Cancer treatment—radiotherapy treatment type, code N[N]

Guide for use:

External beam radiotherapy (EBRT) is delivered by directing the radiation at the tumour from outside the body. Types of external beam radiotherapy include conventional EBRT, intensity modulated radiation therapy (IMRT) and 3-dimensional conformal radiotherapy (3D-CRT).

Brachytherapy is delivered by placing the radiation source in close proximity to the tumour site. The radioactive isotopes are sealed in tiny pellets or “seeds” which are placed in the body using delivery devices such as needles or catheters. Types include interstitial brachytherapy, which uses a source placed within tumour tissue, for example, within a prostate tumour; and intracavitary brachytherapy, whereby the source is placed within a surgical cavity or a body cavity. Brachytherapy can involve the temporary or permanent placement of radioactive sources.

Unsealed radioisotopes or systemic radioisotope therapy is delivered by infusion into the bloodstream or by ingestion and is a form of targeted therapy. Targeting can be due to the chemical properties of the isotope, for example, radioiodine is specifically absorbed by the thyroid gland. It can also be achieved by attaching the radioisotope to another molecule or antibody to guide it to the target tissue. Examples of treatment with unsealed radioisotopes include the infusion of metaiodobenzylguanidine (MIBG) to treat neuroblastoma and of oral iodine-131 to treat thyroid cancer.

Radiotherapy treatment type is collected for all courses of radiotherapy delivered to the patient during the initial course of treatment. The initial course of treatment includes all treatments administered to the patient from diagnosis and before disease progression or recurrence.

The radiotherapy treatment type is recorded regardless of whether the course of treatment is completed as intended, and regardless of the intent or timing of treatment.

More than one radiotherapy treatment type may be administered during the initial course of treatment; select the appropriate code value.

If external beam radiotherapy and/or brachytherapy were administered, the radiation dose received and number of fractions should also be collected as well as the start and finish dates of the radiotherapy.

Most external beam radiotherapy is delivered on an outpatient basis.

Brachytherapy is likely to be delivered to admitted patients.

Commission on Cancer, American College of Surgeons

New South Wales Health Department