Paclitaxel and Hyperthermic Perfusion in Treating Patients With Lung Cancer or Lung Metastases That Cannot Be Removed By Surgery

DISEASE CHARACTERISTICS:

Histologically or cytologically confirmed unresectable primary lung cancer or pulmonary metastases that are unresectable on the basis of technical considerations or are sufficiently numerous that recurrent, potentially inoperable disease is highly probable

Bilateral metastases allowed
Unresectable bronchoalveolar carcinomas allowed
Previously treated primary lung cancer allowed
Disease outside confines of thorax allowed, provided bulk of disease in the chest is clearly the greatest threat to survival and/or extrathoracic disease is controlled
No potentially treatable pulmonary metastases from lymphomas or germ cell tumors
No biopsy proven interstitial fibrosis, radiation induced pneumonitis, or evidence of significant pulmonary hypertension by history, radiologic, echocardiographic, or catheterization studies

No active intracranial or leptomeningeal metastases

Prior resection or radiotherapy for intracranial metastases allowed if the following criteria are met:

No active disease on 2 MRIs done one month apart
No requirement for anticonvulsant medications or steroids

Adequate pulmonary reserve to tolerate pneumonectomy:

Oxygen consumption greater than 50% predicted AND
FEV1 and DLCO greater than 80% predicted OR
FEV1 or DLCO less than 80% predicted allowed if postoperative FEV1 and DLCO is at least 40% predicted on the basis of split function V/Q scan
Prior radiotherapy to chest allowed provided 6 months have elapsed since completion of treatment and no history of, nor current evidence of, interstitial lung disease

PATIENT CHARACTERISTICS:

Age:

18 and over

Performance status:

ECOG 0-1

Life expectancy:

More than 3 months

Hematopoietic:

Platelet count greater than 100,000/mm^3
Hemoglobin greater than 10 g/dL
WBC greater than 3,500/mm^3

Hepatic:

PT/PTT normal
Bilirubin less than 1.5 times upper limit of normal (ULN)
AST/ALT less than 1.5 times ULN

Renal:

Creatinine less than 1.6 mg/dL

Cardiovascular:

Fixed defects on thallium scanning with ejection fraction greater than 40% allowed
Reversible or ischemic defects allowed only after cardiology clearance

Pulmonary:

See Disease Characteristics
Resting oxygen saturation greater than 90%
pCO_2 less than 45 mmHg by arterial blood gas

Other:

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No active infections
HIV negative

PRIOR CONCURRENT THERAPY:

Biologic therapy:

More than 30 days since prior biologic therapy for this malignancy

Chemotherapy:

More than 30 days since prior chemotherapy for this malignancy
Prior paclitaxel allowed
No prior bleomycin, nitrosoureas, or busulfan

Endocrine therapy:

See Disease Characteristics

Radiotherapy:

See Disease Characteristics

Surgery:

See Disease Characteristics
Prior thoracic surgery allowed