Indications for radiotherapy of common tumors Head and neck tumors: 1.Nasopharyngeal carcinoma at all stages: radiotherapy is the main treatment, and chemotherapy is administered according to the situation. 2.Tongue cancer: Stage I and II radiotherapy or surgery for radical treatment, but radiotherapy can preserve the function and should have radiotherapy as the main treatment. Stage III and IV chemotherapy, radiotherapy and surgery are combined. 3.Other oral cancers (floor of mouth, buccal mucosa, gingival cancer, etc.): Stage I: surgery or radiotherapy. Stage II: surgery and preoperative or postoperative radiotherapy. Stage III and IV: integrated treatment such as radiotherapy, chemotherapy and surgery. 4.Malignant tumor of nasal cavity (undifferentiated carcinoma, squamous carcinoma, adenocarcinoma, malignant lymphoma and malignant granuloma, etc.): Stage I and II: surgery or radiotherapy. Stage III: preoperative radiotherapy + surgery + postoperative radiotherapy. Stage IV: palliative radiotherapy + chemotherapy or surgery + radiotherapy + chemotherapy. (Undifferentiated carcinoma, malignant lymphoma, etc. can be treated with chemotherapy first). 5.Septal sinus cancer: stage I and II: radiotherapy and surgery have similar efficacy. stage III: preoperative radiotherapy + surgery + postoperative radiotherapy and chemotherapy. Stage IV: surgery + radiotherapy + chemotherapy or palliative radiotherapy + chemotherapy. 6.Malignant tumor of maxillary sinus: preoperative radiotherapy + surgery ± postoperative radiotherapy and chemotherapy. 7.Tonsil cancer: radiotherapy is the main treatment, and surgery + radiotherapy is feasible in early stage limited to tonsil fossa. If the pathology is radiotherapy-insensitive tumor: preoperative radiotherapy + surgery. 8.Parotid cancer: T1: surgery or radiotherapy alone; T2: surgery ± postoperative radiotherapy; T3, T4: preoperative radiotherapy + surgery. Late stage can also be treated with palliative radiotherapy. 9.Laryngeal cancer: T1 acoustic cancer: radiotherapy is preferred (with comparable effect to surgery). stage II, III, IV: surgery, preoperative or postoperative radiotherapy. stage II, III, IV: surgery, preoperative or postoperative radiotherapy. 10.Malignant tumor of salivary gland: surgery is the main treatment, and adjuvant radiotherapy is applied. 11.Carcinoma of the external ear and middle ear: surgery, radiotherapy or comprehensive treatment. 12.Ocular tumors: basal cell carcinoma of eyelid, squamous carcinoma: surgery or radiotherapy. Adenocarcinoma of the eyelid: surgery is the main focus, and preoperative or postoperative radiotherapy is feasible. Intraocular tumors: X(r)-knife or 3D conformal radiotherapy. Thyroid cancer: papillary thyroid cancer: mainly surgery, postoperative radiotherapy for residual. Follicular carcinoma of thyroid: surgery is the main focus, residual or reissue 131I treatment or radiotherapy. Undifferentiated carcinoma of the thyroid: radiotherapy is the mainstay, and radical surgery is feasible for a few cases without metastasis in early stages. 1) Small cell lung cancer (SCLC): limited stage: induction chemotherapy + synchronous radiotherapy chemotherapy. Extensive stage: induction chemotherapy followed by radiotherapy of residual lesions. Patients in complete remission after chemoradiotherapy plus whole brain radiotherapy. (2) Non-small cell lung cancer (NSCLC): surgery is the main treatment, and radiotherapy is feasible for stage I, II and III patients who refuse or cannot tolerate surgery. Adjuvant preoperative or postoperative radiotherapy. Indications for postoperative radiotherapy: postoperative residual; lung hilar or mediastinal lymph node metastasis found by postoperative pathology; 3) lung metastases: three-dimensional conformal radiotherapy, and whole lung radiotherapy may be performed as appropriate according to the pathology of the primary lesion. 2.Mediastinal tumor: surgery is the main focus; those who cannot be operated to obtain pathological diagnosis and mark out the tumor scope for postoperative radiotherapy. 3. Chest wall and pleural tumors: surgery is the main focus, or radiotherapy after obtaining pathology. 4.Esophageal cancer: radiotherapy is preferred for the cervical and upper thoracic segments. Surgery is preferred for middle and lower segments, and radical surgery is the main treatment for stage I and II, while stage III T3N1M0 is the main treatment for radical surgery, and the combination of surgery and radiotherapy can improve the treatment. Indications for postoperative radiotherapy: postoperative residual; postoperative staging of T3 or lymph node metastasis 5, breast cancer: 0, stage I: conservative surgery with breast preservation + postoperative radical radiotherapy or modified radical surgery. Stage II: modified radical surgery + radiotherapy + chemotherapy ± endocrine therapy. Stage III: neoadjuvant chemotherapy ± radiotherapy + modified radical surgery (or radical surgery) + postoperative radiotherapy + chemotherapy ± endocrine therapy. Stage IV: chemotherapy and endocrine therapy mainly ± local radiotherapy ± local surgery. Indications for postoperative