1.How to deal with anorexia, nausea and vomiting caused by radiotherapy? Nausea and vomiting is one of the common side effects of radiotherapy, and most of them are caused by gastrointestinal dysfunction caused by radiotherapy. The prevention and treatment methods are: at this time, patients should pay attention to bed rest and drink more water to facilitate the excretion of metabolites. Food should be carefully prepared, eat less and more meals, eat easily digestible food, do not eat too sweet, spicy and greasy and improper smelling food, eat salty snacks and food. Oral administration of vitamin B6, methotrexate and other drugs can reduce nausea. If vomiting is serious, intramuscular injection of methotrexate and other drugs can be given. The easiest way to help is to press or needle the Neiguan point and the Foot San Li point by hand, which will also help. Anorexia is one of the earliest symptoms and also a side effect of radiotherapy. If the loss of appetite is caused by radiotherapy, vitamin B6 and digestive and appetizing drugs can be taken, and appetizing food such as hawthorn can also be chosen. If the effect of general treatment of the above symptoms is not good, infusion or stop radiotherapy can be considered. 2.How to treat the fever caused by radiotherapy correctly? Fever during radiotherapy can occur from time to time, and there are many reasons. The tissue damage caused by radiotherapy itself, especially the absorption of tumor tissue necrosis can cause hypothermia; the toxic side effects of radiotherapy can cause the decrease of blood picture and immune function, and it is also easy to combine with viral or bacterial infection and cause fever, and the use of chemotherapy or other immune enhancing drugs can also cause fever to increase. Therefore, when fever occurs, the cause should be clarified first in order to deal with it properly. The fever can be treated according to different degrees. If the fever is lower than 38℃, it can be tolerated and stabilized to normal without antipyretic drugs, drinking more warm water, paying attention to rest and promoting sweating and urination. If the body temperature exceeds 38℃, causing obvious headache or general discomfort, antipyretic drugs should be used, such as aspirin, antipyretic tablets, etc. Wet towels can also be used to perform cold compresses on the head, and then do the corresponding treatment after further clarification of the cause of fever. For example, apply antibiotics to control bacterial infection, apply antiviral drugs to control viral infection, or adjust the original radiotherapy or chemotherapy program appropriately. If the body temperature continues to rise above 38.5℃, radiotherapy should be suspended, stabilized, supported by intravenous fluids, and if necessary, antibiotics, vitamins and adrenocorticotropic hormone should be applied. 3.What is the effect of radiotherapy on blood picture? The hematopoietic system is highly sensitive to radiation, and some patients may experience a decrease in peripheral blood picture during radiotherapy. The reason for this is that the division and reproduction of various hematopoietic cells in the bone marrow are inhibited during radiation therapy, resulting in a decrease in the release of mature cells, including white blood cells, red blood cells and platelets, into the peripheral blood. Radiation is equally radiosensitive to the precursor cells that produce these three types of cells, but because leukocytes and platelets have a short lifespan, the counts in the peripheral blood drop quickly, whereas red blood cells have a long production time and anemia appears later. Therefore, blood picture should be checked once a week during radiotherapy, and radiotherapy should be suspended if the white blood cells are lower than 3.0×109/L. Radiotherapy alone is generally not easy to cause an obvious decline in blood picture, and the amount of decline is related to the size of the irradiation field, site and whether or not drugs have been applied or applied at the same time, etc. Diet nutrition should be enhanced during radiotherapy to promote hematopoietic function and reduce the damage of radiation on bone marrow. Food should be high in vitamins and protein. For those with obvious decline, drugs that elevate blood picture should be used, such as leukocyte-raising drugs shark’s liver alcohol, blood leucovorin, vitamin B4. For those with severe leukocyte decline and risk of infection, granulocyte colony factor, such as Wheal blood, can be applied to bring back the number of leukocytes rapidly. Component transfusion or fresh whole blood transfusion may also be used. Those with a significant decrease in white blood cells have a significantly lower resistance and are prone to combined bacterial and viral infections, so attention should be paid to prevention. Those who have thrombocytopenia should pay attention to the presence of bleeding to prevent various injuries and prevent the occurrence of bleeding. In case of bleeding, hemostatic drugs should be actively applied. For those who have serious decline in blood picture, radiation therapy should be stopped and corrected in time, and antibiotics should be applied to prevent infection. 