Patients with lung cancer commonly experience multiple interrelated symptoms during chemotherapy, including fatigue, pain, and sleep disturbance, which together form a core symptom cluster and substantially impair daily functioning, treatment experience, and quality of life. At present, evidence regarding the non-pharmacological management of this core symptom cluster remains fragmented, and there is a lack of standardized, comprehensible, and practical guidance tools designed for patients and their caregivers. This guideline was developed using an evidence-based methodological framework. Stakeholders’ health-related needs and concerns were identified through qualitative interviews and on-site questionnaire surveys. In accordance with predefined inclusion and exclusion criteria, systematic searches were conducted across domestic and international guideline repositories, websites of relevant professional associations, and comprehensive databases. The included literature was subjected to quality appraisal, and recommendations were extracted, synthesized, and graded to produce a summary of the best available evidence. Based on the identified health concerns and the evidence summary, preliminary recommendations for the patient guideline were formulated. These recommendations were subsequently revised through two rounds of Delphi expert consultation, during which consensus was reached on the strength of each recommendation. The final guideline comprises four major domains: screening and assessment of the core symptom cluster, daily management, intervention strategies, and indications for referral. Its core content covers nine areas: symptom-cluster screening, assessment, lifestyle modification, dietary interventions, sleep environment optimization, exercise interventions, psychological interventions, Traditional Chinese Medicine interventions, and referral criteria. The development of this patient guideline followed a rigorous process and fully incorporated patients’ needs, which demonstrates good feasibility, appropriateness, and clinical relevance, and can provide a decision-making basis for the self-management of the core symptom cluster among patients with lung cancer undergoing chemotherapy.