Inclusion Criteria:

- Cytologic or histologic proof of non-small cell lung cancer (NSCLC)

- Stages III, IV or recurrent disease

- Documented endobronchial luminal disease by either endoscopy or CT-imaging

- Candidate for palliative thoracic radiation therapy because of cough, shortness of
breath or hemoptysis

Exclusion Criteria:

- Age less than 18 years of age

- Uncontrolled or symptomatic brain metastases

- Anticipated survival of less than 3 months

- Systemic therapy planned to begin within 6 weeks following randomization

- Systemic therapy within 4 weeks of planned study randomization

- Any prior radiotherapy involving the lungs

- Cardiac arrest or myocardial infarction within 6 months prior to study
randomization

- Inability to receive sedation or undergo invasive procedures due to severe chronic
obstructive pulmonary disease (COPD), bleeding disorders, or other medical conditions
which will preclude the use of HDRIB

- Prior history of other cancers within the past 3 years, (excluding basal cell skin
cancer and carcinoma in-situ of any site, such as cervix or breast).

- Pregnancy, lactation, or failure to use dual-method contraception in pre-menopausal
women

- Unwillingness or inability (e.g. incompetence, severe psychiatric disorders) to
complete informed consent and the baseline QoL assessments required for the trial

- Having received an investigational agent within one month of study randomization

- Inability to attend regular follow-up evaluations due to psychiatric or addictive
disorder or geographic inaccessibility