4.Does radiation therapy have any effect on the body’s immunity? The radiation currently used in clinical practice inevitably affects the normal tissues while killing tumor cells, causing the body’s immune function to diminish. Some patients need to do certain regional lymphatic system irradiation and high dose irradiation to certain immune organs (such as thymus) adjacent to the tumor during the treatment, and some need to do whole body irradiation, hemibody irradiation or whole lymphatic system irradiation, which makes the patient’s white blood cell drop and immunoglobulin level drop, thus affecting the immune function. 5.How can patients protect the skin in the radiation area during the radiation therapy? In order to protect the skin in the radiation area during radiation therapy, tumor patients should wear loose and soft underwear, preferably cotton absorbent underwear, so as to reduce the stimulation of local skin such as friction and moisture. Keep the irradiated area clean and dry, and mark the irradiated field clearly and visibly; if it is blurred, it should be re-marked by the doctor. Do not apply adhesive tape, red mercury, iodine and other irritating drugs in the irradiated field, do not wash the area with alkaline substances such as soap, do not expose to the sun, etc. Avoid stimulation by all physical and chemical factors. Patients should pay attention to protect the skin of the radiation area to ensure its integrity in order to successfully complete radiotherapy. 6.What about the itchy skin in the radiation treatment area? Radiation skin damage is a problem frequently encountered in and after radiotherapy, and it occurs in the neck, axilla and groin and other areas with thin and tender skin and many folds. The occurrence of radiation skin lesions is not only related to the anatomical structure of the local skin, but also to the total dose of radiation, the split dose, the total duration of treatment, the type of radiation, the external climatic conditions and the self-protection of the patient. In case of erythema, burning and tingling sensation on the irradiated skin, gently pat the local skin with the palm of your hand. Apply 0.2% ice starch or sterile and dry talcum powder. During this period, the patient should expose, breathe and keep dry the skin in the radiation field, and avoid using petroleum jelly ointment or wet compresses. Minimize soap application and rubbing of the skin in the radiation field. Avoid scratching with hands to avoid aggravating the local skin damage. 7.What should I do if the skin at the radiation treatment site is peeling, erosion and oozing? During radiotherapy, physicians should regularly check the skin reaction in the radiation field. Once skin redness, swelling or dry peeling occurs, the radiation can be stopped for 2 to 3 days to avoid further development of skin damage and wet peeling. If the skin in the irradiated area becomes congested, edematous or even oozing and erosion, radiotherapy should be suspended. To keep the affected area clean and prevent infection, use ointment containing antibiotics and dexamethasone, such as chlorodi cream topical or wet compress with boric acid solution to make the lesion heal as soon as possible to resume treatment, available gentamicin, rehabilitation new wet compress after exposure therapy, can play a role in anti-infection, eliminate inflammation, edema, accelerate the repair of lesion tissue. Also can apply comfrey oil, prohibit the use of alcohol wipe. Wet burn cream is also very effective for skin damage caused by radiotherapy. For bacterial infections combined with skin breakdown, if it is light and limited, topical anti-inflammatory ointment can be used, such as erythromycin and chloramphenicol ointment; when the infection is heavy, anti-inflammatory drugs can be injected intramuscularly or ordered quietly. In short, the skin breakdown in the irradiated area is a normal reaction to radiotherapy, which can be cured as long as the patient cooperates with the doctor and is treated reasonably. 