Optimization of Treatment of Advanced Nonsmall Cell Lung Cancer Using Radiotherapy and Chemotherapy

Study A Inclusion Criteria: * Histologically or cytologically confirmed NSCLC * Stage IIIA/IIIB staged with * CT chest and upper abdomen * Liver, renal, hematological reserve appropriate (according to "standard" institutional values) * Brain CT and/or bone scan only if clinical symptoms request such investigation * Performance status KPS 60-90 * No second cancer except skin non-melanoma * No previous treatment * Patient must be contactable for follow-up * Patient to be able to start treatment within 2 weeks from randomization (institutional confirmation needed) * Life expectancy \> 3 months * Patient must be able and willing to give informed consent, and fill in questionnaires Study A Exclusion Criteria: * Stage III B "wet" (existing pleural effusion , but not necessarily cytologically verified) * RT field \> 200 cm2 * Pregnancy Study B Inclusion Criteria: * KPS 60-90 * Stage IV and Stage III B (existing pleural effusions , but not necessarily cytologically verified) * Histologically or cytologically confirmed * CT staged disease (thorax and possible upper abdomen) * No second cancer except skin non-melanoma * Liver, renal, haematological reserve appropriate (according to "standard" institutional values) * No previous treatment * Patient must be contactable for follow-up * Patient must be able and willing to give informed consent and fill in questionnaires * Patient to be able to start treatment within 2 weeks from randomization (institutional confirmation needed) * Life expectancy \> 3 months Study B Exclusion Criteria: * Brain metastasis (brain CT and/or MRI not needed, unless symptoms exist - clinically indicated) * RT field \> 200 cm2 * Pregnancy * A-P separation too large to be adequately treated with 60-Co (?)