Lobectomy and Mediastinal Radiochemotherapy in Unresectable Stage III Non-Small Cell Lung Cancer Responding to Induction Chemotherapy

Inclusion Criteria: * Histological or cytological diagnosis of non-small cell carcinoma of the lung * Initially stage III NSCLC * Pathologically proven N2 or N3 disease * Any response to induction chemotherapy (whatever the regimen administered) * Disease still not fully resectable (because of extensive mediastinal N disease) and not suitable for radical radiotherapy (single field) after induction chemotherapy * Lobectomy possible for the treatment of T disease * Availability for participating in the detailed follow-up of the protocol * Informed consent Exclusion Criteria: * Prior treatment with radiotherapy or surgery * Karnofsky PS \< 60 * Functional or anatomical contra-indication to mediastinal radiotherapy * Functional or anatomical contra-indication to surgical lobectomy * A history of prior malignant tumour, except non-melanoma skin cancer or in situ carcinoma of the cervix or cured malignant tumour (more than 5 year disease-free interval) * Malignant pleural or pericardial effusion * Neutrophils \< 2,000/mm³ * Platelet cells \< 100,000/mm3 * Serum bilirubin \> 1.5 mg/100 ml * Serum creatinine \> 1.5 mg/100 ml and/or creatinine clearance \< 60 ml/min * Recent myocardial infarction (less than 3 months prior to date of diagnosis) * Congestive cardiac failure or cardiac arrhythmia requiring medical treatment * Uncontrolled infectious disease * Hearing loss * Symptomatic polyneuropathy * Serious medical or psychological factors which may prevent adherence to the treatment schedule