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<h3>Background</h3> Palliative radiotherapy is an important component of the treatment of advanced lung cancer, used to control local disease and improve symptoms. However, existing literature demonstrates wide variability in symptomatic improvement.<sup>1</sup> The effect on quality of life and survival is poorly understood.<sup>2</sup> We audited outcomes of lung cancer patients treated with palliative radiotherapy in East Sussex, UK. <h3>Methods</h3> A retrospective review was implemented for patients with lung cancer referred for palliative radiotherapy from 5th November 2021 to 18th April 2024. Emergency referrals for metastatic spinal cord compression were excluded. Parameters assessed included time from referral to treatment, symptom benefit (guided by the Integrated Palliative Care Outcome Scale, IPOS), and time to death following radiotherapy. <h3>Results</h3> 52 eligible patients were identified. Median patient age was 71. Histology included: adenocarcinoma (44%), small cell (15%), unknown (15%), squamous cell (11%), and mesothelioma (2%). Indications for radiotherapy included: bone pain (BP) (n=18), brain metastases (BM) (n=10), high dose palliative thoracic (HDPRT) (n=7), palliative dose thoracic (PRT) (n=12), subcutaneous lesions (n=2) and superior vena cava obstruction (n=1). Median time to treatment was 14 days (range: 3-63 days). Rates of symptom benefit per group was as follows: BP=56%, BM=40%, HDPRT=67% and PRT=50%. Median overall survival (MOS) for the cohort was 5.68 months (95% CI 4.04 - 8.51 months). The MOS (months) for each treatment group was: HDPRT=16.9; PRT=3.2; BM=6.3; BP=5.68. <h3>Conclusion</h3> In general, survival after palliative radiotherapy was poor in this cohort. Patients receiving high dose palliative radiotherapy for locally advanced disease survived much longer. Prospective quality of life studies are needed to demonstrate that treating patients with a poor prognosis is beneficial. Incorporating IPOS into a standardised pre and post-treatment evaluation would enrich our understanding of the impact of radiotherapy on symptom control. <h3>References</h3> Stevens R, Macbeth F Toy E, Coles B, Lester JF. Palliative radiotherapy regimens for patients with thoracic symptoms from non-small cell lung cancer. <i>Cochrane Database Syst Rev</i> 2015;<b>1</b>:CD002143. Thanthong S, Kotronoulas G, Johnston B. Descriptors and factors affecting patients’ symptom experiences for symptom self-management throughout palliative radiotherapy for advanced lung cancer: a systematic review. <i>Asia-Pacific Journal of Oncology Nursing</i> 2024;<b>11</b>(10):100577.