8.What are the problems that patients with head and neck tumors should pay attention to when they undergo radiation therapy? Head and neck is a good site for tumor, and the occurrence of various tumors accounts for about 20% of the whole body tumors. Most of the malignant tumors of head and neck need radiotherapy in different periods of treatment. What should patients with head and neck tumors pay attention to when receiving radiotherapy? Before radiotherapy, patients should consciously quit smoking, alcohol and other bad habits. On one hand, this can reduce the damage to normal tissues caused by radiation during radiotherapy, such as throat erosion and mouth ulcers. In addition, it can avoid the recurrence of tumor or the development of second primary tumor caused by the stimulation of smoking and alcohol. If the scope of radiotherapy includes the oral cavity, a dentist should be consulted before radiotherapy for a comprehensive examination and treatment of oral lesions if necessary, in order to control oral infection foci, remove residual tooth roots and repair dental caries. In case of oral surgery such as tooth extraction, radiotherapy should be considered at least 2 weeks after surgery. During and after radiotherapy, the function of salivary gland is often reduced due to radiation, saliva secretion is decreased, and self-protection function of teeth is reduced, so besides dry mouth and discomfort, patients are prone to infection in the oral cavity and radioactive caries. Therefore, patients should pay more attention to oral hygiene, rinse and brush their teeth after meals, and choose some fluoride toothpaste for toothpaste. Within 2 years after radiotherapy, oral surgery such as tooth extraction should be avoided as much as possible to avoid the occurrence of radioactive osteonecrosis caused by surgical trauma. If surgery is necessary, you can go to a specialist hospital for consultation. During and after radiotherapy, it is important to maintain regularity of life and improve physical fitness to avoid upper respiratory tract infections, thus avoiding dilatation of submucosal capillaries and hemorrhage in the nasopharynx and nasal cavity due to upper respiratory tract infections. In the dry season of spring and autumn, peppermint and paraffin oil can be used in the nasal cavity to protect the local mucosa. After radiotherapy for nasopharyngeal cancer patients, the anti-infection ability of nasopharyngeal mucosa decreases and local mucositis is easy to occur, and the secretion increases sometimes with odor, so nasopharyngeal rinsing can be used under the guidance of physicians to relieve the symptoms. Some patients with healed nasopharyngeal cancer may develop temporomandibular joint ankylosis and surrounding muscle contracture, difficulty in opening mouth and other late radiation injuries. Therefore, after the radiotherapy course, patients can usually do some functional training for opening and closing the mouth. 9.What is the therapeutic significance of teeth cleaning for head and neck radiotherapy patients? Oral reactions of head and neck radiotherapy patients are a common side effect due to the irradiation site and irradiation range. When people eat or eat other foods, some food residues and bacteria will inevitably remain in the teeth. When the radiation therapy reaches a certain amount, the salivary glands, blood vessels in the dental bed and dental pulp are damaged, causing local resistance to decrease and leading to infection, manifesting dry mouth, toothache, pulpitis, oral mucosal edema and oral ulcers. Therefore, it is very important to keep the oral cavity and teeth clean during radiotherapy to ensure the smooth implementation of radiotherapy. Why should nasopharyngeal cancer patients practice mouth opening and closing exercises during radiotherapy? Mouth opening restriction is a long-term radiotherapy reaction of nasopharyngeal cancer patients, and there is no special treatment. Patients should do mouth opening exercise frequently during and after radiotherapy to prevent fibrosis of masticatory muscles and surrounding tissues. Once mouth opening restriction occurs, patients should be instructed to perform functional exercises and pay attention to oral hygiene. How to deal with oral and throat pain during radiotherapy of nasopharyngeal cancer patients? Pain in the oral cavity and throat is the most common side effect of radiotherapy for nasopharyngeal carcinoma patients, which often starts to occur around 2 weeks after radiotherapy. In the early stage, the oral mucosa is congested and edematous, and there are dots and flakes of white film, and the patient shows dry throat, sore throat and difficulty in swallowing. To alleviate the reaction, drink more water, keep the mouth moist, and rinse the mouth with oral Tai or Dobelle’s solution, and take oral Shuahe 25 mg 3 times a day. In case of severe mucosal reactions, such as oral ulcers, erosions, and interfering with eating, radiotherapy can be suspended and oropharyngeal spraying with Rehabin 20 ml, Gentamicin 240,000 U, and Lidocaine 100 mg three times a day half an hour before meals can be given. If necessary, antibiotic treatment is given intravenously, and oral hygiene is paid attention to. 10.What are the commonly used nasal rinse solutions? Nasopharyngeal rinsing can remove secretions and detached necrotic tissue, prevent local infection, prevent mucosal damage, and enhance the penetration of radiation. Generally, the rinsing solution is saline, 2.5%-3% sodium