Comparing Carboplatin with Stereotactic Body Radiation Therapy for locally advanced lung non-small cell carcinoma

Inclusion

• +Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• +Patients must have an identified primary tumor and at least one nodal metastasis (peribronchial/hilar/intrapulmonary, mediastinal/subcarinal, supraclavicular/scalene)
• +Pathologically (histologically or cytologically) proven diagnosis of non-operable stage IIB or III, node positive (American Joint Committee on Cancer \[AJCC\] eighth edition) non-small cell lung cancer (NSCLC) with known PD-L1 status prior to registration
• +Patients with separate tumor nodules in the same lobe of the primary tumor are eligible
• +The patient must be deemed clinically appropriate for curative intent definitive combined modality therapy, based on the following staging assessments:
• +History/physical examination prior to registration;
• +Magnetic resonance imaging (MRI) scan of the brain (preferred) or CT scan of the brain (if available, contrast is preferred for all neuroimaging) prior to registration;
• +CT chest with IV contrast (if contrast is available and unless contraindicated, such as for abnormal kidney function) prior to registration. PET/CT may be used if the CT portion is of identical diagnostic quality as achieved in a stand-alone CT
• +No evidence of distant metastases based on FDG PET/CT scan obtained within 60 days of registration
• +Primary tumor =\< 7 cm
• +Age \>= 18
• +Creatinine clearance \>= 25 mL/min by the Cockcroft-Gault (C-G) equation
• +Subjects with non-malignant pleural effusion are eligible provided the effusion is not known or demonstrated to be an exudative effusion
• +If a pleural effusion is present, the following criteria must be met to exclude malignant involvement:
• +When pleural fluid is visible on both the CT scan and on a chest x-ray, a pleuracentesis is required to confirm that the pleural fluid is cytologically negative;
• +Effusions that are minimal (i.e., not visible on chest x-ray) that are too small to safely tap are eligible
• +Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen
• +The patient or a legally authorized representative must provide study-specific informed consentInformed consentThe process of being told what taking part involves, then choosing freely.Read more → prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information
• +Negative pregnancy test =\< 14 days prior to registration for participants of childbearing potential
• +Up to 4 cycles of systemic therapy received prior to registration for the current study cancer is allowable; any prior chemotherapy for a different cancer is also permissible
• +Patients who refuse surgery, in addition to those who are technically unresectable or medically inoperable, are eligible.
• +Hematologic function (e.g. platelets, leukocytes, hemoglobin) amenable, at the discretion of the treating physician, to allow for treatment with chemotherapy and concurrent radiation therapy
• +Medical history consistent with the patient being amenable, at the discretion of the treating physician, to allow for treating with consolidation immunotherapy. Patients with known EGFR/ALK/other driver mutation at the time of registration are eligible, and these patients can be treated with consolidation systemic therapy at the discretion of the treating physician