|
Code
|
Display
|
Definition
|
|
1.1
|
RT to a vol exposing the thyroid gland |
RT to a vol exposing the thyroid gland |
|
1.2
|
TBI |
TBI |
|
1.3
|
MIBG therapy (I-131 MIBG therapy) |
MIBG therapy (I-131 MIBG therapy) |
|
10.2
|
HSCT |
HSCT |
|
11.1
|
RT to a volume exposing the hypothalamus or pituatary gland |
RT to a volume exposing the hypothalamus or pituatary gland |
|
11.3
|
Hypothalamic or pituitary tumour |
Hypothalamic or pituitary tumour |
|
11.4
|
Neurosurgery of the hypothalamus or pituitary gland |
Neurosurgery of the hypothalamus or pituitary gland |
|
12.1
|
RT to a vol exposing the kidneys, heart and associated large vessels |
RT to a vol exposing the kidneys, heart and associated large vessels |
|
12.3
|
Nephrectomy |
Nephrectomy |
|
12.4
|
Ifosfamide |
Ifosfamide |
|
12.5
|
Platinium based chemotherapy |
Platinium based chemotherapy |
|
12.6
|
Nitrosureas |
Nitrosureas |
|
12.7
|
Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously) |
Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously) |
|
13.1
|
Cranial and/or spinal RT |
Cranial and/or spinal RT |
|
13.3
|
Methotrexate |
Methotrexate |
|
13.4
|
Gonadal failure |
Gonadal failure |
|
13.5
|
Growth hormone deficiency |
Growth hormone deficiency |
|
13.6
|
Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment |
Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment |
|
13.7
|
HSCT, especially with an history of GVHD |
HSCT, especially with an history of GVHD |
|
14.3
|
High dose RT |
High dose RT |
|
15.1
|
Radiotherapy to a vol exposing the HP region >= 30 Gy |
Radiotherapy to a vol exposing the HP region >= 30 Gy |
|
15.2
|
Surgery near or within the HP region |
Surgery near or within the HP region |
|
15.3
|
CNS tumours near or within the HP region |
CNS tumours near or within the HP region |
|
16.1
|
Radiotherapy to a vol exposing the HP region
< 30 Gy |
Radiotherapy to a vol exposing the HP region
< 30 Gy |
|
16.2
|
Hydrocephalus or cerebrospinal fluid shunt (Risk factor for GHD) |
Hydrocephalus or cerebrospinal fluid shunt (Risk factor for GHD) |
|
17.1
|
Radiotherapy to a vol exposing the HP region |
Radiotherapy to a vol exposing the HP region |
|
17.5
|
hydrocephalus or cerebrospinal fluid shunt |
hydrocephalus or cerebrospinal fluid shunt |
|
19.3
|
Radioiodine therapy (I-131 ablation therapy) |
Radioiodine therapy (I-131 ablation therapy) |
|
19.5
|
Allogenic HSCT |
Allogenic HSCT |
|
19.6
|
Total thyroidectomy |
Total thyroidectomy |
|
2.1
|
RT >= 10 Gy to a vol exposing the breasts |
RT >= 10 Gy to a vol exposing the breasts |
|
2.2
|
OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age |
OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age |
|
20.1
|
RT to a vol exposing the head, brain or neck
|
RT to a vol exposing the head, brain or neck
|
|
21.1
|
History of a central nervous system tumor |
History of a central nervous system tumor |
|
21.2
|
RT to a vol exposing the brain ANY DOSE |
RT to a vol exposing the brain ANY DOSE |
|
21.4
|
Brain surgery |
Brain surgery |
|
21.5
|
High dose cytarabine IV (intravenous) |
High dose cytarabine IV (intravenous) |
|
21.6
|
High dose MTX IV |
High dose MTX IV |
|
21.7
|
Any Chemotherapy IT (intrathecal) |
Any Chemotherapy IT (intrathecal) |
|
22.1
|
Vinca-Alkaloids |
Vinca-Alkaloids |
|
22.2
|
Cisplatin or carboplatin |
Cisplatin or carboplatin |
|
23.1
|
RT to a vol exposing the lens |
RT to a vol exposing the lens |
|
24.1
|
RT to a vol exposing the eye and orbit |
RT to a vol exposing the eye and orbit |
|
25.1
|
RT to a vol exposing the craniofacial area, especially after high doses and at a young age |
RT to a vol exposing the craniofacial area, especially after high doses and at a young age |
|
25.3
|
Surgery to the face, especially at a young age |
Surgery to the face, especially at a young age |
|
26.1
|
Surgery of the spine |
Surgery of the spine |
|
26.2
|
Surgery of the chest (Does not include CVC pose) |
Surgery of the chest (Does not include CVC pose) |
|
26.3
|
RT to a vol exposing the spine |
RT to a vol exposing the spine |
|
26.4
|
Spinal or paraspinal malignancies |
Spinal or paraspinal malignancies |
|
27.1
|
Cyclophosphamide |
Cyclophosphamide |
|
27.3
|
RT to a vol exposing the bladder |
RT to a vol exposing the bladder |
|
27.5
|
Cystectomy |
Cystectomy |
|
27.6
|
Hysterectomy |
Hysterectomy |
|
27.7
|
Pelvic surgery |
Pelvic surgery |
|
27.8
|
Spinal cord surgery |
Spinal cord surgery |
|
28.1
|
RT to a vol exposing the uterus
only female |
