Response and treatment of radiation therapy for esophageal cancer 1. Systemic reaction Most patients do not have obvious systemic reaction or have very mild reaction, so there is no need to deal with it. Some patients may have obvious systemic reactions, which are often manifested as weakness, lack of appetite, nausea and vomiting. Give fluids, supportive therapy and medication to increase appetite. 2.Bone Marrow Inhibition: white blood cells, platelets decline, give recombinant human granulocyte colony-stimulating factor to promote white treatment, platelet low, give interleukin-11 to promote platelet therapy. 3.Radiation esophagitis Most patients manifested as pain in swallowing, difficulty in eating symptoms worse than before. Or postoperative radiotherapy patients with symptoms of swallowing obstruction. Most of them occur in DT20Gy-40Gy, mainly due to the congestion, edema, exudation and erosion of esophageal mucosa. Treatment: (1) Eliminate the patient’s burden of thinking that the condition is worsening, and explain the reasons; (2) Observe the mild cases, and give fluids to the severe cases. Appropriate small amount of hormone and antibiotic treatment can achieve better results. 4. Radiation pneumonitis is an inflammatory reaction caused by the damage of normal lung tissues in the radiation field after radiation therapy for chest tumor. In mild cases, there is no symptom and the inflammation can dissipate by itself; in severe cases, the lungs will be widely fibrosis, leading to respiratory function damage and even respiratory failure. Treatment is mainly symptomatic, secondary infection in the lungs given antibiotics. Early application of glucocorticoids is effective, and prednisone is usually used. Oxygen inhalation can improve hypoxemia. 5. Esophageal perforation Perforation of esophageal cancer is considered to be catastrophic. Causes of perforation: (1) Tumor regression is fast, tumor is sensitive to radiotherapy, irradiation dose is large and fast. (2) Factors affecting the repair ability of normal tissues, fibrosis and/or poor local blood supply after radiotherapy; combined infection. Clinical manifestations (1) elevated white blood cells, especially neutrophils; (2) fever, often low fever; (3) chest pain or chest discomfort, a sinking feeling. Treatment (1) Strengthen the anti-infection and promote the normal tissue repair ability of the treatment, the use of effective antibiotics; strengthen and timely supplementation of nutrition, protein, correct anemia, promote appetite, etc.. (2) Place esophageal stent after anti-inflammatory treatment. 6.Esophageal obstruction Patients who can enter more than semi-liquid before radiotherapy, in the process of radiotherapy, rarely happen to drip. Most of the patients who can only eat fluids before radiotherapy or have difficulties in eating fluids may not be able to enter the water in the first 3 weeks before the start of radiotherapy. The reason is mostly due to peripheral infiltrative growth of the lesion and loss of normal elasticity of the esophagus. The tumor invades and occupies the lumen of the esophagus, coupled with edema and local inflammatory exudation caused by radiotherapy. (1) Ensure the patient’s daily intake, including infusion and intravenous high nutrition or nasal feeding, to ensure that the patient’s daily needs of fluid, protein and calories. (2) Aggressive anti-inflammatory and anti-oedematous treatment. A small amount of hormone therapy can reduce edema. (3) Obstruction caused by tumor does not affect radiation therapy, and most patients can get relief from feeding obstruction around 40Gy of radiation therapy.