Objective To analyze the influence of traditional Chinese medicine（TCM） on the survival of elderly patients with phase Ⅲ-Ⅳ lung squamous cell carcinoma（LSCC）

and to explore the related prognostic factors. Methods An ambispective cohort study was designed. The data on medical cases from January 2003 to December 2012 were retrospectively collected

and was followed up through telephone every three months if the patient was still alive since February 1 st

2013. Totally 96 cases LSCC patients including phase Ⅲ 50 cases and phase Ⅳ 46 cases who were ≥65 years old and were treated by TCM therapies were enrolled and were grouped into TCM group or TCM plus chemotherapy（TCM-chemo） group. Case report form was developed to collect the data. The symptom improvement

adverse reactions

one-year survival rate

two-year survival rate

progression-free survival time（PFS）

and median survival time（MST） were assessed and compared between groups at different disease stage. And prognostic factors were analyzed. Results Upto the last follow-up on November 20 th

2020

11 patients were lost to follow-up while the remaining 85 patients were followed up till the end-point outcome of death. Regarding the elderly patients with phase Ⅲ LSCC

there were no statistical differences in symptom improvement

one-year survival rate

two-year survival rate and median PFS between TCM group and TCM-chemo group（P>0.05）; but TCM group had longer MST than in TCM-chemo group（P<0.05）. For elderly patients of phase Ⅳ LSCC

the results favored TCM-chemo group on symptom improvement compared to TCM group（P<0.05）

and one-year survival rate

two-year survival rate

median PFS and MST was significantly lower in TCM group than TCM-chemo group（P<0.05）. The adverse reaction rate of TCM group was significantly lower than that of TCM-chemo group for both phase Ⅲ and phase Ⅳ elderly LSCC patients（P<0.05）. Multivariate analysis showed that no history of smoking and having received radiotherapy were independent protective factors for prognosis of elderly patients with phase Ⅲ and Ⅳ LSCC. Conclusion TCM can improve symptoms and reduce adverse actions when treating phase Ⅲ-Ⅳ elderly LSCC patients. TCM in combination with chemotherapy is supperior to TCM therapy alone in increasing survival rate and prolonging PFS and overall survival time. Radiotherapy is an important therapy for phase Ⅲ-Ⅳ elderly LSCC patients

and smoking can affect the prognosis.