RT to a vol exposing the uterus
only female |
|
29.1
|
RT to a vol exposing the oral cavity or salivary glands |
RT to a vol exposing the oral cavity or salivary glands |
|
29.4
|
Chemotherapy |
Chemotherapy |
|
3.1
|
RT >= 35 Gy to a vol exposing the heart |
RT >= 35 Gy to a vol exposing the heart |
|
3.2
|
Anthracyclines (doxorubicin isotoxic equivalents)>= 250 mg/m2 |
Anthracyclines (doxorubicin isotoxic equivalents)>= 250 mg/m2 |
|
3.3
|
RT >= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)>= 100 mg/m2 |
RT >= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)>= 100 mg/m2 |
|
30.1
|
RT to a vol exposing the gastro-intestinal tract |
RT to a vol exposing the gastro-intestinal tract |
|
30.3
|
Oesophageal surgery |
Oesophageal surgery |
|
30.4
|
Abdominal surgery |
Abdominal surgery |
|
30.5
|
With a history of chronic GVHD |
With a history of chronic GVHD |
|
31.1
|
Anthracyclines (doxorubicin isotoxic equivalents) <100 mg/m2 |
Anthracyclines (doxorubicin isotoxic equivalents) <100 mg/m2 |
|
32.1
|
RT to a vol exposing the lungs |
RT to a vol exposing the lungs |
|
32.3
|
Bleomycin |
Bleomycin |
|
32.4
|
Busulfan |
Busulfan |
|
32.5
|
BCNU Carmustine |
BCNU Carmustine |
|
32.6
|
CCNU Lomustine |
CCNU Lomustine |
|
32.7
|
Thoracic surgery |
Thoracic surgery |
|
33.1
|
Cisplatin Any dose |
Cisplatin Any dose |
|
33.2
|
Ifosfamide Any dose |
Ifosfamide Any dose |
|
33.3
|
Carboplatin Any dose |
Carboplatin Any dose |
|
34.1
|
RT to a volume exposing the liver |
RT to a volume exposing the liver |
|
34.10
|
Chronic GVHD |
Chronic GVHD |
|
34.11
|
Liver surgery |
Liver surgery |
|
34.3
|
HSCT (irrespective of GVHD) |
HSCT (irrespective of GVHD) |
|
34.5
|
Mercaptopurine Thioguanine |
Mercaptopurine Thioguanine |
|
34.6
|
Dactinomycin |
Dactinomycin |
|
34.8
|
Chronic viral hepatitis |
Chronic viral hepatitis |
|
34.9
|
Sinusoidal obstruction syndrome |
Sinusoidal obstruction syndrome |
|
35.1
|
HSCT (irrespective of GVHD) |
HSCT (irrespective of GVHD) |
|
35.2
|
Multiple red blood cell transfusions |
Multiple red blood cell transfusions |
|
36.1
|
Splenectomy |
Splenectomy |
|
36.2
|
RT >= 10 Gy to a vol exposing the spleen |
RT >= 10 Gy to a vol exposing the spleen |
|
36.3
|
Allogenic HSCT (with or without TBI) |
Allogenic HSCT (with or without TBI) |
|
36.4
|
Autologus HSCT conditioned with TBI |
Autologus HSCT conditioned with TBI |
|
37.1
|
Hereditary cancer sd |
Hereditary cancer sd |
|
38.1
|
Any RT including TBI (predominantly in the RT field) |
Any RT including TBI (predominantly in the RT field) |
|
38.2
|
HSCT Especially with a history of skin GvHD |
HSCT Especially with a history of skin GvHD |
|
39.1
|
RT to a vol exposing the colon and rectum |
RT to a vol exposing the colon and rectum |
|
4.1
|
Alkylating agents |
Alkylating agents |
|
4.2
|
RT to a vol exposing the testes |
RT to a vol exposing the testes |
|
4.3
|
Including TBI |
Including TBI |
|
40.1
|
RT to a vol exposing the lungs |
RT to a vol exposing the lungs |
|
41.2
|
Anthracyclines and/or Mitoxantrone |
Anthracyclines and/or Mitoxantrone |
|
41.3
|
Epipodophyllotoxins or autologous |
Epipodophyllotoxins or autologous |
|
41.4
|
Autologous haematopoietic stem cell transplant |
Autologous haematopoietic stem cell transplant |
|
42.1
|
Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis) |
Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis) |
|
45.1
|
RT to a vol exposing the head or brain |
RT to a vol exposing the head or brain |
|
46.1
|
RT between 15 and 35 Gy to a vol exposing the heart |
RT between 15 and 35 Gy to a vol exposing the heart |
|
46.2
|
Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2 |
Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2 |
|
47.1
|
RT to a vol exposing the kidney or urinary tract |
RT to a vol exposing the kidney or urinary tract |
|
5.1
|
RT >=12 Gy to a vol exposing the testicles |
RT >=12 Gy to a vol exposing the testicles |
|
6.3
|
Surgery to the spinal cord, sympathetic nerves or pelvis |
Surgery to the spinal cord, sympathetic nerves or pelvis |
|
6.4
|
Hypogonadal |
Hypogonadal |
|
7.2
|
RT to a vol exposing the ovaries |
RT to a vol exposing the ovaries |
|
8.1
|
RT >= 30 Gy to a vol exposing the head or the brain |
RT >= 30 Gy to a vol exposing the head or the brain |
|
8.2
|
Cisplatin (with or without carboplatin > 1500 mg/m2) |
Cisplatin (with or without carboplatin > 1500 mg/m2) |
|
9.1
|
RT to a vol exposing the pancreas |
RT to a vol exposing the pancreas |