borate solution or 2% hydrogen peroxide solution twice a day. Rinse once before each radiotherapy treatment. For severe local inflammation, antibiotic rinses, such as gentamicin and butalbital kanamycin, can be added appropriately. For those with severe nasal congestion, ephedrine nasal drops can be used first followed by rinsing. How to rinse the nasal cavity of nasopharyngeal cancer patients? Put the front end of the nasopharyngeal irrigator with solution into one nostril gently, and the patient should breathe with open mouth and gently squeeze the nasopharyngeal irrigator with hands to make the irrigation solution flow into the nasopharynx slowly and out from the other nostril, alternating between the two sides. (1) Nasopharyngeal irrigation should be performed once or twice a day. (2) The pressure should not be too high when flushing to avoid complications. (3) Do not talk while flushing to avoid choking and coughing. (4) After rinsing, ask the patient not to blow the nose forcefully to avoid bleeding in the nasopharyngeal cavity caused by excessive force. What should be done when cancer patients have oropharyngeal pain? (1) Ask the patient to drink more water and eat warm soft food to reduce food irritation, and if necessary, gargle with 0.2% procaine solution before meals to achieve surface anesthesia and facilitate eating. (2) Use gentamicin 240,000 U, dexamethasone 5 mg, saline 20 ml nebulized inhalation twice a day. (3) For those who have severe pain and cannot eat, intravenous fluid should be supplemented to ensure the nutrient supply of the organism. 11.Why will head and neck tumor patients have dry mouth after radiotherapy and how to prevent and treat it? The saliva of normal people is secreted by parotid gland, submandibular gland, sublingual gland and especially parotid gland to keep the mouth moist and help digestion of food, while patients suffering from malignant tumor of head and neck are mostly in the radiation field when receiving radiation therapy. After receiving high dose of radiotherapy, the gland cells of normal glands cannot secrete enough saliva and the saliva becomes less and sticky, so the patient will feel dry mouth. This condition starts during radiotherapy and may last for a lifetime. Although there is no good way to restore salivary secretion to normal, the following methods can reduce the symptoms: ① When planning treatment, doctors should use various treatment methods to avoid irradiating the parotid glands and other glands if they can be avoided or their exposure is too high, especially if one side of the tongue, gingival cancer and buccal mucosa cancer; ② Use various treatment plans, such as radiotherapy plus surgery, external radiotherapy plus interstitial tissue insertion or intracavitary treatment, controlling the dose of large area radiotherapy and enhancing the local dose. Even if the damage of the gland is reduced. The tumor can also be well controlled; ③Patients drink water several times in the treatment process, eat more vitamin-rich food and fruits, such as vegetables, pears, watermelon, strawberries, etc.; ④Save spicy food and “tonic medicine” (such as ginseng, etc.), avoid smoking and alcohol; ⑤Pay attention to oral hygiene, rinse more mouth; ⑤Cooperate with the Chinese herbal medicine treatment to produce fluid and remove fire, such as fat sea, maitong, chrysanthemum, green tea brewed to take. 12.How to deal with the white film and rupture of oral mucosa during head and neck radiotherapy? Patients suffering from head and neck tumors are not only treated in the tumor area, but also in the corresponding preventive treatment area, generally the oral cavity and pharynx are within the radiation treatment field, so the normal tissue area is larger. When the radiation therapy reaches 20-30 Gorey, due to acute congestion and edema of oropharyngeal mucosa, patients will feel dry mouth and sore throat, especially when swallowing things, and many patients say “it is difficult to even swallow saliva”. With the increase of radiation therapy dose, some mucous membranes will break down and form ulcers, and some necrotic materials will be deposited there, forming a white film, which we call “white film”, and the doctor will find congestion, erosion, ulcers and white film in the oropharynx when he/she examines them. At this time, the patient’s reaction is very heavy, and some patients do not even drip. At this time, for the patient should contain more rinses, keep the mouth clean, eat more light food, like milk, egg custard, rice porridge, pear water, watermelon juice, etc., avoid spicy food and tobacco and alcohol. For doctors, patients can be given large doses of vitamin B, C, E, etc. They can also take oral dicaine sugar cubes half an hour before meals to reduce the pain in the lower throat to facilitate eating, and can also be treated with Chinese herbs such as fatty sea, chrysanthemum, maitake, etc. After the above treatment, most of the patients will gradually reduce their symptoms and can adhere to the treatment with the narrowing of radiotherapy field, only a few patients have very serious reactions due to various reasons to suspend radiotherapy. In this case, patients may have fever and localized septicemia, which can be treated with fluids and systemic anti-inflammatory treatment. Severe reactions are usually seen in patients with poor nutrition, weak constitution, high single dose of radiotherapy, rapid radiotherapy or combined chemotherapy. 