In the past 10 years or so, despite many advances in oncologic treatment, chemotherapy has shown only slight improvement in efficacy for advanced non-small cell lung cancer, with patients having a median survival of 8 – 16 months after diagnosis, a 1-year survival rate of about 30%, and a 2-year survival rate of only about 10%. The general principle of treatment for patients with advanced disease is: palliative care. The goal is: to improve the patient’s quality of life and prolong the survival without obvious symptoms. The main treatment for advanced non-small cell lung cancer is systemic chemotherapy, however, chemotherapy brings with it bone marrow suppression, toxic side effects in the digestive tract and other systems. Does chemotherapy have a place in treating patients with advanced disease compared to best supportive care? Clinical experience over the past 10 years has demonstrated that, overall, the use of cisplatin-based systemic chemotherapy improves the quality of patient survival and prolongs median survival compared to best supportive care. A meta-analysis of data from several prospective randomized clinical trials showed that chemotherapy was better than best supportive care in prolonging patient survival, and that there was an improvement in quality of survival without a significant increase in chemotherapy-related toxicities. So are all patients with advanced disease suitable for chemotherapy? The US SWOG Study Group conducted an analytical study of prognostic factors, and the results of a multifactorial regression analysis showed that favorable prognostic factors were: good general condition; female; small tumor load; normal lactate dehydrogenase; normal blood calcium levels; and hemoglobin >= 110 g/L. The consensus on the indications for chemotherapy in patients with advanced disease is that the patient’s general condition determines the efficacy of chemotherapy, and in patients with good general condition, chemotherapy improves survival and improve the quality of survival; in patients with moderate general condition, chemotherapy only improves clinical symptoms and does not prolong survival; in patients with poor general condition, chemotherapy has no benefit. Age does not affect the efficacy of chemotherapy; therefore, the indications for systemic chemotherapy for patients with advanced non-small cell lung cancer should be: patients in good general condition. Patients in poor general condition should be recommended for targeted therapy or best supportive care.