Over the last few years Palliative Radiation Therapy (PRT) has been recognized as a useful means of reducing specific symptoms and delaying disease progression in advanced cancer patients (pts). The indications for the use of PRT must, however, be based on several important factors: control of clinical symptoms, absence of therapy-related toxicity, and life expectancy. For these reasons alternative treatment schemes (short-course) of PRT have been defined which maintain the same clinical efficacy (symptom control), but are less burdensome on both patients and health care settings. The Palliative Care Group of IOR activated an observational study to validate the predictive capacity of the PaP-Score (Pirovano M. et al., JPSM, 1999) in advanced pts who were considered candidates for palliative radiotherapy. Inclusion criteria were: pts not amenable to chemotherapy and/or who had concluded antiblastic therapy at least 2 weeks before radiotherapy evaluation. PRTwas to be used for pain management in pts with metastatic disease and for disease control in those with locally advanced and symptomatic disease. Pts with primary cerebral, haematological, and renal tumours, multiple myeloma or other lymphatic pathologies were excluded from the study. From January 2001 to June 2003, data on 255 pts from 10 oncology and radiotherapy centres were analyzed. 10 pts did not satisfy the inclusion criteria and other 11 pts had missing data. Of the 234 valuable pts, median survival was 15 weeks. The PaP Score classified 130 pts in group A, 90 in group B and only 6 in group C, with 22, 7 and 3 weeks of median survival and a 95%, 77% and 50% probability of a 30-day survival, respectively (Logrank = 78.2, p <0.001). From this preliminary analysis, the PaP Score would seem to be a valid instrument to assist radiation oncologists in deciding which type of PRT to use.