adjuvant radiotherapy. II. Compare failure free survival of these patients. III.
Describe the patterns of local and distant recurrence in these patients. IV. Determine the
toxicities associated with chemotherapy with or without adjuvant radiotherapy in these
patients.

OUTLINE: This is a randomized, multicenter study. Four to eight weeks after surgery, all
patients receive paclitaxel IV over 3 hours followed by carboplatin IV over 1-2 hours on
days 1, 22, 43, and 64. Following completion of four courses of chemotherapy, patients are
randomized into one of two treatment arms.

DISEASE CHARACTERISTICS: Histologically confirmed stage IIIA non-small cell lung cancer
that has been completely resected by lobectomy, bilobectomy, pneumonectomy, or sleeve
lobectomy through any incision (thoracoscopic or video assisted resection is acceptable)
No known residual disease present Involvement in N2 nodes must have been determined only
at the time of surgical exploration or by postoperative pathologic diagnosis All grossly
involved nodes must be removed at surgery No positive mediastinoscopy (if lymph nodes on
CT scan are greater than 1.5 cm in diameter, mediastinoscopy is required)

PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ZUBROD 0-1 Life expectancy:
Not specified Hematopoietic: Granulocyte count at least 1,500/mm3 Platelet count at least
100,000/mm3 Hepatic: Bilirubin less than 1.5 mg/dL SGOT no greater than upper limit of
normal Renal: Creatinine clearance at least 20 mL/min Other: Not pregnant or nursing

PRIOR CONCURRENT THERAPY: Biologic therapy: No concurrent growth factors Chemotherapy: No
prior chemotherapy for non-small cell lung cancer No other concurrent chemotherapy
Endocrine therapy: No concurrent hormone therapy except: Steroids for adrenal failure
Hormones for nondisease related conditions Dexamethasone as an antiemetic Radiation
therapy: No prior radiotherapy for non-small cell lung cancer Surgery: See Disease
Characteristics