I. What is radiation therapy? Radiation therapy refers to the method of using the selective radiation of X-ray or other ionizing radiation and the radioactivity of radioactive elements to destroy cells and tissues to achieve the purpose of treatment. Its characteristic is: it has a great effect on the infantile and vigorous growth of tumor cells; the disadvantage is: while the radioactivity destroys and kills the tumor cells, it also has a destructive effect on the surrounding normal tissue cells. At present, the more perfect and practical radiotherapy techniques are: conventional irradiation technique, X-knife technique, three-dimensional conformal irradiation technique, three-dimensional intensity adjustment irradiation technique. What is the difference between internal and external irradiation in radiotherapy? Intracorporeal irradiation is the direct insertion of radiation source into the tumor (such as skin cancer, tongue cancer, etc.) or the internal cavity of the organ (such as esophagus, cervix) for irradiation, which are called intertissue irradiation and intracavity irradiation, respectively. In vitro irradiation is a certain distance from the person and concentrates on irradiating a certain area. According to the shooting distance, there are two kinds of irradiation: near distance (15-40 cm) irradiation and far distance (60-150 cm) irradiation. The difference between them is that: the intensity of the radiation source of in vivo irradiation is smaller, so the treatment distance is shorter, and most of the energy is absorbed; most of the ray energy of in vitro irradiation is screened out, and only a small part of the energy reaches the tissue. The radiation of external irradiation reaches the tumor through the skin and normal tissue. With the tolerance and sensitivity of different tumors, different types of radiation with different energy and multi-wild irradiation techniques should be selected. Which tumors are sensitive to radiotherapy? Tumors sensitive to radiation include: retinoblastoma, nasopharyngeal carcinoma, asexual cell tumor in ovarian cancer, testicular seminoma, renal embryonal tumor, malignant lymphoma, etc. Tumors with low sensitivity to radiation include: osteogenic sarcoma, fibrosarcoma, liposarcoma, malignant melanoma, etc. Generally speaking, radiotherapy is less effective for tumors with low sensitivity, but this does not mean that the radiosensitivity of tumors is proportional to the cure rate of radiotherapy. Some tumors with high radiosensitivity, although the local curative effect is high and the tumor disappears quickly, it is difficult to cure them because of their high malignancy and more chances of distant metastasis. When can radiotherapy not be carried out? 8, heart failure, heart disease and tumor located near the heart (such as lung cancer); 9, lung cancer patients with severe lung function insufficiency, etc. V. What are the adverse effects of radiotherapy? 1, radiotherapy adverse local reactions, mainly refers to local dry skin dermatitis and wet dermatitis, which can form radioactive fibrosis later. 2.Irradiation of the oral cavity can cause a decrease in the secretion function of the salivary glands and dry mouth. 3.Irradiation of bladder and rectum may cause radioactive cystitis (high frequency of urination, painful urination, hematuria) and radioactive proctitis (high frequency of stool, cramping, red and white peper). 4.Excessive amount of brain irradiation may cause brain necrosis and excessive amount of spinal cord irradiation may cause paraplegia. Generally speaking, there is no need to suspend radiotherapy, as long as we carry out radiotherapy reasonably, there will be no serious local and systemic reactions. Can cancer patients do physical exercise? Physical exercise is also a kind of adjuvant therapy, which is both local and systemic therapy. Through local muscle movement, it can play an exercise role for the whole body organs. Therefore, physical exercise is an important method for cancer patients to recover, and its main purpose is to improve and promote the recovery of various functions of cancer patients as soon as possible. To carry out physical exercise when cancer patients are recovering, it is necessary to choose appropriate exercise methods, master the appropriate amount of exercise and follow the following principles according to the characteristics and functional status of each patient: 1. That is, we must choose the exercise method and content according to their physical condition. 2, step by step, perseverance. 