 5. The primary tumor must be deemed technically resectable after chemoradiation by an experienced thoracic cancer clinician, with a reasonable possibility of obtaining a gross total resection with negative margins defined as a potentially curative resection, PCR. However, the patient must not be a candidate for PCR based on pathologic evidence of persistent mediastinal lymphadenopathy after chemoradiation or because of underlying physiological medical problems that would prohibit a PCR due to a low probability of tolerating general anesthesia, the operation, the postoperative recovery period, or the removal of adjacent functioning lung. These types of patients with severe underlying health problems are deemed medically inoperable. Standard justification for deeming a patient medically inoperable based on pulmonary function for surgical resection of NSCLC may include any of the following: Baseline FEV1 40 predicted, post-operative predicted FEV1 30 predicted, severely reduced diffusion capacity, baseline hypoxemia andor hypercapnia, exercise oxygen consumption 50 predicted, severe pulmonary hypertension, diabetes mellitus with severe end organ damage, severe cerebral, cardiac, or peripheral vascular disease, or severe chronic heart disease. 