Background: Half of NSCLC patients present with stage IV disease where cure is not possible. Priority should be given to such patients to control symptoms where thoracic RT remains an important treatment. Use of hypofractionated RT schedule has economic and logistic advantages for Radiation Oncology departments and high degree of patient convenience than conventional fractionation. 

Aim and Objectives: To evaluate outcome between 17 Gy in 2 fractions and 36 Gy in 12 fractions RT regarding relief of thoracic symptoms in IV NSCLC patients. 

Materials and methods: This quasi-experimental study was done at Radiation Oncology department, NICRH from July, 2022 to June, 2023. Total sixty (60) study participants were assigned into two groups, 30 in each arm. Arm-A received 17 Gy in 2 fractions, 1 week apart and Arm-B received 36 Gy RT in 12 fractions in two and half weeks. Assessments was done weekly during RT and thereafter 6 weeks, 12 weeks and 24 weeks after treatment. 

Result: Total symptom score of cough, hemoptysis, dyspnea and chest pain before RT was 62, 42, 47 and 41 in Arm-A and it was 60, 47, 41 & 46 in Arm-B respectively. After 6 months of completion of RT, the scores reduced to 33, 19, 26 & 11 in Arm-A and 35, 12, 20 & 12 in Arm-B respectively. There was no statistical significance (p-value

>0.05) between two arms. 

Conclusion: Hypofractionated RT with 17 Gy in 2 fractions renders similar symptoms relief with minimum toxicities compared with 36 Gy in 12 fractions RT to primary lesion in stage IV NSCLC.