e18049 Background: Outcomes data on treatment of oligometastatic (OM) non-small cell lung carcinoma (NSCLC) with hypofractionated image guided radiotherapy (HIGRT) are limited. Methods: Consecutive OM NSCLC patients were reviewed. Treatment of all active disease was required. Lesions receiving prior radiation or with radiographic/metabolic resolution after chemotherapy were inactive, and did not receive HIGRT. Time to progression (TTP) was defined as time from the start of HIGRT to any failure. Local failure was defined as ≥20% increase in size on single dimensional axial measurement. Lesion control (LC), TTP, progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier method. Multivariate analysis (MVA) was performed using Cox proportional hazards regression. Results: Of 26 patients screened, 24 met the inclusion criteria. Median follow-up was 12.4 months. Median age was 66 yrs. Ten patients had adenocarcinoma, 14 had newly diagnosed stage IV disease, and 11 received HIGRT for progressive disease (PD) after chemo. Eighteen patients received systemic therapy prior to HIGRT, having received an average of 1.3 regimens. Seventeen patients received HIGRT to all disease and 7 received treatment to active disease only. A median of 2 (range 1-5) OM lesions were treated per patient. Median OS and TTP were 16.7, and 8.1 months, respectively. The 1 yr OS and PFS were 76.7% and 48.1%, respectively. On MVA, newly diagnosed stage IV disease independently predicted TTP (HR 0.22, p = 0.04). Fifty-eight individual lesions were treated, with a median size of 2.65cm (range 0.6 to 9.6 cm). Median total and fraction dose were 42 (range 18-70) and 8 Gy (range 3.5-18), respectively. The 1 yr LC was 84%. The calculated median standard equivalent dose (SED) in 2 Gy fractions was 64.6 Gy for extracranial lesions. SED ≥ 64.6 Gy was associated with a trend towards increased control (18 mo LC 89 vs 52%, p = 0.06). Two patients experienced grade 3 toxicity. Conclusions: Treatment of OM NSCLC with HIGRT is safe and provides durable LC when sufficient doses are used. Future studies should be aimed at optimizing patient selection for HIGRT and integration with systemic therapy. No significant financial relationships to disclose.