Non-small cell lung cancer

Inclusion Criteria:

• Histologically or cytologically (if cannot be proven histologically, at least twice positive findings on fine needle aspiration or sputum cytology) confirmed SCLC
• Limited stage (Clinical stage I-IIIb, lesion limited to one side of thorax, e.g. Excluding T4 disease with malignant pleural effusion or N3 disease with contralateral hilum/supraclavicular lymph node invasion).
• Measurable or assessable lesion
• Age over 18 years old
• Performance status (ECOG scale): 0~2
• Adequate organ functions: ANC ≥ 1500/ul, PLT ≥ 100 x 103/u, Total Bilirubin ≤ 1.5 mg/dl, Creatinine ≤ 1.5 mg/dl
• Inclusion of tumor within the limited radiation field without significant loss of pulmonary function (confirmed by radiation oncologist)
• Sexually active fertile men and women using a contraceptive method
• Patients should sign a written informed consest before study entry

Exclusion Criteria:

• T4 disease with malignant pleural effusion; N3 disease with contralateral hilum/supraclavicular lymph node invasion
• Lesion with mixed small cell nonsmall cell feature (pathologically)
• prior chemotherapy or radiation therapy.
• Pericardial or pleural effusion on chest X-ray image regardless of cytological finding
• T4 disease with tumor invasion to great vessels, heart, trachea, or esophagus; Concerns about possible perforation by tumor necrosis
• Severe comorbidities such as cardiac disease with symptom, myocardiac infarction within 6 months, chronic obstructive pulmonary disease with FEV1 less than 1.0ℓ, or uncontrolled bronchospasm of unaffected lung
• With atelectasis that makes GTV unidentifiable
• Other primary malignancy (except in situ carcinoma of the cervix or adequately treated basal cell carcinoma of the skin or prior malignancy treated more than 3 years ago without recurrence)
• Uncontrolled psychiatric disorder, serious head injury, chronic alcoholism, drug addiction and central nervous system disease