Shortened High-dose Palliative Radiotherapy for Lung Cancer

Inclusion Criteria: * Age ≥ 18 * Patient has locally advanced (stage IIIB or IIIC) or metastatic (stage IV) NSCLC * Patient is treatment naïve or had limited progression after first-line systemic therapy (using chemotherapy, immunotherapy, or targeted therapy) * Patient is suitable for high dose palliative RT (36Gy in 12# or 39Gy in 13#) * Obtained written informed consent for the SHiP-Rt study. * Patients receiving RT after first-line systemic therapy must have a wash-out period of at least 3 weeks (i.e., 3-4 weeks). * Treatment naïve patients should be able to proceed to definitive systemic therapy without undue delay, i.e., within 3-4 weeks. Exclusion Criteria: * Contraindication for thoracic RT * Requiring lung RT after second-line systemic therapy for NSCLC * Has more than 1 cancer that is requiring active treatment * On cytotoxic treatment for rheumatoid arthritis or connective tissue disorders * Poor life expectancy, likely less than 6 months * Patients with difficulty regarding compliance to the study treatment or follow-up * Previous radiotherapy to the same area