[en] Purpose/Objective: To assess quality of life factors in patients receiving both initial and re-treatment with XRT for NSCLC.Materials and Methods: Over 600 patients with NSCLC were treated with primary XRT at the Medical College of Virginia (MCV) between 1990 and 1995. Twenty-six patients who initially received a median dose of 60 Gy (range = 50 to 66) were given re-treatment to a median dose of 30 Gy (range = 12 to 33) for worsening symptoms and/or radiographic progression. Sixteen patients received their initial therapy by split course, while 10 had continuous course XRT. The median interval between initial and re-treatment was 11 months (range = 1 to 51). All re-treatments were delivered twice per day at 1.5 Gy per fraction. The median total dose to this group was 90 Gy (range = 72 to 96). The observer portion of the Lung Cancer Symptom Scale (LCSS) was employed to score the effects of treatment on symptoms including loss of appetite, fatigue, cough, dyspnea, hemoptysis, and pain. The patients were noted to have experienced improvement, worsening, or no change following therapy. Survival analysis was completed using the Kaplan-Meier method, while the sign rank method compared survival with other factors. Results: Median follow-up was 22 months (range = 3 to 73). Fifteen patients have died of their disease, and 11 remain alive with disease. Patient characteristics at the time of first treatment included median age of 64 years (range = 39 to 77), median PS of 1 (92% with either 0 or 1), > 5% weight loss in 15%, and male to female ratio of 3.3 to 1. Stage breakdown was: I = 12%, II = 12%, IIIA = 38%, IIIB 19%, and IV = 19%. Squamous cell carcinoma was the most represented histology, found in 58%. The median number of LCSS symptoms at initial presentation was 1 (69% with 1 or 2). Sixty-one percent of the patients experienced relief in at least one of their pre-treatment symptoms. By the time of re-treatment, 100% of the patients had at least one complaint, and the median number of symptoms was 3 (69% with 2 or 3). After re-treatment, 51% of the patients had improvement in at least one symptom. Five of the patients died immediately after re-treatment and were not evaluable. Symptomatic relief after the first course of therapy did not predict palliation after the second course. Overall survival was 27 months and was independent of age (< versus > 65 years), stage (IIIA versus IIIB or IV), weight loss, presence of any one specific LCSS symptom, time during which initial therapy was given (< versus> 50 days), and fractionation of initial therapy (split versus continuous course). There was a statistically significant survival advantage in patients with a time to retreatment of more than 11 months (p = 0.03). Toxicity was limited to transient, mild esophagitis during the initial therapy, and no specific acute or late side effects were noted after re-treatment. Discussion: Here, we retrospectively describe a NSCLC population with good prognostic factors which underwent primary radiation therapy with a 61% symptomatic response. Subsequent re-treatment with XRT was feasible, well tolerated, and provided symptom relief in half of the patients. These results are consistent with our previously-published report on palliation rates in patients receiving short course therapy for advanced NSCLC, and we continue prospective accrual with the LCSS of all lung cancer patients treated at MCV