Objective To compare the curative effect and safety of drug-eluting beads bronchial artery chemoembolization(DEB-BACE)with those of simple intravenous chemotherapy in treating elderly patients with intermediate to advanced lung cancer.Methods A total of 213 patients aged＞65 years with intermediate to advanced lung cancer,who were admitted to the Lishui Municipal Central Hospital of China between January 2018 and January 2022,were enrolled in this study.According to the therapeutic scheme,the patients were divided into chemotherapy group(n=107)and DEB-BACE group(n=106).After propensity score matching,chemotherapy group and the DEB-BACE group had 42 patients each.The short-term efficacy and the incidence of adverse reactions were compared between the two groups.Survival curve and Log-rank test were used to compare the survival between the two groups.Cox regression analysis was used to analyze the factors influencing the prognostic survival.Results The postoperative one-,3-,and 6-month disease control rate and objective remission rate in DEB-BACE group were better than those in the chemotherapy group.Before propensity score matching,the median progression-free survival(mPFS)time in DEB-BACE group was 7.0 months,which in the chemotherapy group was 6.0 months(P＜0.001).After propensity score matching,the mPFS in DEB-BACE group was 7.0 months,which in the chemotherapy group was 5.0 months(P=0.001).Before propensity score matching,the median overall survival(mOS)time in DEB-BACE group was 23.0 months,which in the chemotherapy group was 20.0 months(P＜0.001).After propensity score matching,the mOS in DEB-BACE group was 24.0 months,which in the chemotherapy group was 18.0 months(P=0.001).Multivariate Cox regression analysis revealed that therapeutic scheme,tumor size,and TNM stage were the influencing factors for OS.In terms of the adverse reactions,the incidences of both the pre-matched and post-matched myelosuppression in DEB-BACE group were lower than those in the chemotherapy group(P＜0.05).Conclusion For the treatment of intermediate to advanced lung cancer in elderly patients,DEB-BACE is superior to simple intravenous chemotherapy in curative efficacy and safety.