The Art of War: Factors Affecting the Effectiveness of Radiotherapy If tumors and radiotherapy are like two armies, the factors affecting the effectiveness of radiotherapy are the key to the success or failure of this battle. Since the two armies are fighting against each other, there will be the scene of the two opposing forces. How to win the battle, know the enemy, can win a hundred battles, now let us analyze down one by one. How is the enemy’s strength? The larger the lump means the more tumor cells, relative to the small lump of the same malignant tumor, its treatment effect is relatively poor. How is the enemy distributed? The more dispersed the tumor means the more metastatic it is, and its treatment effect is relatively poorer than that of the same malignant tumor that grows only in a restricted area, that is to say, the later the staging of the tumor, the worse the treatment effect is compared with that of early-stage patients. How about the strength and back-up of the enemy? Tumors with poor sensitivity to radiotherapy have relatively poorer therapeutic effects compared with tumors with higher sensitivity to radiotherapy, but when it comes to the speed of cell reproduction, the higher the degree of malignancy, the worse the therapeutic effect. For example, invasive ductal carcinoma of breast is often insensitive to radiotherapy, but after receiving radiotherapy, its survival rate and recurrence rate have increased and decreased to a certain extent. On the contrary, small-cell lung cancer, which is extremely sensitive to radiotherapy, has a high malignancy degree and high tumor reproduction rate, and distant metastasis may appear rapidly in a short period of time after receiving radiotherapy. How about our strength? The irradiation dose of radiotherapy must reach the therapeutic dose of different tumors, insufficient dose often fails to have the best effect, and too high dose not only fails to improve the therapeutic effect but also aggravates the damage of normal tissues. What is the distribution of our side? It is very important to outline the target area of radiation therapy, too small a range of surroundings often makes the peripheral residual or recurrence, too large a range of surroundings not only fails to improve the therapeutic effect but also increases the scope of damage to normal tissues. How about our strength and backup? For some tumors, radiotherapy alone is often less effective than the combination of synchronous chemotherapy or sensitizers, while the improvement of radiotherapy technology, such as the use of three-dimensional conformal and intensity-modulated radiotherapy and other high-precision radiotherapy, improves the dose to the target area of the tumor and protects the normal tissues with greater efficacy, so as to achieve the improvement of therapeutic efficacy while improving the quality of survival of the patients. In addition to these factors of success or failure between the two armies themselves, there are also timing, geographical advantage, and human harmony. Timing. The time of radiotherapy has some subtle role, not every day radiotherapy, every day without interruption is the poor pursuit of the treatment of the tumor, often also consider the normal tissue repair time. The current routine timing of treatment is based on a once-a-day, five-day-a-week treatment cycle and is preferably continuous, with long intervals also providing an opportunity for tumor cell repair. For some tumors, it can also be adjusted to twice a day, but the interval between the two needs to be more than six hours or more, as a way to strengthen the fight against tumor cells in the time that normal cells can tolerate, thus improving the efficacy. Dilly. For tumor cells, the dose is as high as possible to help improve the efficacy of treatment, but because tumors often grow in and around normal tissues or vital organs, and the radiotherapy dose tolerance of these normal tissues and organs limits the radiation dose that can be given to the tumor, the efficacy of treatment for the same malignant tumor in different parts of the body varies somewhat. People and. The patient’s own physical condition also affects treatment efficacy. Those with good physical tolerance are better than those with poor physical tolerance; those with good organ function are better than those with poor organ function; those with good nutritional status are better than those with poor nutritional supplementation; the recovery ability of young patients is better than that of old patients; anemia affects the normal cells and at the same time puts the tumor cells in the state of oxygen deprivation, which reduces the therapeutic effect. And so on and so forth. To sum up, the efficacy of radiotherapy is affected by many aspects, only after considering many aspects and then formulating personalized radiotherapy plan for each patient and each tumor, can the expected efficacy be better achieved.