Background Our retrospective study aimed to evaluate the efficacy and safety of the combined-modality therapy for tumor invading the chest wall of locally advanced non-small-cell lung cancer (NSCLC) in the elderly. Methods We retrospectively enrolled 21 elderly patients (aged ≥ 60 years) with locally advanced NSCLC diagnosed as tumor invading the chest wall. The prescription dose of the primary tumor adopting external beam radiotherapy (EBRT) was given 40 Gy which was supplemented with

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... 5 seed implantation, meanwhile the lymph nodes of mediastinum undergoing EBRT was given 60 Gy. Follow-up was conducted every 3 months postoperatively. The related analytic parameters were the change of tumor size, the objective response rate (ORR), the disease control rate (DCR), the degree of pain relief, the improvement of physical status and the toxicity. Results The combined-modality therapy could significantly inhibit the local growth of tumor (from 7.84 ± 1.20 to 4.69 ± 1.90 cm) (P < 0.0001), indicating a better validity with an ORR of 71.4% and DCR 90.5%, respectively at 1 year. The cancer-related pain was significantly relieved (P < 0.05) and the physical status were also significantly improved (P < 0.05). There was no procedure-associated death or grade > 2 irradiation-related adverse effect in our study. Conclusions The combined-modality therapy of EBRT with 40 Gy and permanent iodine-125 seed implantation is an efficacious and safe option and may be recommended as a treatment pattern for the elderly of locally advanced NSCLC with tumor invading the chest wall.