Organization

Field Name

ID

Required

KCR

Rad Treatment Volume (RadVolume)

50310

no

NAACCR

Rad--Treatment Volume

1540

no


Field Length: 2

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. It is an optional field and it is only required for data entry to ACoS flagged hospitals.

Rationale

This data item provides information describing the anatomical structures targeted by the regional radiation therapy and can be used to determine whether the site of the primary disease was treated with radiation or if other regional or distant sites were targeted. This information is useful in evaluating the patterns of care within a facility (local analysis of physician practices) and on a regional or national basis.

Instructions for Coding

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.

Code

Label

Description

01

Eye/orbit 

The radiation therapy target volume is limited to the eye and/or orbit.

02

Pituitary                                    

The target volume is restricted to the pituitary gland and all adjacent volumes are irradiated incidentally.

03

Brain (NOS)                            

Treatment is directed at tumors lying within the substance of the brain, or its meninges.

04

Brain (limited)                           

The treatment volume encompasses less than the total brain, or less than all of meninges.

05

Head and Neck (NOS)           

 The treatment volume is directed at a primary tumor o the oropharyngeal complex, usually encompassing regional lymph nodes.

06

Head and Neck (limited)          

 Limited volume treatment of a head and neck primary with the exception of glottis (code 8), sinuses (code 9), or parotid (code 10).

07

Glottis                                      

Treatment is limited to a volume in the immediate neighborhood of the vocal cords.

08

Sinuses                                    

The primary target is one or both of the maxillary sinuses or the ethmoidal frontal sinuses. In some cases, the adjacent lymph node regions may be irradiated.

09

Parotid                                    

 The primary target is one of the parotid glands. There may be secondary regional lymph node irradiation as well.

10

Chest/lung (NOS)                    

 Radiation therapy is directed to some combination of hilar, mediastinal, and/or supraclavicular lymph nodes, and/or peripheral lung structures.

11

Lung (limited)                           

Radiation therapy is directed at one region of the lung without nodal irradiation.

12

Esophagus                                

The primary target is some portion of the esophagus. Regional lymph nodes may or may not be included in the treatment. Include tumors of the gastroesophageal junction.

13

Stomach                                  

 The primary malignancy is in the stomach. Radiation is directed to the stomach and possibly adjacent lymph nodes.

14

Liver                                        

The primary target is all or a portion of the liver, for either primary or metastatic disease.

15

Pancreas                                 

The primary tumor is in the pancreas. The treatment field encompasses the pancreas and possibly adjacent lymph node regions.

16

Kidney                                     

The target is primary or metastatic disease in the kidney or the kidney bed after resection of a primary kidney tumor. Adjacent lymph node regions may be included in the field.

17

Abdomen (NOS)                     

Include all treatment of abdominal contents that do not fit codes 12-16.

18

Breast                                      

The primary target is the intact breast and no attempt has been made to irradiate the regional lymph nodes.

19

Breast/lymph nodes                  

A deliberate attempt has been made to include regional lymph nodes in the treatment of an intact breast.

20

Chest wall

Treatment encompasses the chest wall (following mastectomy).

21

Chest wall/lymph nodes            

Treatment encompasses the chest wall (following mastectomy) plus fields directed at regional lymph nodes.

22

Mantle, mini-mantle

Treatment consists of a large radiation field designed to encompass all of the regional lymph nodes above the diaphragm, including cervical, supraclavicular axillary, mediastinal, and hilar nodes (mantel), or most of them (mini-mantle). This code is used exclusively for patients with Hodgkin’s or non-Hodgkin’s lymphoma.

23

Lower extended field                

The target zone includes lymph nodes below the diaphragm along th paraaortic chain. It may include extension to one side of the pelvis. This code includes the 'hockey stick' field utilized to treat seminomas.

24

Spine                                        

The primary target relates to the bones of the spine, including the sacrum. Spinal cord malignancies should be coded 40 (Spinal cord).

25

Skull                                         

Treatment is directed at the bones of the skull. Any brain irradiation is a secondary consequence.

26

Ribs

Treatment is directed toward metastatic disease in one or more ribs. Fields may be tangential or direct.

27

Hip

The target includes the proximal femur for metastatic disease. In many cases there may be acetabular disease as well.

28

Pelvic Bones

The target includes structures of the bones of the pelvis other than the hip or sacrum.

29

Pelvis (NOS)

Irradiation is directed at soft tissues within the pelvic region and codes 34-36 do not apply.

30

Skin

The primary malignancy originates in the skin and the skin is the primary target. So-called skin metastasis are usually subcutaneous and should be coded 31 (soft tissue).

31

Soft tissue

All treatment of primary or metastatic soft tissue malignancies not fitting other categories.

32

Hemibody

A single treatment volume encompassing either all structures above the diaphragm, or all structures below the diaphragm. This is almost always administered for palliation of widespread bone metastasis in patients with prostate or breast cancer.

33

Whole body

Entire body included in a single treatment.

34

Bladder and pelvis

The primary malignancy originated in the bladder, all or most of the pelvis is treated as prat of the plan, typically with a boost to the bladder.

35

Prostate and pelvis

The primary malignancy originated in the prostate, all or most of the pelvis is treated as part of the plan, typically with a boost to the prostate.

36

Uterus and cervix

Treatment is confined to the uterus and cervix or vaginal cuff, usually by intracavitary or interstitial technique. If entire pelvis is included in a portion of the treatment, then code 29 (Pelvis, NOS).

37

Shoulder

Treatment is directed to the proximal humerus, scapula, clavicle, or other components of the shoulder complex. This is usually administered for control of symptoms for metastasis.

38

Extremity bone, NOS

Bones of the arms or legs. This excludes the proximal femur, code 27 (Hip). This excludes the proximal humerus, code 37 (Shoulder).

39

Inverted Y

Treatment has been given to a field that encompasses the paraaortic and bilateral inguinal or inguinofemoral lymph nodes in a single port.

40

Spinal Cord                              

Treatment is directed at the spinal cord or its meninges.

41

Prostate

Treatment is directed at the prostate with or without the seminal vesicles, without regional lymph node treatment.

50

Thyroid

Treatment is directed at the thyroid gland.

60

Lymph node region, NOS         

The target is a group of lymph nodes not listed above. Examples include isolated treatment of a cervical, supraclavicular, or inguinofemoral region.

98

Other

Radiation therapy administered, treatment volume other than those previously categorized.

99

Unknown

Radiation therapy administered, treatment volume unknown or not stated in patient record; it is unknown if radiation therapy was administered.