Intensity-Modulated Radiation Therapy Using a Contralateral Esophagus-Sparing Technique in Treating Patients with Locally Advanced Non-small Cell Lung Cancer or Limited-Stage Small Cell Lung Cancer

Inclusion Criteria

• Histologically or cytologically proven diagnosis of NSCLC or SCLC; in cases where the histology and cytopathology results are consistent with a carcinoma but immunohistochemistry stains are indeterminate and unable to support the lungs as the most likely site of origin, the diagnosis of NSCLC or SCLC may be established in conjunction with the radiographic and clinical picture
• For NSCLC, patients with clinical stage IIB-IV patients (American Joint Committee on Cancer [AJCC], 7th edition [ed.]) are eligible, and for SCLC, limited-stage patients are eligible, if documented to be a candidate for definitive radiation and concurrent chemotherapy in the radiation oncologist or medical oncologist clinic note * Stage IV NSCLC patients are eligible only if they have a solitary brain metastasis * Patients with non-malignant pleural effusion are eligible, ** If a pleural effusion is present, the following criteria must be met to exclude malignant involvement: *** When pleural fluid is visible on both the computed tomography (CT) scan and on a chest x-ray, a pleuracentesis is required to confirm that the pleural fluid is cytologically negative *** Exudative pleural effusions are excluded, regardless of cytology *** Effusions that are minimal (i.e., not visible on chest x-ray) that are too small to safely tap are eligible
• Gross tumor (primary tumor or involved lymph node) must be within 1 cm of esophagus on the most recent chest CT scan
• Eastern Cooperative Oncology Group (ECOG) performance status 0-1 within 30 days prior to registration
• Women of childbearing potential must indicate that there is not a possibility of being pregnant at the time of enrollment or have a negative serum pregnancy test prior to the initiation of radiation therapy
• Women of childbearing potential and male participants must practice adequate contraception
• Patient must provide study-specific informed consent prior to study entry

Exclusion Criteria

• Greater than minimal, exudative, or cytologically positive pleural effusions
• Tumor suspected or known to invade the esophagus
• Prior chemotherapy if this precludes administration of concurrent chemotherapy for protocol treatment; note that induction chemotherapy is allowed as long as concurrent chemotherapy is possible
• Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
• Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that human immunodeficiency virus (HIV) testing is not required for entry into this protocol; protocol-specific requirements may also exclude immune-compromised patients
• Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception
• Any history of allergic reaction to chemotherapies used