It takes time to design radiotherapy plan, too many Chinese doctors are too busy, and it is difficult to satisfy both quality and efficiency. Chinese tumor patients, and even doctors, are not aware of “radiotherapy planning”, which often leads to poor results of radiotherapy and delays in patient treatment. “Radiation treatment planning” is to determine the irradiation mode with the help of special computer system, to calculate the dose distribution of different treatment methods, and to select the most reasonable dose distribution plan for tumor treatment according to the calculation results, and to implement it. Radiation treatment planning is the pivotal link in the realization of radiotherapy technology, especially precision radiotherapy technology. The formulation of radiotherapy treatment plan directly affects the accuracy of treatment. There is a general lack of attention to radiation treatment planning in China. The importance of radiation treatment planning is similar to a prescription as commonly understood by the public. Imagine how it is possible to cure a disease if the doctor prescribes a dose of medication that is insufficient or the wrong way to take it. There are many cases in radiation therapy in China where the patient’s treatment was delayed because the radiation treatment plan was not designed properly. In some cases of tumors that could have been cured, the dose designed in the radiation treatment plan was not sufficient to cure the tumor at all, and the patient was treated for nothing; in other cases, the radiation treatment plan was not designed with reasonable dose distribution, resulting in damage to normal tissues and organs around the tumor, which increased the patient’s pain. On the other hand, the design of an excellent radiation treatment plan usually takes 1 to 3 days, and the volume of Chinese patients is so large that doctors and physiotherapists are simply too busy to achieve both quality and efficiency. Therefore, radiation treatment planning should be one of the most important aspects for Chinese hospitals to improve the level of radiotherapy and even oncology treatment. Many hospitals in the United States are now using advanced radiation treatment planning software to design radiation treatment plans, which are then reviewed and implemented collaboratively by physicians, physicists, and dosimetrists. This artificially intelligent radiation treatment planning software can reduce human-caused errors, improve the accuracy of radiation treatment planning, and enhance patients’ post-operative survival time and quality of life. At the same time, the radiation treatment planning software can also improve the efficiency of hospital doctors and physicists and greatly alleviate the problem of medical resource shortage. It is believed that advanced radiation treatment planning software will also become a trend in the future. Correct understanding of radiation therapy More than half of the tumors in the United States are cured by radiation therapy Among the treatment methods of cancer, human beings have explored surgical resection, chemotherapy and radiotherapy. Surgical resection and chemotherapy have been widely known, while radiation therapy, as one of the cancer treatment methods, has a late start from the direction of medical development, resulting in many people, including doctors, still have a slightly insufficient understanding of it. Conventional radiotherapy refers to photon therapy, while proton therapy is relatively more new technology. According to statistics, among all tumor treatments in the United States, about 70% of patients need radiation therapy; 70% of them are radical or involved in radical treatment, including playing a major or adjuvant role in radical treatment; and among these 70% of radical (involved in radical) treatment, 70-80% of patients are cured; that is, 35-40% of all tumor patients receiving radiation therapy are cured. Of the patients treated with radiation therapy, 35-40% were cured. In the United States, the overall cure rate for tumors is approximately 60-70%, meaning that more than half of all tumors are cured by, or with the involvement of, radiation therapy. The data show that less than 14% of all oncology treatment costs are spent on radiation therapy, i.e., we cure/participate in curing 40% of oncology patients with less than 14% of society’s resources, not to mention its role in other areas such as palliative care. It can be said that radiation therapy is one of the treatments with the highest efficacy ratio when the indications are met. And for many cancer patients, radiation therapy is even the only treatment that is necessary. Many patients have some misconceptions about radiation therapy, for example, they think that radiation therapy is only a palliative treatment and surgery is the only curative treatment, that radiation can “cause” cancer rather than “cure” it, and that they are afraid of the side effects of radiation therapy. All these concepts are actually wrong. First of all, there are many data showing that in the treatment of early-stage lung cancer, the cure rate and survival of radiation therapy with stereotactic guidance is no different from that of surgical resection, and there are even data published in some major journals showing that in some cases, radiation therapy is more effective than surgical resection. Secondly, radiation therapy nowadays is generally well protected for doctors and patients, and there is no chance of radiation “causing” cancer. In fact, radiation is not terrible, we are exposed to