7. What is meant by cancer cure? Clinical cure can be defined as long as the original symptoms and tumor disappear after treatment. According to clinical practice and follow-up observation, many cancer patients are indeed cured. If there is no recurrence of cancer for 5 years after treatment, it is possible to be cured permanently. This is because only a few percent of these patients will have further problems in the future. According to the above criteria, a significant proportion of cancer patients are cured. The 5-year survival rate of nasopharyngeal cancer is 54% after treatment, and the 5-year survival rate of cervical cancer is 60-70%, so that cancer can be cured with reasonable treatment. Spiritual factors are important after an individual has cancer. Individual patients, under the influence of the old concept of “cancer is an incurable disease” always feel that everything is over for them, they do not think about their food and tea, they are bedridden, and even refuse to take medicine and treatment, as a result, their condition deteriorates quickly and they die. On the contrary, many cancer patients can treat the disease correctly, be emotionally optimistic, actively cooperate with treatment, follow medical advice, enhance nutrition, pay attention to regular life, strengthen exercise, and strive to mobilize the body’s ability to fight the disease, so that the disease can be controlled, constantly improve, and finally cured. Although the evidence is not very sufficient, a positive mental state can improve the patient’s ability to live with the disease and enhance the effectiveness of the medicine. Any bad mental state such as fear, anger, loss of self-esteem, isolation, etc., will weaken the patient’s will to live, while aspirations for life, courage, hard work, patience and unlimited trust in medical staff and family can indeed strengthen the patient’s will to live. The right attitude after an illness is: to realize that one is living in reality, not in memories of the past; to propose reasonable and realistic goals for oneself, society and family; to admit that a new problem has appeared in one’s life, to recognize it objectively and to be willing to solve it together with others around one; to try to remove one’s negative emotions and pessimistic thoughts; to take the initiative to do In the treatment, become an active collaborator, see yourself as an important member of the whole medical process, even when your condition is critical, physically and mentally make yourself feel that there is still potential to be explored, so that you are always in the realm of optimism. When patients receive radiotherapy, they will have more or less radiotherapy reactions, such as oral mucosal reactions, loss of appetite, oropharyngeal pain, and decrease of blood picture, etc. As these reactions will affect the appetite of patients and lead to the aggravation of reactions, the vicious circle will eventually affect the smooth progress of treatment and even interrupt the treatment. Therefore, the dietary management of radiotherapy patients is a very important issue. 1, the patient’s diet should follow the principle of “three highs and one low”. The so-called three high means high vitamin, high protein, high calorie, such as lean meat, seafood, fresh fruits, vegetables, etc.; a low refers to low fat; 2, the patient should eat light and easy to digest food, avoid greasy and spicy, as far as possible to make the taste mellow, so that the patient can easily accept; 3, according to the reaction in radiation therapy to adjust food, such as white blood cell decline should pay attention to eat some animal liver, spinach, soybean products etc. If patients have loss of appetite and indigestion due to radiotherapy, they can be given a small number of meals and eat several times without reducing the total intake. It is not recommended to avoid eating during radiotherapy. 9.What are the problems that patients need to pay attention to in the process of radiotherapy? 1.There is no need to abstain from eating during the treatment process. Patients should take more high vitamin and high protein diet to enhance nutrition and cooperate with radiotherapy. 2, should keep the irradiated skin clean, avoid sunlight, friction or mechanical trauma, do not abuse acidic, alkaline, iodine, ointment and other drugs, find a doctor to deal with the ulceration of the irradiated skin. The marker line of the irradiated field must be clearly visible; wash the skin with water every day, forbid to wash with soap to prevent the marker line from washing off; if it is slightly blurred, find a doctor to re-draw it with special ink; do not take the initiative to draw it by yourself or by your family members to avoid mistakes or inaccuracy of the treatment site. Some patients with poor physical condition can complete radiotherapy even if they cannot receive surgery or chemotherapy. The systemic reactions of patients in the course of radiotherapy are generally mild, because of the different irradiation sites and volume doses, coupled with physical differences, each patient has different reactions to treatment, a few patients have slight weakness, poor appetite or nausea, and a few other patients have decreased white blood cells; the latter patients are mainly due to bone marrow suppression after chemotherapy or large area radiotherapy, which will be recovered soon after the use of leukocyte-raising drugs. The latter group of patients is mainly caused by bone marrow suppression after chemotherapy or large area radiotherapy, which will recover soon after using leukocyte-raising drugs. 