Phase I Study of Irinotecan and Cisplatin in Combination With Twice Daily Thoracic Radiotherapy (45 Gy) or Once Daily Thoracic Radiotherapy (70 Gy) for Patients With Limited Stage Small Cell Lung Cancer

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed small cell lung cancer by one of two
methods:

- Fine needle aspiration biopsy

- Two positive sputa

- Must have limited disease as defined by all of the following:

- Stage I-IIIB

- Confined to 1 hemithorax

- No T4 tumor based on malignant pleural or pericardial effusion

- Patients with pleural effusion too small to tap under CT guidance and not
evident on chest x-ray are allowed

- No N3 disease based on contralateral hilar or contralateral supraclavicular
involvement

- Measurable or evaluable disease

- Tumor must be able to be encompassed by specified radiotherapy fields without
unacceptable risk of serious pulmonary compromise

- No complete tumor resection

- No pericardial effusion (regardless of cytology)

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- Zubrod 0-1

Life expectancy

- Not specified

Hematopoietic

- Absolute granulocyte count at least 1,500/mm^3

- Platelet count at least 120,000/mm^3

Hepatic

- Bilirubin no greater than 1.5 mg/dL

- No known Gilbert's disease

Renal

- Creatinine no greater than 1.5 mg/dL

Cardiovascular

- No myocardial infarction within the past 6 months

- No symptomatic heart disease

Pulmonary

- FEV_1 at least 1.0 L/sec

- No uncontrolled bronchospasms

- No uncompensated chronic obstructive pulmonary disease

Other

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No pre-existing peripheral neuropathy grade 2 or greater

- No other malignancy within the past 2 years except curatively treated basal or
squamous cell skin cancer or carcinoma in situ of the bladder or cervix

- No other concurrent serious medical illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No prior biologic therapy

Chemotherapy

- No prior chemotherapy

Endocrine therapy

- Not specified

Radiotherapy

- No prior radiotherapy

- No concurrent intensity-modulated radiotherapy

Surgery

- See Disease Characteristics

Other

- At least 7 days since prior enzyme-inducing anti-convulsant drugs (EIACDs) (e.g.,
phenytoin, carbamazepine, or phenobarbital) if used on a regular basis for more than
2 weeks

- Less than 2 weeks of regular use of EIACDs does not require a 7-day wash-out
period

- At least 14 days since prior Hypericum perforatum (St. John's wort)

- No concurrent EIACDs

- No concurrent amifostine during chemoradiotherapy

- Concurrent gabapentin or other non-EIACDs allowed