ObjectiveThis study aims to investigate the network structures of symptoms and symptom clusters in patients with lung cancer post-chemotherapy, with a focus on identifying the central symptom cluster. Understanding the central cluster is crucial for targeted and effective symptom management.MethodsSymptom occurrence and severity were assessed using the Memorial Symptom Assessment Scale (MSAS). Principal component analysis (PCA) was employed to explore symptom clusters, while network analysis unveiled the network structure and pinpointed the central symptom cluster.ResultsThe study included 512 patients with lung cancer. Four distinct symptom clusters emerged: sickness behavior, psychological, lung cancer-specific, and epithelial. The sickness behavior symptom cluster was identified as the central symptom cluster.ConclusionsThis research designates the sickness behavior symptom cluster as central in post-chemotherapy patients with lung cancer, offering valuable insights for clinical nurses in devising more effective symptom management strategies.Trial registrationChiCTR2300070944 (Chinese Clinical Trial Register)