Organization

Field Name

ID

Required

KCR

Boost Tx Modality (RadBoostMod)

50340

no

NAACCR

Rad--Boost RX Modality

3200

no


Field Length: 2

Description

Records the dominant modality of radiation therapy used to deliver he 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. It is an optional field and it is only required for data entry to ACoS flagged hospitals.

Rationale

Radiation treatment is frequently delivered in two or more phases which can be summarized as "regional" and "boost" treatments. To evaluate patterns of radiation oncology care, it is necessary to know which radiation resources were employed in the delivery of therapy. For outcomes analysis, the modalities used for each of these phases can be very important.

Instructions for Coding

  • 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.

Code

Label

Description

00

No boost treatment

A boost dose was no administered to the patient.

20

External beam, NOS     

The treatment is known to be by external beam, but there is insufficient information to determine the specific modality.

21

Orthovoltage                            

External beam therapy administered using equipment with a maximum energy of less than one (1) million volts (MV). Orthovoltage energies are typically expressed in units of kilovolts (kV).

22

Cobalt-60, Cesium-137

External beam therapy using a machine containing either a Cobalt-60 or Cesium-137 source. Intracavitary use of these sources is coded either 50 or 51.

23

Photons (2-5 MV)                    

External beam therapy using a photon producing machine with a beam energy in the range of 2-5 MV.

24

Photons (6-10 MV)                 

External beam therapy using a photon producing machine with a beam energy in the range of 6-10 MV.

25

Photons (11-19 MV)               

External beam therapy using a photon producing machine with a beam energy in the range of 11-19 MV.

26

Photons (>19 MV)                  

External beam therapy using a photon producing machine with a beam energy of more than 19 MV.

27

Photons (mixed energies)          

External beam therapy using more than one energy over the course of treatment.

28

Electrons                                 

Treatment delivered by electron beam.

29

Photons and electrons mixed

Treatment delivered using a combination of photon and electron beams.

30

Neutrons, with or without photons/electrons

Treatment delivered using neutron beam.

31

IMRT                                      

Intensity modulated radiation therapy, an external beam technique that should be clearly stated in patient record.

32

Conformal or 3-D therapy        

An external beam technique using multiple, fixed portals shaped to conform to a defined target volume. Should be clearly described as conformal or 3-D therapy in patient record.

40

Protons

Treatment delivered using proton therapy.

41

Stereotactic radiosurgery, NOS

Treatment delivered using stereotactic radiosurgery, type not specified in patient record.

42

   Linac radiosurgery

Treatment categorized as using stereotactic technique delivered with a linear accelerator.

43

Gamma Knife

Treatment categorized as using stereotactic technique delivered using a Gamma Knife machine.

50

Brachytherapy, NOS

Brachytherapy, interstitial implants, molds, seeds, needles, or intracavitary applicators of radioactive materials not otherwise specified.  Includes radioembolization.

51

Brachytherapy, Intracavity, LDR

Intracavitary (no direct insertion into tissues) radio-isotope treatment using low dose rate applicators and isotopes (Cesium-137, Fletcher applicator).

52

Brachytherapy, Intracavity, HDR

Intracavitary (no direct insertion into tissues) radio-isotope treatment using high dose rate after-loading applicators and isotopes.

53

Brachytherapy, Interstitial, LDR

Interstitial (direct insertion into tissues) radioisotope treatment using low dose rate sources.

54

Brachytherapy, Interstitial, HDR

Interstitial (direct insertion into tissues) radioisotope treatment using high dose rate sources.

55

Radium

Infrequently used for low dose rate (LDR) interstitial and intracavitary therapy.

60

Radioisotopes, NOD 

Iodine-131, Phosphorus-32, etc.

61

Strontium-89  

Treatment primarily by intravenous routes for bone metastases.

62

Strontium-90 


98

Other, NOS

Radiation therapy administered, but the treatment modality is not specified or is unknown.

99

Unknown

It is unknown whether boost treatment was administered.