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National Cancer Data Base - Data Dictionary PUF 2015

Radiation

Reason For No Radiation

DD_category: 
PUF Data Item Name: 
REASON_FOR_NO_RADIATION
NAACCR Item #: 
1430
length: 
1
Allowable values: 
0 – 2, 5 – 9
Description: 
Records the reason that no regional radiation therapy was administered to the patient.
Registry Coding Instructions: 
  • If Regional Treatment Modality (NAACCR Item #1570) is coded 00, then record the reason based on documentation in patient record.
  • Code 1 if the treatment plan offered multiple options and the patient selected treatment that did not include radiation therapy.
  • Code 7 if the patient refused recommended radiation therapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Cases coded 8 should be followed and updated to a more definitive code as appropriate.
  • Code 9 if the treatment plan offered multiple options, but it is unknown which treatment, if any, was provided.
Analytic Note: 

Prior to the implementation of FORDS in 2003, the information recorded in this item was limited to the content recorded as 0, 1, 7, 8 and 9.

Radiation Ended, Days from Start of Radiation

DD_category: 
PUF Data Item Name: 
RAD_ELAPSED_RX_DAYS
length: 
3
Allowable values: 
0 - 999
Description: 
For diagnosis years prior to 2003, this item uses a single ROADS item containing the number of elapsed days between the start and end of radiation. For diagnosis years 2003 and later, this item is calculated as the number of days between the date radiation started (NAACCR Item #1210) and the date on which radiation therapy ended (NAACCR Item #3220). 1 is added to the number of days elapsed. This means that if radiation starts and ends on the same date, then 1 day has elapsed, if radiation ends the day after it is started, then 2 days have elapsed, and so on.
Registry Coding Instructions: 

None.

Code Definition
0 None, radiation not administered
1-998 Number of elapsed days
999 Missing or incomplete dates for radiation start and end, days elapsed missing, or unknown if had radiation


Radiation Surgery Sequence

DD_category: 
PUF Data Item Name: 
RX_SUMM_SURGRAD_SEQ
NAACCR Item #: 
1380
length: 
1
Allowable values: 
0, 2-6, 9
Description: 
Records the sequencing of radiation and surgical procedures given as part of the first course of treatment.
Registry Coding Instructions: 
  • Surgical procedures include Surgical Procedure of Primary Site (NAACCR Item #1290); Scope of Regional Lymph Node Surgery (NAACCR Item #1292); Surgical Procedure/Other Site (NAACCR Item #1294). If none of these procedures was performed and/or if no radiation therapy was administered then this item is coded 0.
  • If the patient received both radiation therapy and any one or a combination of the following surgical procedures: Surgical Procedure of Primary Site, Regional Lymph Node Surgery, or Surgical Procedure/Other Site, then code this item 2–9, as appropriate.
Analytic Note: 

This item is reported as an optional item per the ROADS manual for cases diagnosed between January 1, 1996, and December 31, 2002, and required thereafter. For cases diagnosed December 31, 2002 and earlier where this item was not reported, a value was imputed from the following ROADS items: Radiation Therapy (NAACCR Item# 1350); Date Radiation Started (NAACCR Item# 1210); Surgical Procedure of Primary Site (NAACCR Item #1290); Scope of Regional Lymph Node Surgery (NAACCR Item #1292); Surgical Procedure/Other Site (NAACCR Item #1294); and Date of Definitive Surgery (NAACCR Item #3170) have been used to assign this item.

Beginning with 2010 diagnoses, when it is unknown whether radiation and/or surgery was performed, the code assigned changed from 9 to 0. It is likely a shift in distribution of these two codes may be noticeable around that time.

