People with lung cancer (LCa) and symptomatic metastatic disease deserve palliative radiotherapy to promote a better quality of remaining life. On the other hand, in the case being described that of a LCa patient with brain and spinal metastases who died shortly after irradiation— could management consisting of hospice and/or supportive care have been a better choice? Prognostic factors were analyzed in this retrospective study of the early deaths of 20 LCa patients with brain metastases in order to assist in a more rational decision making regarding treatment.