Invasive lung adenocarcinoma should be judged according to the stage of the disease and the severity of the disease development, and not all invasive lung adenocarcinoma does not require chemotherapy. For early stage invasive lung adenocarcinoma, chemotherapy may not be used, but for advanced invasive lung adenocarcinoma, chemotherapy should be used under the guidance of the patient’s physician for remission. Some patients with lung adenocarcinoma have EGFR-sensitive mutations, ALK fusion, MET gene amplification and other positive driver genes. Some patients in this part can choose drug therapy, and can first choose targeted drugs instead of chemotherapy directly. Invasive lung adenocarcinoma is generally a malignant tumor in which the cancer cells have appeared to infiltrate the surrounding lung tissues, and the shadow border is not clear, the margin is not smooth, and the manifestation of lobulation and burr can be observed by imaging examination. For patients with early stage invasive lung adenocarcinoma, the cancer lesion is small, such as less than 3 cm, and it appears as an isolated single lesion, which has not metastasized and has not damaged nerves or blood vessels. Patients with incomplete excision of lesions or immune dysfunction should be treated with postoperative adjuvant chemotherapy to remove the remaining lesions and reduce the chance of recurrence, and be reviewed regularly. In addition, for patients who are already in the middle and late stage, with lymph node metastasis or invasion of dirty wall layer or pleura, and the lesions are less differentiated, they should also take postoperative chemotherapy as adjuvant treatment in time, and cooperate with targeted therapy and other methods to try to control patients’ condition and improve their quality of life. Therefore, whether to use chemotherapy for invasive lung adenocarcinoma should be judged comprehensively according to the patient’s specific situation. For driver gene-positive lung adenocarcinoma, targeted drugs can be chosen first. For patients with driver gene negative, chemotherapy can be chosen. However, if the general patient’s condition is mild and the prognosis is good, there is no need to worry too much and just actively cooperate with the treatment.