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National Cancer Data Base - Data Dictionary PUF 2014

Chemotherapy

DD_category: 
PUF Data Item Name: 
RX_SUMM_CHEMO
NAACCR Item #: 
1390
length: 
2
Allowable values: 
00 – 03, 82, 85 – 88, 99
Description: 
Records the type of chemotherapy administered as first course treatment at any facility. If chemotherapy was not administered, then this item records the reason it was not administered to the patient. Chemotherapy consists of a group of anticancer drugs that inhibit the reproduction of cancer cells by interfering with DNA synthesis and mitosis.
Registry Coding Instructions: 

·         Code 00 if chemotherapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
·         Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include chemotherapy.
·         If it is known that chemotherapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
·         Code 87 if the patient refused recommended chemotherapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
·         Code 99 if it is not known whether chemotherapy is usually administered for this type and stage of cancer and there is no mention in the patient record whether it was recommended or administered.
·         If the managing physician changes one of the agents in a combination regimen, and the replacement agent belongs to a different group (chemotherapeutic agents are grouped as alkylating agents, antimetabolites, natural products, or other miscellaneous) than the original agent, the new regimen represents the start of subsequent therapy, and only the original agent or regimen is recorded as first course therapy.
·         Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for coding of chemotherapeutic, hormonal and immunotherapies.
·         If chemotherapy was provided to prolong a patient’s life by controlling symptoms, to alleviate pain, or to make the patient more comfortable, then also record the chemotherapy administered in the item Palliative Care (NAACCR Item #3270).
 
Update for 2013 PUF: Six drugs previously classified as Chemotherapy are now classified as BRM/Immunotherapy. This change in classification is effective only for cases diagnosed in January 1st, 2013 and forward. While the NCDB does not provide drug-specific data, changes in case counts may be observed for the Chemotherapy and Immunotherapy variables for cases diagnosed in 2013 due to the change in classification. The drugs are: Alemtuzumab/Campath, Bvacizumab/Avastin, Rituximab, Trastuzumab/Herceptin, Pertuzumab/Perjeta, and Cetuxumab/Erbitux.

Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources.  Chemotherapy treatment may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file.  This refers to chemotherapy to treat the cancer by any facility. 

Code

Definition

00

None, chemotherapy was not part of the planned first course of therapy.  Diagnosed at autopsy.

01

Chemotherapy administered as first course therapy, but the type and number of agents is not documented in patient record.

02

Single-agent chemotherapy administered as first course therapy.

03

Multiagent chemotherapy administered as first course therapy.

82

Chemotherapy was not recommended/administered because it was contraindicated due to patient risk factors (ie, comorbid conditions, advanced age).

85

Chemotherapy was not administered because the patient died prior to planned or recommended therapy.

86

Chemotherapy was not administered. It was recommended by the patient's physician, but was not administered as part of the first course of therapy. No reason was stated in patient record.

87

Chemotherapy was not administered. It was recommended by the patient's physician, but this treatment was refused by the patient, a patient's family member, or the patient's guardian. The refusal was noted in patient record.

88

Chemotherapy was recommended, but it is unknown if it was administered.

99

It is unknown whether a chemotherapeutic agent(s) was recommended or administered because it is not stated in patient record. Death certificate only.