Abstract: Objective The treatment of large cell neuroendocrine carcinoma (LCNEC) is inconclusive, We evaluated whether advanced LCNEC should be treated similarly to small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). Methods Total of 23 patients were diagnosed as advanced LCNEC retrospectively examined and divided into SCLC regimen group (n=13) and NSCLC regimen group (n=10) according to first-line chemotherapeutic regimens. Results Most patients were male with a median age of 62.5 years. The survival rates in SCLC regimen group and NSCLC regimen group were 8.2% and 7.1% (P=0.27), respectively. Conclusion Regarding chemotherapy for advanced LCNEC, SCLC regimen is superior to NSCLC.