Radiation therapy is an effective tumor treatment that uses modern high-tech computer-controlled advanced radiation generating equipment “medical electronic linear gas pedal” to treat tumors without incision, painless, less damage and less physical consumption by controlling the direction of radiation incidence and radiation area.
Classification of tumor treatment.
At present, there are three main treatment means of international and domestic tumor treatment: tumor surgery, tumor radiotherapy department, and tumor medical department. The recognized overall efficiency of tumor treatment is 45%.
1.Tumor surgery is the treatment of tumor by scalpel, commonly known as surgical treatment, with an efficiency of 21%; the disadvantage is that surgery is physically demanding, and minimally invasive surgery through endoscopy is often limited to very early small tumors, and there is also a certain amount of physical exertion;
2.Tumor radiotherapy is the use of radiation as a tool to kill tumor, commonly known as tumor radiotherapy, the characteristics of tumor radiotherapy are no pain, no incision, little damage to patients, no physical consumption to patients, the overall efficiency of tumor treatment is 18%, especially worth mentioning is that for head and neck tumor radiation therapy can achieve better results than surgical treatment, and not disfiguring;
Nowadays, computers are widely used in tumor radiation therapy, and the application of computer-controlled radiation generation equipment with high technological content makes radiation therapy more accurate and precise. Three-dimensional, three-dimensional, multi-directional focus aiming at tumor or tumor area emitting rays greatly improves the limitation of radiation therapy in the past when rays were concentrated through relatively fixed areas of tumor surrounding tissues and organs, greatly reduces the radiation dose through normal tissues around the tumor, and makes the purpose of improving the radiation dose for killing tumors realized.
Particularly worth mentioning is the tumor-adapted intensity-modulated radiation therapy equipped with an electronic computerized tumor treatment planning workstation with high-speed computing capability, a computer-controlled gas pedal and a computer-controlled 120-slice, 5-slice thick tungsten alloy multileaf collimator. This treatment technology avoids the radiation to pass through the important organs around the tumor to the maximum extent, so that the function of important organs can be fully protected, and at the same time, the tumor or the tumor area can get the effective tumor lethal radiation dose, which improves the tumor treatment effect. Intensity modulated radiation therapy is currently the best and most advanced treatment technology in the field of tumor radiation therapy.
At present, some experts propose stereotactic radiation therapy for early stage lung cancer, the efficacy can be comparable to that of surgical treatment, and it enables patients to avoid the damage to their bodies caused by surgery.
In the process of treating tumor patients with chemotherapy drugs, normal tissues and organs are also damaged by the drugs to different degrees. Compared with surgery and radiotherapy, chemotherapy patients have greater reaction to chemotherapy, and most of the patients receiving chemotherapy are more painful and physically exhausted, while the efficiency of chemotherapy for tumor only reaches 5%.
How to treat tumor?
Most of the patients who have tumor firstly consider how to remove the tumor from their body. Because of the development of surgery for hundreds of years and people’s urgent feeling to remove the tumor, it is natural to think of surgical treatment. It is true that surgery is the ideal means of effective, fast and simple local treatment of tumor. However, in terms of malignant tumor, it is not just a local phenomenon that we can see. When a tumor is found in human body, it has different tissue types and different clinical regressions according to different organs. In the treatment, according to these characteristics of the tumor, the comprehensive treatment plan of the tumor is formulated. Therefore, the correct selection of the first treatment for tumor is the key to the success or failure of the whole tumor treatment, and the key to whether the tumor treatment can achieve a good prognosis.
How to choose the treatment?
We should know that the growth characteristic of tumor is infiltrative, the tumor grows infiltratively and extensively to the surrounding tissues and organs like the roots of a tree in its central part, and also metastasizes to distant places with the help of surrounding lampa drainage and blood vessels.
All tumors have one commonality, invasive growth; no boundary with surrounding normal tissues and organs. Moreover, tumor cells are very wandering and can easily metastasize along lymphatic vessels and blood vessels. Different tumor histological classification and differentiation levels have different clinical growth and metastatic characteristics. Different tumor histological classification and differentiation levels also have different sensitivity to treatment. Therefore, for the treatment of tumor, as a doctor, you should fully consider and understand the type of tumor, its development, and choose the right means and methods for the first treatment. Because such a disease as tumor is quite complex. It is necessary to combine several treatment methods according to the type of tumor, tumor site, tissue type, clinical stage of tumor, and patient’s physical condition. It is necessary to eliminate local tumor and also consider the control of tumor metastasis.
Different therapeutic means have different therapeutic effects, and tumor treatment is divided into two kinds.
(1) local treatment of tumor.
(2) systemic treatment for tumor patients. When people face tumor, the choice of treatment means is the key to the final therapeutic effect of tumor treatment.
According to the law of tumor development, the effective combination of various treatment means should be arranged reasonably. It is a comprehensive treatment for tumor to implement local combat and removal, expand and eliminate local peripheral infiltration and control systemic metastasis.
Classification, role and requirements of treatment methods.
1.Treatment means of local combat and removal.
