Radiotherapy has always been the preferred treatment for nasopharyngeal carcinoma because most nasopharyngeal carcinomas are hypofractionated carcinomas with high sensitivity to radiation, and the primary focus and lymphatic drainage area of the neck are easily included in the irradiation field. Since the 1940s, deep x-ray radiotherapy for nasopharyngeal cancer has been carried out in China, and from the 1950s to 1960s, external radiation radiotherapy with 60Co has been carried out. Currently the most effective and sure method is with 60Co teletherapy machine.
Radiation reactions and regression and their treatment 1. Radiotherapy complications ① Systemic reactions: including weakness, dizziness, decreased appetite, nausea and vomiting, tastelessness in the mouth, change of taste insomnia or drowsiness, etc. Individual patients can have blood picture changes, especially leukopenia. Although the phenomenon varies in degree but can generally be overcome by symptomatic treatment. Vitamin B1, vitamin B6, vitamin C, gastrodia, etc. can be taken when necessary to complete radiation therapy, and radiation therapy should be suspended if the white blood cell count drops below 3×109 children.
② local reactions: including skin mucosa salivary gland reactions, skin reactions manifested as dry dermatitis or wet dermatitis. Mucosal reactions, such as nasopharyngeal and oropharyngeal mucosal congestion and edema, exudation and accumulation of secretions, can be treated locally with 0.1% glacial talc or lanolin-based anti-inflammatory ointment. Local gargle and lubricating anti-inflammatory agent can be used. In a few patients, swelling of parotid gland can occur after 2Gy irradiation for 2-3d, and then the swelling gradually decreases. When 40Gy is irradiated, salivary secretion is obviously reduced, while oral mucosal secretion increases, mucosal congestion and redness, and patients have dry mouth and difficulty in eating dry food, so parotid gland should avoid excessive irradiation.
2, radiation therapy regression: mainly temporomandibular joint dysfunction and soft tissue atrophy fibrosis, radioactive caries and radioactive jaw spur osteomyelitis and radioactive encephalomyelopathy. There is no proper solution for reversal, symptomatic treatment and support methods are helpful, and over-irradiation of important tissues and organs should be strictly avoided.
Precautions needed for radiotherapy for patients with nasopharyngeal carcinoma: 1) Lie still for half an hour after each radiotherapy and pay attention to drinking more water.
2) Pay attention to protecting the skin of radiation field, underwear should be soft, wide and moisture-absorbing; avoid wiping the skin of irradiated field with soap and coarse towel; avoid hot and cold stimulation, do not use hot water bag or hot compress locally; wear a hat to cover when going out in summer to prevent direct sunlight.
(3), irradiation for about 10-20 days, can successively appear oral mucosa edema, congestion, pain, reduced saliva secretion, dry mouth and other symptoms, patients should keep the oral cavity clean, use Dobelle’s liquid gargle, about 10 times a day; brush teeth with a soft-haired toothbrush, until the oral mucosa is normal.
4）.Use antimicrobial nasal drops 2-3 times a day as prescribed by the doctor to keep the nasal cavity clean and do not dig the nose hard to prevent bleeding.
5）.In order to prevent stiffness and dysfunction of temporomandibular joint, you should be persistent and do mouth opening exercise more than 100 times a day.
6）.Rinse the nasopharynx according to the situation to keep the local cleanliness and improve the sensitivity of radiotherapy.
7) High protein, high vitamin, easy to digest diet is recommended, avoid overheating, too cold, and hard, rough food. Eat more vegetables and fruits.
8) Do not smoke and drink alcohol. For those who have dry mouth, use honeysuckle and chrysanthemum to make tea.