Zimmermann J S, Seegenschmiedt M H, Niehoff P, Galalae R, Kimmig B
Klinik für Strahlentherapie (Radioonkologie), Christian-Albrechts-Universität Kiel.
Strahlenther Onkol. 1998 Nov;174 Suppl 3:30-6.
The clinical knowledge on the frequency and severity of acute radiation morbidity is very sparse. With established morbidity recording, only severe side effects are revealed. The lower morbidity (I/II degree) as a major part of the data base is neglected. Another problem may be the lack of interdisciplinary and international compatibility in other systems. For these reasons, our intention was to create an easily acceptable, international and interdisciplinary compatible documentation form for routine use in radiotherapy.
A detailed topographic documentation sheet for each major topographic site of clinical radiation oncology has been developed (CNS, head and neck, thorax, female breast, abdomen, extremities). It is based upon existing toxicity codes and documentation systems (CTC[WHO], RTOG and EORTC, DEGRO, ADT, KIEL). Furthermore, basic oncological data like TNM, previous surgery or chemotherapy, drugs and more are included. For each topographic body site, one DIN A4 format is required for documentation of a 6 to 7-week treatment course. The toxicity prescription is coded according to the "DEGRO/RTOG Coding System for acute side effects" and to the "EORTC Acute Toxicity Code" to achieve optimal international and interdisciplinary compatibility.
Complete documentation of toxicities level 0 to 4 is to be performed within 2 to 5 minutes per week/patient within preformed marks. The clinical performance has proven excellent. Not only level III/IV toxicities are recorded, but also level I/II morbidity.
The topographic documentation system improves recording of acute morbidity in radiation oncology not only by time, but also in quality. Experimental, radiobiological and former clinical data may be proved for their actual plausibility.
关于急性放射病发病率及其严重程度的临床知识非常匮乏。在现有的发病率记录中，仅揭示了严重的副作用。作为数据库主要组成部分的较低发病率（I/II级）被忽视了。另一个问题可能是其他系统缺乏跨学科和国际兼容性。出于这些原因，我们的目的是创建一种易于接受的、国际和跨学科兼容的文档表格，用于放射治疗的常规使用。
已针对临床放射肿瘤学的每个主要部位（中枢神经系统、头颈部、胸部、女性乳腺、腹部、四肢）开发了详细的局部文档表格。它基于现有的毒性编码和文档系统（世界卫生组织的常见毒性标准、美国放射肿瘤学协作组和欧洲癌症研究与治疗组织、德国放射肿瘤学协会、澳大利亚剂量学与治疗学协会、基尔大学的系统）。此外，还包括诸如TNM分期、既往手术或化疗、药物等基本肿瘤学数据。对于每个身体局部部位，记录一个6至7周治疗疗程需要一张DIN A4格式的纸张。毒性处方根据“德国放射肿瘤学协会/美国放射肿瘤学协作组急性副作用编码系统”和“欧洲癌症研究与治疗组织急性毒性编码”进行编码，以实现最佳的国际和跨学科兼容性。
每周/每位患者在预先设定的标记内，2至5分钟即可完成0至4级毒性的完整记录。临床实践证明效果极佳。不仅记录了III/IV级毒性，还记录了I/II级发病率。
局部文档系统不仅在时间上，而且在质量上改善了放射肿瘤学中急性发病率的记录。实验、放射生物学和既往临床数据的实际合理性可得到验证。