(1) Surgical resection: The tumor is required to be confined to the local area, without infiltration and metastasis of adjacent tissues and organs around the tumor.
(2) Radiation therapy: It is suitable for tumor confined to local area and also for tumor with infiltration and metastasis of adjacent tissues and organs.
(3) Interventional chemotherapy.
(4) Inter-tissue brachytherapy.
(5) Intergroup radiofrequency ablation therapy.
(6) Intergroup cryotherapy.
(7) Radiation therapy combined with local thermotherapy.
(8) Combined treatment of the above treatments.
(2) Systemic treatment or treatment for systemic spread by means of
(1) chemotherapy.
(2) immunotherapy.
(3) Chinese herbal medicine treatment.
(4) chemotherapy combined with systemic thermotherapy.
(5) chemotherapy combined with immunotherapy and Chinese herbal medicine.
(6) Combination of the above treatments.
3.Salvage treatment for recurrence after surgical treatment.
(1) radiation therapy
(2) chemotherapy.
(3) radiotherapy combined with heat therapy.
(4) radiotherapy combined with chemotherapy.
(5) radiotherapy combined with immunotherapy and herbal medicine.
Indications for various treatment methods
1.Surgical treatment
Applicable to
(1) intracranial tumor.
(2) thyroid cancer.
(3) thymic carcinoma and malignant thymoma.
(4) localized early non-small cell lung cancer
(5) early and mid-stage middle and lower esophageal cancer.
(6) early and mid-stage gastric cancer
(7) early-stage hepatocellular carcinoma
(8) early stage pancreatic body and tail cancer
(9) early and mid-stage colorectal cancer
(10) kidney cancer.
(11) ureteral and bladder cancer
(12) endometrial cancer
(13) mid-stage cervical cancer.
In addition to surgical treatment, systemic chemotherapy and other immunotherapy and Chinese herbal medicine should be used for these malignant tumors according to the post-operative pathology and differentiation degree. If the postoperative pathology determines that the tumor has peripheral invasion and lymph node metastasis, postoperative radiation therapy is also needed to consolidate the local tumor control rate.
2.Radiation therapy
Applicable to.
(1) postoperative intracranial tumor.
(2) septal sinus cancer.
(3) maxillary sinus cancer.
(4) Nasopharyngeal carcinoma.
(5) nasal lymphoma.
(6) Tonsil cancer.
(7) early to mid-stage lymphoma.
(8) postoperative thyroid cancer with pathological determination of peripheral invasion or lymph node metastasis
(9) Small cell lung cancer after chemotherapy.
(10) mid- to late-stage non-small cell lung cancer.
(11) laryngeal cancer.
(12) upper segment esophageal cancer.
(13) hepatocellular carcinoma after interventional treatment
(14) pancreatic cancer.
(15) cervical cancer.
(16) Pre-operative rectal cancer.
(17) postoperative bladder cancer
(18) postoperative residual soft tissue tumors
(19) postoperative residual or recurrence of various malignant tumors
(20) Spinal hemangioma.
(21) Benign lesions (skin scarring, finger and toe warts).
For head and neck tumors: surgical treatment often results in facial disfigurement of the patient, while radiation therapy can completely avoid facial disfigurement and achieve better results than surgical treatment.
For tumor residual in surgery: radiation therapy is also an effective remedial treatment for incomplete surgical treatment.
In the comprehensive treatment of tumor: it is an effective and indispensable treatment for improving the local control rate of tumor. Especially, with the rapid development of tumor radiation therapy technology in recent times. The role of radiation therapy in the field of tumor treatment has become more and more important. It has developed into a major indispensable treatment tool for tumor treatment. Radiation therapy can be applied to the patient without pain and the radiation issued by advanced equipment, just like a scalpel to remove the tumor accurately and effectively, so it is also called gamma knife.
2.Radiotherapy technology classification
(1) Stereotactic precise modulated radiation therapy.
Definition of intensity modulated radiation therapy
Intensity-modulated conformal radiation therapy (IMRT) represents the most advanced modern radiation therapy technology, and one of the most important technological advances is the more advanced three-dimensional conformal radiotherapy. It is a more advanced three-dimensional conformal radiotherapy. It is a computerized adjustment of the beam intensity for the three-dimensional shape of the tumor target area and the specific anatomical relationship between the vital organs and the target area under the condition that the radiation field at each location is consistent with the shape of the target area.
Advantages of intensity-modulated radiation therapy compared with normal 3D radiation therapy
(1) Intensity-modulated radiation therapy can form the ideal shape of dose distribution, increase the treatment dose in the target area, and achieve the purpose of radical tumor treatment as much as possible.
(2) Reduce the radiation damage to the normal tissues around the target area, especially when the target area contains important organs, it can protect the function of important gas organs to the maximum extent.
(3) It is possible to treat multiple target areas and a large range simultaneously. Intensity modulated radiation therapy can integrate multiple target areas (large masses, subclinical lesions, lymphatic drainage areas) and multiple courses of field reduction treatment in one plan, and can give appropriate dose gradients for better treatment effect and less treatment times.