radiotherapy: after breast-conserving surgery; tumor larger than 5cm or lymph node metastasis after radical surgery. Abdominal malignant tumors 1. Gastric cancer: early gastric cancer is mainly operated, while preoperative radiotherapy and neoadjuvant chemotherapy for middle and late gastric cancer can improve the surgical resection rate and patient survival rate. Indications for postoperative radiotherapy: tumor invasion to the whole layer or lymph node metastasis; age less than 50 years, tumor invasion to the muscle layer, low differentiation tumor 2, rectal and anal canal cancer: early stage: simple surgery or intracavitary radiotherapy, conformal radiotherapy while preserving the anus. Tumor after stage IIA: preoperative radiotherapy can improve the surgical resection rate and create anus-preserving surgical treatment opportunity for low rectal cancer. Indications for postoperative radiotherapy: Tumor penetrating the intestinal wall, lymph node metastasis, involvement of adjacent organs and residual lesions after surgery should be treated with postoperative radiotherapy, and the tumor bed should be marked during surgery so that radiotherapy can be added for field reduction. 3.Pancreatic cancer: Surgery should be preferred if there is no contraindication to surgery. Radical radiotherapy: If the tumor can be removed surgically, but the patient cannot tolerate surgery or refuse surgery for other reasons. Palliative radiotherapy: In advanced stage patients with distant metastasis and severe local pain, radiotherapy has good pain relief effect. Postoperative radiotherapy is feasible for postoperative residuals. 4.Hepatocellular carcinoma Small hepatocellular carcinoma: surgery. Postoperative radiotherapy for those who cannot be completely resected. Large hepatocellular carcinoma: 3D conformal radiotherapy with interventional radiotherapy, the tumor can be operated after shrinking. 5.Biliary tract cancer: 3D conformal radiotherapy is mainly used for bile duct cancer that is not suitable for surgery, and can play a palliative and symptom reduction role for patients with residual or recurrent disease after surgery. 4. Urological tumors 1. Kidney cancer: Preoperative radiotherapy: cases with high malignancy or large tumors, which are estimated to be difficult to operate. Postoperative radiotherapy: A. Tumor remains after surgery B. Tumor is large or penetrates the peritoneum C. Regional lymph node metastasis D. Renal vein invasion Radiotherapy alone: A. Tumor is locally advanced and cannot be removed by surgery B. Patient cannot tolerate surgery due to other diseases or refuses surgery 2. Bladder cancer: Superficial bladder cancer is mainly treated by surgery. Invasive bladder cancer needs integrated treatment of surgery and radiotherapy. Pre-operative, intra-operative and post-operative radiotherapy have achieved better results. 3.Prostate cancer: Due to the progress of 3D conformal radiotherapy, radiotherapy has become the main treatment for intermediate and advanced prostate cancer. Stage A1, A2, B1: Radical prostate cancer surgery or radiotherapy + endocrine therapy. Stage B2: Radical prostatectomy + pelvic lymph node dissection + endocrine therapy. If the lymph nodes are positive, postoperative radiotherapy or radiotherapy + endocrine therapy will be added. Stage C: Radiation therapy + endocrine therapy or endocrine therapy + radical prostate cancer surgery. Stage D: Radical radiotherapy or palliative radiotherapy + endocrine therapy. 4. Testicular malignancy: high spermatic cord ligation and orchiectomy. Seminogenic cell tumor: Stage I and IIa: radiotherapy after surgery. Stage IIb and IIc: chemotherapy + radiotherapy + chemotherapy after surgery. Stage III: chemotherapy after surgery mainly + adjuvant radiotherapy. 4. Penile cancer: radiotherapy is one of the main treatment means, and radiotherapy can be preferred in early stage, and local radiotherapy + surgery in middle and late stage. V. Female reproductive system tumors 1. Cervical cancer: radiotherapy is available at all stages. Postoperative radiotherapy: the tumor invades parametrial tissue or lymph node metastasis, or the tumor is larger than 4cm, invades deep interstitium and has cancer embolism in the vasculature. 2.Endometrial cancer: preoperative radiotherapy: for stage I, uterine cavity larger than 8cm, poorly differentiated cells, stage II and stage III. Postoperative radiotherapy: for stage IA with cellular grading of G3, stage IB with poor prognostic factors or cellular grading of G2, stage II, stage III. stage IV: chemotherapy, radiotherapy, endocrine therapy and adjuvant surgery 3, ovarian malignancy: local palliative radiotherapy is feasible for advanced or recalcitrant lesions. Total abdominal irradiation is rarely used due to the progress of chemotherapy. 4.Malignant trophoblastic tumor: local radiotherapy can be given to residual lesions of chemotherapy and major organ metastases or metastases with hemorrhage and urgent need to relieve symptoms. 5. Vulvovaginal cancer: radiotherapy can be given to all stages. Central nervous system tumors 1. Malignant glioma with invasive growth: radiotherapy should be given after removing the tumor as much as possible. 