4.The degree of local radiation reaction is related to the size of the irradiated area, the dose level and the presence of other lesions in the tissues and organs. In general, for brain tumor patients, hair may fall out at the irradiated area after head irradiation, but after the end of treatment, hair will generally grow out soon; after irradiation of face and neck, there may be dry mouth; after irradiation of certain dose of chest, pain when swallowing occurs, which is generally tolerable and can continue irradiation, and the pain disappears soon after the end of irradiation; diarrhea occurs after abdominal irradiation, and it will stop soon after the end of irradiation. X. Why do I need to go to the hospital for regular review after radiotherapy? 1. All malignant tumors have the possibility of recurrence and metastasis, and no current treatment can fundamentally eliminate this possibility, but only reduce the chance of recurrence and metastasis. The same is true for radiation therapy. Therefore, patients must go to the hospital regularly for review after radiotherapy in order to find out early and treat recurring tumors in time. 2.Some tumors are not very sensitive to radiation, and the fading is not obvious during radiation therapy, while the tumor will gradually fade after the end of radiation therapy when sufficient amount of irradiation is reached. In this case, patients should strictly follow the doctor’s instructions and go to hospital for regular review so as to make further treatment and treatment according to the situation. Radiation not only kills tumor but also has a killing effect on normal tissues, and the damage of radiation to some normal tissues is a delayed and chronic reaction, which gradually manifests after the end of radiation therapy. Some reactions can be recovered if they are found in time and treated in time, otherwise serious consequences will affect patients’ quality of life. The above-mentioned patients must pay enough attention to the review, do not think that everything is fine after the end of radiation therapy. The time of review can generally be 3-6 months after treatment, and in some cases can be reviewed 1 month after treatment as requested by the doctor. In some cases, it can be reviewed one month after the treatment as requested by the doctor, and then every six months or one year. XI. 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 dysfunction after radiotherapy, but also because the brainstem is irradiated or the radiotherapy field is too large, plus the patient’s mental tension, anxiety, pain, etc. can aggravate these reactions. Some gastrointestinal drugs such as vitamin B 6, gastrofacial or morpholine, pepsin, etc. can be taken to promote gastrointestinal motility 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 a systemic reaction, and 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. During the radiotherapy period, the blood picture should be checked at least once a week to monitor the changes of blood cells, and early symptomatic treatment should be given to ensure the smooth progress of treatment. When the white blood cell is less than 3 X 10 9/liter and platelet is less than 70 X 10 9/liter, radiotherapy should be suspended, and the blood should be raised for symptomatic treatment, and the treatment should be started again after the blood picture recovers. What are the precautions in the course of radiation therapy? 1.The side effects of radiotherapy are mild and much smaller compared with chemotherapy. 2.The irradiation site determined before treatment should not be traced or changed by yourself to avoid missing tumor tissue and injuring healthy tissue. 3.The treatment center should keep the irradiation field markings on the body surface intact and clear, otherwise the attending physician should be consulted in time to determine the body surface markings. 4.Patients should pose well when irradiating as instructed by the doctor. 5.After posing the irradiated part, do not move the irradiated part by yourself, because sometimes the part with symptoms may not be the part where the tumor is located. 