Absolute indications for intensity-modulated radiation therapy
(1) The target area is irregular in shape and adjacent to vital organs or requires extremely high treatment doses.
(2) Only narrow borders can be used to envelop the target area so as to protect the adjacent normal tissues.
(3) The adjacent area has received previous radiation treatment.
(4) The concave target area of radiation therapy requires moderate dose distribution.
Applicable disease types of intensity modulated radiation therapy
(1) Tumors of the nervous system including glioma, pituitary tumor, meningioma, brain metastases, germ cell tumor, medulloblastoma
(2) Head and neck tumors include nasopharyngeal cancer, laryngeal cancer, maxillary sinus cancer, oral cavity cancer, middle ear cancer, etc.
(3) Thoracic tumors include lung cancer, esophageal cancer, mediastinal tumors and breast cancer, etc.
(4) Abdominal tumors including pancreatic cancer, liver cancer, bile duct cancer, intestinal cancer, etc.
(5) Urinary and reproductive system tumors including prostate cancer, kidney cancer and pelvic tumors, etc.
(6) Bone tumors including osteosarcoma, chondrosarcoma, fibrosarcoma, etc.
(7) Other hemangioma, malignant granuloma, etc.
At present, the main means of tumor treatment are: surgery, radiation therapy and chemotherapy. Surgery is the removal of tumor by surgeon using scalpel. Radiation therapy is performed by radiation oncologists with the help of image scanning equipment such as CT, MRI and PET-CT, as well as digital reconstruction display equipment for images of tumors and various organs in the body. Radiation oncologists call it the electronic computer workstation for tumor radiation therapy program, which uses the principle that radiation can kill tissue cells and kill tumors in multiple directions in a three-dimensional manner, while multi-dimensional and three-dimensional The purpose of radiation projection to the tumor is to avoid and minimize the amount of radiation absorbed by normal tissues and organs around the tumor.
Nature of radiotherapy work
1. For some tumors, it can avoid the mental and physical pain of the tumor patients, and get the radiation to kill the tumor without bloodshed, pain and feeling.
2. For some tumor patients who still have tumor residue after surgery and tumor that cannot be completely removed by surgery, postoperative radiation therapy is an effective remedial treatment, which can improve the local control rate or long-term survival rate.
At the same time, it can improve the local control rate or long-term survival rate.
The Department of Radiation Oncology has been providing symptomatic management and treatment for other systemic disorders and systemic and local side effects that may occur when tumor patients receive radiation therapy.
Radiation Oncology Practice Guidelines
As an oncology patient or family member who is not engaged in clinical oncology research, it is difficult to choose the right treatment. However, as a qualified oncology clinical treatment research worker must have the ability to choose the correct treatment plan and process for tumor patients, the treatment of tumor must go through the following steps.
Step 1: Fully understand the process of tumor development, the patient’s past medical history and the family history of tumor patients
Step 2: Fully examine the patient to understand the site, extent and degree of tumor invasion, histological classification, grading and whether there is tumor metastasis and infiltration in other parts of the tumor patient’s body, and to what parts and organs the tumor has metastasized, so as to make accurate staging for the tumor patient. To fully understand whether there are other diseases in the patient’s body or the function of other organs that affect tumor treatment.
Step 3: Select the most suitable and correct treatment plan according to the international and domestic tumor treatment norms, and wholeheartedly choose the correct first treatment plan and the first treatment means for the patient. Because the first treatment of tumor is related to the success or failure of tumor treatment
It is very important to make the correct treatment plan for tumor patients.
Step 4: If necessary, the joint consultation of oncology surgery, oncology radiotherapy and oncology medicine will be recruited to jointly formulate the tumor treatment plan. And full communication with patients and family members will be made, and the implementation of the treatment plan will be started only after a unanimous opinion is obtained.
The preferred tumors for radiation therapy are.
Nasopharyngeal cancer, tongue cancer, laryngeal cancer, upper segment esophageal cancer, middle and advanced lung cancer, middle and advanced pancreatic cancer, low rectal cancer
Tumors that can be treated well with radiation therapy after surgery are
Craniocerebral region: pituitary tumor, ventricular meningioma, pineal tumor, medulloblastoma, glioma, intracranial meningioma, and
Maxillofacial region: tonsil cancer, parotid cancer, thyroid cancer
Thoracic region: lung cancer, middle and lower esophageal cancer
Abdominal region: stomach cancer, pancreatic cancer, liver cancer, bile duct and biliary tract cancer
Pelvic region: endometrial cancer, cervical cancer, ovarian cancer, rectal cancer
Other tumors: postoperative soft tissue tumors, bone tumors, and
Treatment of benign diseases: keloid, finger warts (commonly known as monkeys), toe warts (commonly known as monkeys), cone hemangioma
Tumors for which chemotherapy with radiation therapy can achieve good results are.
Lymphoma, small cell lung cancer, liver cancer, leukemia brain metastasis, advanced pancreatic cancer, post-operative recurrence of rectal cancer,
lung cancer recurrence, esophageal cancer recurrence after surgery, etc.