13.Why do patients lose hair during head and neck radiotherapy and will the hair grow back? The high-energy radiation used in radiotherapy has a strong penetrating ability, and the size of human head is limited, so the radiation can completely penetrate. As long as there is hair in the irradiated field of the head and neck or hair in the path of the rays, the rays will have an effect on the growth of hair follicles and will cause hair loss after a certain dose is reached. Hair will grow back after radiation therapy causes hair loss, but the time for hair to grow back is different for each person. 14.Why do patients with chest irradiation have pain in the throat when they eat? Patients who receive radiotherapy to the chest, when the radiation therapy to 20 gore, patients will appear hypopharyngeal pain or discomfort behind the sternum, especially when eating buns, rice, this is because in the radiation field of the esophagus received radiation therapy, mucosal congestion, edema, this is generally a temporary phenomenon, through into the soft, light food, radiation therapy field changes, the above symptoms will be reduced or adapt, patients should not be anxious. If the symptoms worsen, radiation esophagitis, the patient can not eat, through the infusion, oral local anesthetic drugs, or even suspend radiotherapy and other methods to relieve the symptoms. 15.What systemic reactions will patients have during radiotherapy. How to deal with them? The common systemic reactions during radiotherapy include nausea and vomiting, loss of appetite, fatigue, etc. They are usually not very serious, mostly due to gastrointestinal disorders after radiotherapy, but also because the brainstem is irradiated or the radiotherapy field is too large, plus the patient’s mental tension, anxiety and pain can aggravate these reactions. You can take some gastrointestinal drugs, such as vitamin B6, gastrodia or morpholine, pepsin, etc., to promote gastrointestinal peristalsis and digestion. In addition, we should establish the confidence to overcome the disease, strengthen the courage to fight with the disease, treat eating well as the first treatment, and make the diet with good color, aroma and taste, various kinds, easy to digest, no special smell, and make some exercises after meals. If the reaction is very serious, it can be solved by combining with infusion, static antiemetic drugs, or even temporary suspension of treatment. In addition, the decrease of white blood cells and platelets is also one of the systemic reactions, which can be treated with blood-supplementing foods such as pork liver, pig’s feet, blood-raising drugs and Chinese herbal medicine, and if necessary, transfusion of component blood and suspension of radiotherapy. 16.To what extent should the white blood cell and platelet drop to stop radiotherapy? When patients receive radiotherapy, especially when irradiating large areas of flat bone, bone marrow, spleen and large area, such as whole lung radiotherapy, whole pelvis radiotherapy and whole abdomen radiotherapy. The hematopoietic system is affected resulting in a decline in whole blood cells, such as white blood cells and platelets. The decrease of leukocytes and platelets to a certain degree will affect the human body and have certain harmful effects, such as patients feel general weakness, easily lead to serious infections or even sepsis, and have a tendency to bleed, leading to internal organs and intracranial bleeding leading to death. Therefore, when the white blood cell is less than 3×109/liter and platelet is less than 70×109/liter, radiotherapy should be suspended, and blood elevation symptomatic treatment should be started again after the blood picture recovers. However, when the radiation field is small, such as radiotherapy for pituitary tumors, or when the radiation field does not include the hematopoietic system, such as radiotherapy for the neck and radiotherapy for soft tissues of the extremities, if the white blood cells are less than 3×109/liter but more than 2×109/liter and platelets are less than 70×109/liter but more than 50×109/liter, radiotherapy can still be continued, but the changes of blood cells should be closely monitored, and if there is a gradual decrease If the trend is gradually decreasing, then radiotherapy should be stopped immediately and blood raising therapy should be strengthened.