radiation every day in our daily life. Radiation itself is certainly not beneficial to the human body and can be avoided if not needed, but from the point of view of tumor treatment, the significance of this dose to tumor treatment is much greater compared to the possible side effects. Finally, and in terms of side effects, there are actually side effects to everything. Any surgical procedure also has side effects. For example, the mortality rate of lung cancer patients who die from surgical complications within 30 days of surgery is 5%, and 5 out of 100 patients may die from complications, but in comparison, radiation therapy in the early stage of lung cancer treatment does not say that they die from radiation therapy within 30 days. It is understandable that people are more receptive to traditional surgical methods because surgical treatment has existed for 100 years, and it is more difficult for them to accept new treatment methods. The effect is also very obvious. In China, many tumor patients do not have good radiotherapy effect. In addition to the reasons of the disease itself, there are also several reasons: (1) In China, many young doctors do not go through formal training, often to that department is the level of that department, the level of superior doctors is limited, and the level of subordinate doctors is not high. (2) the defects of the domestic accreditation system: in China, in order to promote, many doctors put their main energy into writing articles, doing topics, human energy is limited, often put time into the clinical limited, in almost every large hospital there are such a group of doctors, very famous at home and abroad, doctor, well-known professor, doctoral director and so on a series of titles, but just can not see patients, because patients do not understand these, often put These patients as a lifesaver, but harmed the life of the Secretary! (3) the different learning ability of individual doctors, for example, RTOG0617 experiment has harmed many people at home and abroad, the conclusion of this topic is that the survival of lung cancer radiotherapy 74Gy and 60Gy is comparable, so many “experts” at home and abroad to 60Gy as the standard of treatment, which has harmed many people, RTOG73-01 early conclusion, 60Gy, 5 years RTOG73-01 concluded that the 5-year survival rate was only 5% for 60Gy. How to interpret this experiment? In principle, the dose of radiotherapy and the efficacy are correlated, the higher the dose, the better the efficacy. The reason for the comparable efficacy of this experiment is that a group of patients died from radiotherapy complications at 74 Gy. The patients are very different and each patient is an individual. In fact, the authors did not mean to say that patients should be treated with 60Gy, not 74Gy, which is a misunderstanding of many people. 2.Is conformal radiotherapy or normal radiotherapy better? In clinical practice, we found that some patients with esophageal cancer have better results with normal radiotherapy than conformal radiotherapy or intensity modulated radiotherapy, and some patients with lung cancer also have the same conclusion, and after taking a closer look at these patients with poor radiotherapy results, we found that the doctors in charge over-relied on the imaging lesions, and the tumors have microinfiltration, so the excessive conformal often caused the insufficient dose of target area prevention. In general radiotherapy, our field is at least 3cm above and 4cm below the esophageal lesion, but in conformal radiotherapy, if we expand 1cm or even 0.5cm on the basis of the imaging lesion, it often results in insufficient preventive dose; another reason is that some physicists are too concerned about the uniformity of the dose in the disease area and use multifield irradiation for this purpose, which leads to an excessive amount of normal lung tissue. In fact, the recurrence of many lesions is related to insufficient dose. In order to improve the dose, we often need to sacrifice the uniformity of dose in the target area to achieve the therapeutic amount of lesions. 3.Is radiotherapy a large dose for a small target area or a conventional dose for a large target area? In fact, these two views are not wrong, what is wrong is the excessive reliance of some doctors, the small target area view is not to do prevention, or even do small prevention, significantly improve the local dose to achieve the purpose of curing the lesion, this view has some truth, but need to be suitable for the conditions, for example, the lung lesion, the lung dynamics itself is very large, if you use the practice of non-prevention, many times led to off-target, not you prevent not to Prevention of things, is your own lesions have not reached the amount of treatment, so it led to the poor results of some patients, and because of the increase in dose, resulting in an increase in radiation pneumonia, so that some doctors finally became a small target area small dose, the patient’s cure rate is further reduced, any theory has its adaptation conditions and quality control assurance, if not achieved, any good theory finally becomes just a theory, the system error, positional error, human error, and theoretical. Systematic errors, positional errors, human errors, etc., lead to the reduction of the efficacy of radiotherapy. In the treatment of specific diseases, because of the great diversity of patients, individualized treatment is very necessary, and providing individual treatment for each patient is a problem that every physician needs to think about.