This randomized controlled trial tested the effects of a specially designed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy. Methods Between August 2010 and December 2011, 46 patients were randomized into two groups receiving either conventional physiotherapy or special physiotherapeutic training. The Barthel Index served as primary endpoint. The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ C-30/LC-13) questionnaire, the 6-Minute Walk Test (6MWT), stair walking, the Modified Borg Scale, and muscle strength. Nonparametrical data were analyzed with the Wilcoxon and Mann–Whitney U test. For parametric, data student t tests were used. A p value of ≤.05 was accepted. Results Twenty-nine patients completed the trial (Intervention group (IG), n =18; control group (CG), n =11). Significant differences were detectable in the Barthel Index (IGmean= 92.08; CGmean=81.67; p =.041), in single scores of the EORTC QLQ C-30/LC-13 questionnaire (physical functioning, p =.025; hemoptysis, p =.019; pain in arms or shoulder, p =.048; peripheral neuropathy, p =.050; cognitive functioning, p =.050), in the 6MWT, stair walking, strength capacity, and in the patient’s dyspnoea perception during submaximal walking activities (IG>CG). Conclusion According to these findings, lung cancer patients should receive enhanced physical activity intervention during palliative chemotherapy