Non-ablative Oligofractionated Radiation Therapy Before Surgical Transplantation As Radiovaccination

This study tests a novel approach for patients who need a lung transplant and also have a suspected early-stage lung cancer or isolated lung metastases that cannot be treated with standard methods (surgery or ablative radiation). The idea is to use low-dose, targeted radiation before the transplant — hoping it might stimulate the immune system to recognize and fight any cancer cells remaining after the transplant. **You may be eligible if...** - You are 18 or older with end-stage lung disease - You have a suspected stage I primary lung cancer, multifocal lung cancer, or isolated lung metastases that cannot be removed by surgery or treated with ablative radiation - You otherwise qualify for a lung transplant (except for the presence of malignancy) - You can understand the risks and benefits and give informed consent **You may NOT be eligible if...** - Your cancer has spread to areas outside one or both lungs - You do not qualify for lung transplantation on other grounds - You are pregnant Talk to your doctor to see if this trial is right for you.