2.Medulloblastoma, germ cell tumor, malignant lymphoma and other chemotherapy-sensitive tumors: radiotherapy + chemotherapy. 3.Deep tumors or tumors in the main functional area: if surgery is difficult and dangerous, or if the patient cannot tolerate surgery for other reasons, solid tumors with clear tumor boundaries (such as craniopharyngioma, auditory neuroma, etc.) whose diameter is less than 3CM and pituitary tumors, conformal radiotherapy, X-knife, r-knife are feasible. 4. Brain metastases: whole brain radiotherapy + 3D conformal radiotherapy, X-knife, r-knife. VII. Hematopoietic malignancies 1. Hodgkin’s lymphoma: IA, IIA: radiotherapy ± chemotherapy. Stage IB, IIB, III: radiotherapy + chemotherapy. Stage IV: chemotherapy-based + adjuvant radiotherapy 2. Non-Hodgkin’s lymphoma: Low malignancy: Stage I, II: radiotherapy + chemotherapy Stage III, IV: chemotherapy + local radiotherapy Moderate malignancy: PSIA stage: radiotherapy alone, chemotherapy above stage II + local radiotherapy High malignancy: chemotherapy-based + local radiotherapy 3. Tumor-like fungal disease: whole-body electron beam irradiation + chemotherapy 4.Malignant sarcoidosis: radiotherapy + chemotherapy 5.Multiple myeloma: chemotherapy-based Radiotherapy is used for: A: myeloma with limited lesions, B: pathological fracture fixation, C: spinal cord compression syndrome, D: intractable local severe pain. 6.Leukemia: radiotherapy is mainly used for central nervous system leukemia, testicular leukemia and chronic leukemia with giant spleen. VIII. Soft tissue tumors The treatment of soft tissue sarcoma has changed from a single surgical treatment to a surgery-based comprehensive treatment. Pre-operative radiotherapy: A: Tumor is growing fast. C: Recurrent tumor with poor differentiation. Post-operative radiotherapy: A: After local tumor resection, if more thorough surgery is not planned; B: The scope of surgical resection includes too little normal tissue, and it is estimated that surgical resection may not be complete; C: There are still residual lesions after extensive resection; D: Extensive resection is planned instead of amputation or hemi-pelvic resection; E: Multiple post-operative recurrence. A: Small tumor, patient cannot operate or refuse to operate due to other reasons, B: Recurrence after operation but small tumor, C: Advanced lesion, palliative reduction radiotherapy is feasible. Primary bone malignant tumors 1. Osteosarcoma: preoperative radiotherapy + chemotherapy can improve the surgical resection rate. Postoperative radiotherapy: for those with local tumor residual after surgery. 2.Chondrosarcoma: radiotherapy is feasible for the parts that are difficult to operate, and palliative radiotherapy is done for patients with advanced stage. 3.Ewing’s tumor: sensitive to radiotherapy and chemotherapy, treatment should be based on radiotherapy and chemotherapy. 4.Giant cell tumor of bone: surgery is the main focus. stage III surgery + radiotherapy. 5.Bone lymphoma: sensitive to radiotherapy, radiotherapy + chemotherapy. 6.Chordoma: surgery is the main focus. Additional postoperative radiotherapy is often required. 7.Fibrosarcoma of bone: radiotherapy is available when surgery is not possible. 8.Spinal hemangioma: radiation therapy alone can achieve better results. 9.Eosinophilic granuloma: radiotherapy should be used for: A: lesions not suitable for surgery; B: relatively limited lesions outside the bone; C: recurrence after surgery; D: multiple lesions with painful areas. X. Skin cancer: Most skin cancers are sensitive to radiotherapy, and radiotherapy can achieve a high cure rate with less impact on beauty and function. Malignant melanoma: the effect of radiotherapy alone is not ideal, but it can significantly improve the local control rate when combined with thermotherapy. Treatment of metastases: 1. Bone metastases: radiotherapy for local bone metastases can relieve pain in 80%-90% of patients, and can control local tumors to varying degrees and prevent pathological fractures. Brain metastases: As long as the condition allows, whole brain radiotherapy should be done, and three-dimensional conformal radiotherapy, X-knife and R-knife should be added before and after whole brain radiotherapy (generally, X-knife or R-knife should not be applied alone). 3. liver metastases and lung metastases: three-dimensional conformal radiotherapy can achieve good results. Multiple metastases in both lungs of seminoma, nephroblastoma, Ewing’s tumor and malignant lymphoma can be treated with whole-lung radiotherapy. XIII. Some benign tumors or non-neoplastic diseases can also be treated by radiotherapy or comprehensive treatment, such as: 1. scar hyperplasia (external irradiation within 24 hours after surgery or scar excision) 2. plantar warts, etc.; 3. hemangioma; 4. fibroma; 5. nasopharyngeal fibrovascular tumor; 6. postoperative parotid fistula; 7. osteomyelitis; 8. pigmented choroidal nodes often synovial; 9. eosinophilic red granuloma; 10. some Prominent goiter is feasible with retrobulbar irradiation; 11, penile fibrous cavernositis, etc.