Radiation Therapy, Chemotherapy, and Soy Isoflavones in Treating Patients With Stage IIIA-IIIB Non-Small Cell Lung Cancer

Inclusion Criteria:

Histologic or cytologic diagnosis of stage III non-small cell lung cancer; patients will need to meet the following criteria for stage IIIA or IIIB diagnosis:

IIIA

Histologic or cytologic diagnosis of ipsilateral mediastinal lymph node involvement, or
Tumors greater than 7 cm or with chest wall invasion, or involvement of one of the following diaphragm, phrenic nerve, mediastinal pleura or parietal pericardium with hilar or mediastinal lymph node involvement
More than one mediastinal lymph node enlarged on computed tomography (CT) scan and the same lymph nodes positive on positron emission tomography (PET) scans or
Paralyzed left vocal cord with separate lung primary distinct from the aorto-pulmonary lymph nodes on the CT scan

IIIB

Histologic or cytologic diagnosis of N3 lymph node involvement; or
Enlarged N3 lymph nodes on CT scan that are positive on PET scan as well; patient must not have extension of lymph node involvement to cervical lymph nodes other than supraclavicular lymph nodes; or
Right sided primary with left vocal cord paralysis; or
Evidence of tumor extension into the mediastinum and/or mediastinal structures either at the time of mediastinoscopy, bronchoscopy or on CT scans
Patients with a nodules in the same lung but no other areas of involvement
Patients with prior surgically resected stage I NSCLC who did not receive any adjuvant therapy, who now have stage IIIA or B NSCLC will be eligible
Southwestern Oncology Group (SWOG) performance status 0 or 1
Absolute neutrophil count of > 1.5 x 10^9/L
Platelet count > 100,000 x 10^9/L
Serum creatinine =< 1.5 times the institutional upper limit of normal (ULN)
Calculated creatinine clearance (Cockcroft-Gault formula) of >= 45mL/min
Serum bilirubin > ULN
Transaminases (serum glutamic oxaloacetic transaminase [SGOT] and/or serum glutamate pyruvate transaminase [SGPT]) > 1.5 times institutional ULN
Alkaline phosphatase >= 2.5 times ULN
Forced expiratory volume in one second (FEV1) of >= 1 liter and diffusion capacity of carbon monoxide (DLCO) >= 40% of predicted
Patient should undergo brain imaging (CT scan or magnetic resonance imaging [MRI ]) to rule out brain metastases
Signed informed consent that details the investigational nature of the study according to institutional and federal guidelines
Registered with Clinical Trials Office at Karmanos Cancer Institute/Wayne State University

Exclusion Criteria:

Prior chemotherapy, radiation for any malignancy in which they received any thoracic radiotherapy
Patients with concurrent malignancy; patients with prior or concurrent malignancy will be allowed as long as the treating physician considers it unlikely to impact the clinical outcome of the patient
Patients with peripheral neuropathy > 2
Serious medical illness including but not limited to uncontrolled congestive heart failure, uncontrolled angina, myocardial infarction or cerebrovascular event with 6 months of registration, history of chronic active hepatitis or history of human immunodeficiency virus (HIV) or an active bacterial infection will not be eligible
Inability or unwillingness to take folic acid or vitamin B12 or dexamethasone
Pregnant or lactating women; all pre-menopausal and peri-menopausal women should have a urine test for pregnancy within a week of starting therapy; all patients of child bearing potential should agree to use an effective contraceptive method
Patients should not participate in any other therapeutic investigational study while taking part in this study
Patients on warfarin will not be allowed on the study; patient on low molecular heparin or anti direct factor Xa inhibitor (Xa) drugs will be allowed
Patients with a soy allergy will be excluded