Many people have misconceptions about radiation therapy. Some people think that radiation therapy is a life-saving straw for cancer patients, thinking that radiotherapy can cure anything; some people think that radiation therapy has almost no effect on cancer, and cancer patients cannot be cured; others think that radiation therapy has "big side effects" and brings too much pain to patients. As one of the main means of treating malignant tumors, radiation therapy has always been covered with a veil of mystery. Fear stems from the unknown, allowing us to unveil the mystery of radiation therapy and explore the "true face" of radiation therapy.
Radiation therapy is a local treatment method that uses radiation of various different energies to irradiate the mass, thereby inhibiting and killing malignant tumor cells, which can be used alone or combined with surgery, chemotherapy and other methods. The pre-radiotherapy physician will discuss the development of the most appropriate individualized radiotherapy plan based on each patient's detailed medical history, signs, pathology, laboratory and imaging information. Below we take head and neck tumor radiotherapy as an example to introduce the flow of radiation therapy.
First, the body film production
After determining the radiotherapy plan, the doctor, physicist and technician select and formulate a fixed mold according to the specific situation of the patient to ensure good postural repeatability during each radiotherapy, and try to make the patient feel comfortable, reduce the impact of postural change error on accurate radiotherapy, and ensure accurate radiotherapy. At present, the body membranes commonly used in the Department of Head and Neck Radiotherapy of Shandong OTOL Hospital are: head membrane, neck and shoulder membrane, head and neck and shoulder membrane, and body model.
Second, simulated positioning
In order to obtain accurate radiotherapy results, the physician places the patient in accordance with the position of the body membrane when the body membrane is made on the flat CT bed, draws a line mark after determining the position, and then performs a CT scan of the corresponding part according to the requirements of the treatment plan, and after the scan, the image is transmitted directly to the treatment plan workstation through the network.
Third, the target area is outlined
For radiotherapy, the core technology is target delineation, that is, determining the scope of radiotherapy. The physicist will import the image into the planning system for preliminary processing to ensure the high quality of the image. Depending on the size and shape of the mass, the physician outlines the target area and the vital organs that need to be protected at the corresponding CT level. Because cancer cells may metastasize, posing a great challenge to target mapping, radiotherapy doctors need to have solid oncology knowledge and rich clinical experience, determine the area where the tumor may metastasize, and use the appropriate dose to carry out radiation at the time of treatment, while also protecting major organs from radiation damage.
4. Plan evaluation
After determining the scope of radiotherapy, the physicist uses different algorithms to generate the optimal radiotherapy plan according to the doctor's target area and prescription dose requirements, so that the radiation dose is highly concentrated in the target area, while ensuring that the irradiation of the surrounding normal vital organs is controlled within the dose limit range. In addition, in the design of radiotherapy plans, close communication with doctors is required, and complex target plans may have to be repeatedly modified to weigh in. After the plan is designed, the radiotherapy doctor will confirm the plan.
V. Verification and treatment of radiotherapy plans
Theoretical treatment plans need to be validated under actual conditions, with radiotherapy center location validation, field validation, and dose validation performed before the plan is executed. Dose verification is performed by a physicist using a simulated body simulation of the human body to verify that the dose of radiation received in the body is consistent with the radiation dose designed by the planning system. Multiple trials ensure the accuracy of the treatment location, as well as the safety of other organs. Once the validation is passed, the patient can lie flat on the treatment bed, maintain the same position as when positioning, and enter the treatment process.
Radiation therapy is becoming more and more precise, not only has it begun to replace surgery, but it is also evolving to "only hit cancer cells". In addition to radiotherapy, anti-cancer methods such as surgical treatment, chemotherapy, and targeted therapy have made rapid progress. There are more and more cancer patients now, but cancer mortality is decreasing. I believe that one day in the future, human beings will eventually be able to overcome cancer!
Department Profile: Head and Neck Radiotherapy
The Department of Radiation Therapy for Oncology Head and Neck of Shandong ENT Hospital has the world's most advanced radiation therapy equipment and treatment planning system. At present, there are more than 40 professional and technical personnel in various types of medical and nursing technology, and the doctor team is all master's degree or above.
According to the professional characteristics, a new model of non-surgical radical treatment of early parenchymal organ tumors and multidisciplinary comprehensive treatment of advanced tumors has been created. At present, the comprehensive treatment of head and neck tumors (various brain tumors, nasopharyngeal cancer, oral cancer, oropharyngeal cancer, hypopharyngeal cancer, laryngeal cancer, salivary gland tumor, nasal sinus tumor, temporal bone tumor, etc.) and chest tumor (lung cancer, esophageal cancer, breast cancer, mediastinal tumor, etc.) is mainly carried out. Radiotherapy techniques are based on intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiation therapy (3DCRT).
Featured medical projects carried out by the department include:
1. Comprehensive treatment of tumor head and neck: The Department of Otolaryngology of our hospital is a national key specialty, and the number of patients with head and neck tumors treated every year reaches thousands of cases, and the head and neck tumor treatment center is one of the largest treatment centers in China, and a number of comprehensive treatments for head and neck squamous cell carcinoma, recurrent metastatic head and neck cancer, including targeted therapy and immunotherapy, have achieved good expected results, improved the local control rate of head and neck tumor patients, and prolonged the survival period. Patients with head and neck tumors admitted to our hospital must enter the treatment mode in line with individualized characteristics after discussion by MDT (multidisciplinary discussion) experts including surgery, radiotherapy, imaging, and pathology, and the radiotherapy department is an important part of it. We have extensive experience in the treatment of radical chemoradiotherapy, targeted drug therapy, preoperative and postoperative chemoradiotherapy, and recurrent metastatic head and neck tumors.
2. People-oriented individualized treatment: the treatment of malignant tumors has entered the era of comprehensive treatment, according to the patient's body condition, tumor pathology type, clinical staging and development trend, etc., scientifically, rationally and systematically apply the existing surgery, radiotherapy, chemotherapy, biological immunotherapy, targeted drug therapy, and cooperate with the Department of Traditional Chinese Medicine to screen patients suitable for traditional Chinese medicine treatment with traditional Chinese medicine adjuvant therapy, the greatest improvement of the cure rate of tumor patients and improve the quality of life of patients.
Expert Profile:
Wei Yumei, Deputy Chief Physician, Director of head and neck radiotherapy, Postdoctoral Fellow of Tianjin Medical University, Ph.D. of Shandong University
Advantages: Good at head and neck tumors and chest tumors of radiotherapy and chemotherapy, targeted and immunotherapy. He has accumulated rich experience in the treatment of radical chemoradiotherapy, neoadjuvant and adjuvant therapy, and recurrent and metastatic tumors of head and neck tumors and thoracic tumors. Concurrently: Member of the Nasopharyngeal Cancer Group of the Chinese Medical Association, Youth Member of the Nasopharyngeal Carcinoma Branch of the Chinese Anti-Cancer Association, Vice Chairman of the Head and Neck Professional Group of the Radiotherapy Branch of the Shandong Medical Doctor Association, Standing Committee Member of the Otolaryngology Head and Neck Surgery Branch of the Shandong Geriatrics Association, Member of the Radiation Therapy Branch of the Shandong Medical Association, Member of the Psychology Branch of the Shandong Rehabilitation Medicine Association, And Member of the Tumor Group of the Shandong Regenerative Medicine Association. He has been awarded the title of "Excellent Physician" of the hospital for many times.