6.Do not use medication on your own during the treatment. 7.The doctor will check 1-2 times a week, and each patient will have a fixed time. In case of discomfort, you may not be limited by time, and you should always seek the doctor who is in charge of you for examination and treatment. 8.Be sure to go to the designated treatment room according to the appointment time, do not be late. Note after treatment: 1.After treatment, you should follow the doctor’s request for further examination and treatment. 2.Keep the treatment appointment card at the end of treatment, you can come to the clinic with this card at any time, and you can check the medical history at the time of treatment for the rest of your life. 3.Come to the outpatient clinic for regular review according to the appointment time, and come to the hospital for examination at any time if you feel unwell. 4.If the patient loses contact with the hospital for a long time, the center will write to you regularly or irregularly, please write back according to the content of the question. 5.If tumor recurrence or post-radiation changes are found during the follow-up review, we will try to give active treatment. XIII. What tumors can be treated by radiation therapy? 1.Head and neck tumors: nasopharyngeal cancer, tongue cancer, other oral cancer, malignant tumor of nasal cavity, septal sinus cancer, malignant tumor of maxillary sinus, tonsil cancer, laryngeal cancer, malignant tumor of salivary gland, cancer of external ear and middle ear, eye tumor, thyroid cancer. Thoracic tumors: lung tumors (small cell lung cancer, non-small cell lung cancer, lung metastases), mediastinal tumors, chest wall and pleura tumors, esophageal cancer, cardia cancer, breast cancer. 3.Abdominal malignant tumors: stomach cancer, colon cancer, pancreatic cancer, liver cancer, biliary tract cancer. 4.Urological tumors: kidney cancer, bladder cancer, prostate cancer, testicular malignant tumor, penile cancer. 5.Female reproductive system tumors: cervical cancer, endometrial cancer, ovarian malignant tumor, malignant trophoblastic tumor, vulvovaginal cancer. 6.Tumors of central nervous system: malignant glioma, medulloblastoma, germ cell tumor, malignant lymphoma, deep brain tumor or tumor of major functional area, brain metastasis. 7.Malignant tumors of hematopoietic system: Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, Tumor-like fungal disease, malignant sarcoidosis, multiple myeloma, leukemia. 8.Soft tissue tumor: soft tissue sarcoma 9.Primary bone malignant tumor: osteosarcoma, Ewing’s tumor, giant cell tumor of bone, bone lymphoma, chordoma, fibrosarcoma of bone, vertebral hemangioma, eosinophilic granuloma 10.Skin cancer: malignant melanoma 11.Treatment of metastatic tumor: bone metastasis, brain metastasis, liver metastasis, lung metastatic lesion 12.Part of benign tumor or non-tumor disease: scarring hyperplasia, Plantar warts, etc. Some early malignant tumors have a high cure rate with radiotherapy alone, such as early nasopharyngeal cancer, cervical cancer, vocal cord cancer, Hodgkin’s lymphoma, skin cancer, etc. The 5-year survival rate of early esophageal cancer, prostate cancer, tongue cancer, etc. are similar to surgery, while the functional cosmetic preservation is more satisfactory. Generally, 70%-80% of the tumor patients who come to the hospital are already in the middle and late stage, most of them cannot be operated, or have difficulties in resection, or have contraindications to surgery, or are unwilling to operate, most of them need to perform radiotherapy, and many of them have good results. Radiation therapy also plays an important role in the comprehensive treatment of tumor, such as preoperative, intraoperative and postoperative radiotherapy with surgery; radiotherapy before, during and after chemotherapy with chemotherapy department; and comprehensive treatment with radiotherapy, surgery and chemotherapy. However, radiotherapy cannot cure all diseases, and radiotherapy is divided into pure radical radiotherapy or palliative radiotherapy in terms of treatment purpose. In the past decade, radiation therapy technology has developed rapidly and the era of new precise radiotherapy has arrived. The combination of general radiotherapy with 3D conformal and intensity modulated radiotherapy has greatly expanded the scope of radiotherapy indications, improved the killing power of radiotherapy on tumors and protected normal tissues more effectively. Therefore, it is crucial to grasp the indications for radiotherapy correctly and timely in order to formulate a reasonable comprehensive treatment plan and improve the efficacy of tumor treatment.