Twenty-six patients with advanced, inoperable, biopsy-proven non-small cell lung cancer (NSCLC) with a Karnofsky score of at least 60, with luminal disease and no prior treatment and without visceral metastasis, malignant pleural effusion, and tracheoesophageal fistula were treated with palliative external beam radiation therapy (EBRT) of 30 Gy in ten fractions during two weeks. Following completion of treatment, patients were randomized to receive further EBRT of 20 Gy in ten fractions during two weeks (group A) or high dose rate intraluminal brachytherapy (HDR-ILBT) of 12 Gy in two fractions during two weeks, 6 Gy given once a week (group B). At monthly follow-up, patient symptomatology was assessed using National Cancer Institute Common Toxicity Criteria (CTC version 2, 1999). The median survival in group A was 440 days, while in group B it was 653 days. There was no significant difference in the overall survival, recurrence-free survival, or metastasis-free survival by either of the treatment regimens (P>.05). On multivariate analysis, none of the ten prognostic variables examined had an impact on either overall survival or local recurrence-free survival. On univariate analysis, histological diagnosis (P=.0001) and site of the disease (P=.0046) were significant for overall survival. The HDR-ILBT boost may be as effective as the EBRT boost in the palliation of symptoms caused by obstructing luminal disease in advanced NSCLC.