Number of Treatments to this Volume

DD_category: 
PUF Data Item Name: 
RAD_NUM_TREAT_VOL
NAACCR Item #: 
1520
length: 
3
Allowable values: 
000 – 999
Description: 
Records the total number of treatment sessions (fractions) administered during the first course of treatment.
Registry Coding Instructions: 
  • The number of treatments or fractions will typically be found in the radiation oncologist’s summary letter for the first course of treatment. Determination of the exact number of treatments or fractions delivered to the patient may require assistance from the radiation oncologist for consistent coding.
  • Although a treatment session may include several treatment portals delivered within a relatively confined period of time—usually a few minutes—it is still considered one session.
  • The total number of treatment sessions (fractions) is the sum of the number of fractions of regional treatment and the number of fractions of boost treatment.
  • Count brachytherapy or implants as a single treatment or fraction.
Analytic Note: 

This item is reported as an optional item per the ROADS manual for cases diagnosed between January 1, 1996 and December 31, 2002, and required thereafter.

Boost Dose

DD_category: 
PUF Data Item Name: 
RAD_BOOST_DOSE_CGY
NAACCR Item #: 
3210
length: 
5
Allowable values: 
00000 – 88887, 88888, 99999
Description: 
Records the additional dose delivered to that part of the treatment volume encompassed by the boost fields or devices. The unit of measure is centiGray (cGy).
Registry Coding Instructions: 
  • The International Council for Radiation Protection (ICRP) recommends recording doses at the axis point where applicable (opposed fields, four field box, wedged pair, and so on). For maximum consistency in this data item, the ICRP recommendations should be followed whenever possible. Where there is no clear axis point, record the dose as indicated in the summary chart. Consult the radiation oncologist for the exact dose, if necessary.
  • Radiation boost treatment dose will typically be found in the radiation oncologist’s summary letter for the first course of treatment. Determination of the additional boost dose of radiation therapy may require assistance from the radiation oncologist for consistent coding.
  • Do not include the regional dose. In general, the boost dose will be calculated as the difference between the maximum prescribed dose and the regional dose. Many patients will not have a boost.
  • Code 88888 when brachytherapy or radioisotopes—codes 50–62 for Boost Treatment Modality (NAACCR Item #3200)—were administered to the patient.
  • Note that dose is still occasionally specified in “rads.” One rad is equivalent to one centiGray (cGy).
  • There may be times when the first course of treatment information is incomplete. Therefore, it is important to continue follow-up efforts to be certain the complete treatment information is collected.
Analytic Note: 

This item was only reported using FORDS diagnosed January 1, 2003, and later.

Boost Treatment Modality

DD_category: 
PUF Data Item Name: 
RAD_BOOST_RX_MODALITY
NAACCR Item #: 
3200
length: 
2
Allowable values: 
00, 20-32, 50-55, 60-62, 98, 99
Description: 
Records the dominant modality of radiation therapy used to deliver the most clinically significant boost dose to the primary volume of interest during the first course of treatment. This is accomplished with external beam fields of reduced size (relative to the regional treatment fields), implants, stereotactic radiosurgery, conformal therapy, or IMRT. External beam boosts may consist of two or more successive phases with progressively smaller fields generally coded as a single entity.
Registry Coding Instructions: 
  • Radiation boost treatment modalities will typically be found in the radiation oncologist’s summary letter for the first course of treatment. Segregation of treatment components into regional and boost and determination of the respective treatment modality may require assistance from the radiation oncologist to ensure consistent coding.
  • In the event that multiple radiation therapy boost modalities were employed during the treatment of the patient, record only the dominant modality.
  • Note that in some circumstances, the boost treatment may precede the regional treatment.
  • For purposes of this field, photons and x-rays are equivalent.
Analytic Note: 

This item was only reported using FORDS diagnosed January 1, 2003, and later.

