I tried it today. I'm not giving up on it yet, but so far it seems i'm stuck. I remember how it was tough to get started in F2 so maybe they wanted to do the same here, but i hope this is not a "kill the player a lot to simulate harshness" thing. I'm at an early point where i have no caps, need caps to do more, and see no way to get caps without dying over and over. I'm sure i'll figure it out but i sure hope they don't think i'm going to walk back and forth between the same 3 cities over and over per each quest, rather than stay in each town long enough to solve a few and then move on (like f2). Looks good though and has that F2-esque feel. Good music too.
I can share a few early hints though: do not use your zip gun on the rats to get out of the starting cave. Use the knife - it's all you need, and you need those bullets for tougher things soon. Also, when in town #3, do not attend the meeting as a representative of that one caravan master until you are really tough - it's a trap - three guys in Leather Armor kill you easily if you go to that meeting. I think, don't even get that quest until you've leveled up a bit (which i realize is what you'd be trying to do by getting the quest). And as always was the case with original Fallouts, save game save game save game as you go.
Some good news: i read their FAQ and it turns out you can install this even if you have killapp's Restoration Project Patch installed. It's working fine for me.