“My father is too old to want him to do radiotherapy, and the purpose of coming to the hospital is to hope for conservative treatment to relieve his pain.” We often hear such statements from patients in the clinic. A considerable number of elderly patients diagnosed with malignant tumors, their families or themselves are often afraid of treatment, especially radiotherapy-related complications, and give up such a simple and effective treatment, missing the best time for tumor treatment. What’s more, there are patients who are so scared of radiotherapy. In fact, radiotherapy is one of the main means of tumor treatment. Reliable data show that about 18% of malignant tumors can be cured by radiotherapy alone, and the cure rate of some specific tumors, such as nasopharyngeal carcinoma, lymphoma, and cervical cancer, is even more than 50%. It is similar to the surgical treatment of tumors. Radiotherapy is mainly aimed at local lesions to produce killing effects, so its systemic treatment-related toxicity is relatively small and easy to tolerate. Especially with the popularization of modern precision radiotherapy techniques such as conformal and intensity-modulated radiotherapy, its treatment-related toxicity will be further reduced. For older or weaker tumor patients, it is crucial to strictly grasp the indications for treatment and accurately formulate the treatment plan. Once palliative radiotherapy is determined, the dose of radiotherapy should be systematically lowered and the target area should be reduced in size, so as not only not to produce intolerable toxicity, but also to more effectively alleviate the patient’s symptoms and provide clinical benefits. For example, radiotherapy to the spine or load-bearing bone invaded by tumor can reduce the incidence of paraplegia or pathological fracture; for patients with brain metastasis of tumor, whole brain radiotherapy can improve the function of limbs and alleviate the neurological symptoms; for patients with inability to eat or intestinal obstruction due to the compression of tumor on the esophagus or intestinal tract, palliative radiotherapy can relieve the obstruction to a certain degree, so that the patients can have normal eating or defecation. Once it is determined that radical radiotherapy can be used, the dose should be pushed up without hesitation and never be “palliative”. Accurate evaluation of the radiotherapy benefit ratio of tumor patients can avoid unnecessary toxicity, so that the advanced age is no longer a “forbidden zone” of radiotherapy for tumor patients.