Regional Dose

DD_category: 
PUF Data Item Name: 
RAD_REGIONAL_DOSE_CGY
NAACCR Item #: 
1510
length: 
5
Allowable values: 
00000 – 88887, 88888, 99999
Description: 
Records the dominant or most clinically significant total dose of regional radiation therapy delivered to the patient during the first course of treatment. The unit of measure is centiGray (cGy).
Registry Coding Instructions: 
  • The International Council for Radiation Protection (ICRP) recommends recording doses at the axis point where applicable (opposed fields, four field box, wedged pair, and so on). For maximum consistency in this data item, the ICRP recommendations should be followed whenever possible. Where there is no clear axis point, record the dose as indicated in the summary chart. Determining the exact dose may be highly subjective and require assistance from the radiation oncologist for consistent coding.
  • Regional dose will typically be found in the radiation oncologist’s summary letter for the first course of treatment. Determination of the total dose of regional radiation therapy may require assistance from the radiation oncologist for consistent coding.
  • Do not include the boost dose, if one was administered.
  • Code 88888 when brachytherapy or radioisotopes—codes 50–62 for Regional Treatment Modality (NAACCR Item #1570)—were administered to the patient.
  • Note that dose is still occasionally specified in “rads.” One rad is equivalent to one centiGray (cGy).
Analytic Note: 

This item is reported as an optional item per the ROADS manual for cases diagnosed between January 1, 1996 and December 31, 2002, and required thereafter.

Regional Treatment Modality

DD_category: 
PUF Data Item Name: 
RAD_REGIONAL_RX_MODALITY
NAACCR Item #: 
1570
length: 
2
Allowable values: 
00, 20-32, 50-55, 60-62, 98, 99
Description: 
Records the dominant modality of radiation therapy used to deliver the most clinically significant regional dose to the primary volume of interest during the first course of treatment.
Registry Coding Instructions: 
  • Radiation treatment modality will typically be found in the radiation oncologist’s summary letter for the first course of treatment. Segregation of treatment components into regional and boost and determination of the respective treatment modality may require assistance from the radiation oncologist to ensure consistent coding.
  • In the event multiple radiation therapy modalities were employed in the treatment of the patient, record only the dominant modality.
  • Note that in some circumstances the boost treatment may precede the regional treatment.
  • For purposes of this data item, photons and x-rays are equivalent.
Analytic Note: 

This item is reported as an optional item per the ROADS manual for cases diagnosed between January 1, 1996, and December 31, 2002, and required thereafter. For cases diagnosed December 31, 2002 and earlier where this item was not reported, an imputed value from the ROADS radiation therapy item (NAACCR Item# 1350) has been used to assign this item.

Codes 80 and 85 retain specific converted descriptions of radiation therapy coded according to ROADS and DAM rules, and were not to be used to record regional radiation for cases diagnosed January 1, 2003, or later.

Radiation Treatment Volume

DD_category: 
PUF Data Item Name: 
RAD_TREAT_VOL
NAACCR Item #: 
1540
length: 
2
Allowable values: 
00-41, 50, 60, 98, 99
Description: 
Identifies the volume or anatomic target of the most clinically significant regional radiation therapy delivered to the patient during the first course of treatment.
Registry Coding Instructions: 

Radiation treatment volume will typically be found in the radiation oncologist’s summary letter for the first course of treatment. Determination of the exact treatment volume may require assistance from the radiation oncologist for consistent coding.
If two discrete volumes are treated and one of those includes the primary site, record the treatment to the primary site.

Analytic Note: 

This item is reported as an optional item per the ROADS manual for cases diagnosed between January 1, 1996, and December 31, 2002, and required thereafter.

Location of Radiation Therapy

DD_category: 
PUF Data Item Name: 
RAD_LOCATION_OF_RX
NAACCR Item #: 
1550
length: 
1
Allowable values: 
0-4, 8, 9
Description: 
Identifies the location where radiation therapy was administered during the first course of treatment, as "at the reporting facility" or "elsewhere".
Registry Coding Instructions: 

If the radiation treatment 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 radiation administered in the items Palliative Care (NAACCR Item #3270) and/or Palliative Care at This Facility (NAACCR Item #3280), as appropriate.

Analytic Note: 

This item is reported as an optional item per the ROADS manual for cases diagnosed between January 1, 1996, and December 31, 2002, and required by FORDS thereafter.

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