Abstract: ob＜x＞jective To analyze the effect of hypo-fractionated intensity-modulated radiotherapy（h-IMRT) on serum tumor markers and short-term efficacy in elderly patients with locally advanced NSCLC. Methods 62 patients with advanced NSCLC treated in our hospital from January 2019 to December 2021 were randomly divided into observation group and control group; The observation group was intervened with hypo-fractionated intensity-modulated radiotherapy and the control group was intervened with conventional three-dimensional conformal radiotherapy. One month after treatment, the patients evaluated the clinical efficacy according to RECIST 1.1 standard; The serum levels of EGFR , TGF-α , NSE , CA19-9 , CA125, CYFRA21-1were measured before and after treatment; The occurrence of adverse reactions was recorded. Results The ob＜x＞jective remission rate of the observation group (74.19%) was better than that of the control group (54.84%), and the difference was statistically significant（χ2=13.094，P=0.000<0.05）. There was no significant difference in serum tumor markers between the two groups before treatment (p>0.05); Serum EGFR and TGF -α in the observation group after treatment . The levels of NSE, CA19-9, CA125 and CYFRA21-1 were 12.03±3.01, 14.28±2.84, 11.73±3.12, 27.89±5.42, 30.82±6.01 and 2.38±1.06 respectivel y, which were significantly lower than those of 14.82±4.11, 18.33±3.01, 20.48±4.19, 45.66±4.95, 46.54±5.48 and 4.23±0.97 in the control group (p<0.05). The incidence of adverse reactions in the observation group and the control group were 22.58% and 29.03% respectively, with no significant difference（χ2=1.086，P>0.05）. Conclusion The intervention of hypo-fractionated intensity-modulated radiotherapy in elderly patients with locally advanced NSCLC can significantly reduce the level of serum tumor markers and effectively improve the short-term curative effect