Inclusion Criteria:

1. Patients > 18 years with any subtype of pathologically proven (biopsy or cytology),
non-small cell lung cancer. The diagnosis may be established from biopsy or cytology
obtained from the primary tumor and/ or from metastatic lymph nodes.

2. Minimal diameter of the primary tumor 4 cm, this to allow for boosting of
sub-volumes.

3. UICC Stage T2-4, N0-3, M0 disease (TNM definition see appendix 2).

4. Only stage IB-II patients who are nog candidates for surgery are study candidates.

5. Measurable disease at registration.

6. ECOG-performance status ≤ 2 (see appendix 6)

7. Lung function: FEV1 and DLCO at least 40 % of the age-adjusted normal value

8. Willing and able to give a written informed consent.

9. Patients with locoregional recurrent lung tumor following surgery or a second primary
cancer (at least 3 years after treatment) are eligible, unless a pneumonectomy was
performed.

10. SUVmax in the pre-treatment FDG-PET scan ≥ 5 for the primary tumor.

11. Adequate organ function, including the following:

- Adequate bone marrow reserve: absolute neutrophil (segmented and bands) count
(ANC) ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, and hemoglobin ≥ 9 g/dL.

- Hepatic: bilirubin ≤ 1.5 times the upper limit of normal (x ULN); alkaline
phosphatase (AP), aspartate aminotransferase (ASAT), and alanine
aminotransferase (ALAT) ≤ 3.0 x ULN (AP, AST, and ALT ≤ 5 x ULN is acceptable
if liver has tumor involvement).

- Renal: calculated creatinine clearance (CrCl) ≥ 45 ml/min based on the original
weight based Cockcroft and Gault formula

12. For women: Must be surgically sterile, postmenopausal, or compliant with a highly
reliable contraceptive method (failure rate <1%) during and for 6 months after the
treatment period; must have a negative serum or urine pregnancy test within 7 days
before study enrollment and must not be breast-feeding.

13. For men: Must during chemotherapy take adequate contraceptive measures.

Exclusion Criteria:

1. Prior radiotherapy to the thorax.

2. Clinical superior vena cava syndrome, malignant pleural effusion or malignant
pericardial effusion.

3. Tumor growth in large blood vessels on spiral CT scan (encasement is eligible).

4. T4 because of multiple nodules in the same or ipsilateral lobe(s).

5. Post-obstructive atelectasis or infiltration that cannot be distinguished from tumor
on a CT-PET scan.

6. Patients with a diagnosis of other cancer within the last 3-years (except in situ
carcinoma's and / or non-melanoma skin cancer).

7. Patients taking non-steroidal anti-inflammatory drugs (NSAID) or acetylsalicylic acid
may not receive pemetrexed.

8. Pregnant women, lactating women