放療前小結(jié),放療后總結(jié)

武警廣東總隊醫(yī)院腫瘤治療中心

放療前小結(jié)

姓名_____________性別_______年齡________放療ID_________________一.診斷:

1.主要診斷及分期_________________________________T______N_______M_______分期___________2.次要診斷_____________________________________________________________________________二.治療計劃:單純放療綜合治療

1.放療方式:根治性姑息性輔助性2.放療程式:連續(xù)分段超分割其它3.放療裝置:直加

60

Co深部X線Cf252其它

4.放療劑量:原發(fā)灶DT___________Gy區(qū)域淋巴結(jié)DT_____________Gy轉(zhuǎn)移灶DT___________Gy

5.放療設(shè)計:__________________________________________________________________________________________________________________________________________________________________________6.放療(前.中.后)配合治療:手術(shù)、化療、熱療、后裝、激光、中醫(yī)藥、增敏、生物學(xué)治療、其它診療經(jīng)過:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________三.放療注意事項:_______________________________________________________________________________

_______________________________________________________________________________

醫(yī)師簽名:__________________

年月日

武警廣東總隊醫(yī)院腫瘤治療中心

放療后總結(jié)

姓名_____________性別_______年齡________放療ID_________________入院診斷____________________________________________T______N_______M_______分期____________出院診斷___________________________________________________________________________________治療時間________________年__________月_________日至________________年_________月_________日單純放療綜合治療

放療方式:根治性姑息性輔助性放療程式:連續(xù)分段超分割其它

放療裝置:直加60Co深部X線Cf252其它

放療劑量:原發(fā)灶DT___________Gy/___________次/___________天

區(qū)域淋巴結(jié)DT___________Gy/___________次/___________天轉(zhuǎn)移灶DT___________Gy/___________次/___________天照射部位:(蓋形體輪廓章并用紅筆標(biāo)記放療區(qū)域)

放療(前.中.后)配合治療:手術(shù)、化療、熱療、后裝、激光、中醫(yī)藥、增敏、生物學(xué)治療、其它

診療經(jīng)過:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________治療效果:原發(fā)灶:全消、殘留、不變、惡化區(qū)域淋巴結(jié):全消、殘留、不變、惡化轉(zhuǎn)移灶:全消、殘留、不變、惡化放療結(jié)束醫(yī)囑:

醫(yī)師簽名:__________________

年月日

擴展閱讀：放療前小結(jié),放療后總結(jié)2

武警廣東總隊醫(yī)院腫瘤治療中心

放療前小結(jié)

姓名_____________性別_______年齡________

1.主要診斷及分期_________________________________T______N_______M_______分期___________2.次要診斷__________________________________________放療ID_________________

一.診斷:___________________________________二.治療計劃:單純放療綜合治療

1.放療方式:根治性姑息性輔助性2.放療程式:連續(xù)分段超分割其它

3.放療裝置:直加60Co深部X線Cf252其它

4.放療劑量:原發(fā)灶DT___________Gy區(qū)域淋巴結(jié)DT_____________Gy轉(zhuǎn)移灶DT___________Gy

5.放療設(shè)計:__________________________________________________________________________________________________________________________________________________________________________6.放療(前.中.后)配合治療:手術(shù)、化療、熱療、后裝、激光、中醫(yī)藥、增敏、生物學(xué)治療、其它診療經(jīng)過:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________三.放療注意事項:_______________________________________________________________________________

_______________________________________________________________________________

醫(yī)師簽名:__________________

年月日

武警廣東總隊醫(yī)院腫瘤治療中心

放療后總結(jié)

姓名_____________性別_______年齡________放療ID_________________入院診斷____________________________________________T______N_______M_______分期____________出院診斷___________________________________________________________________________________治療時間________________年__________月_________日至________________年_________月_________日單純放療綜合治療

放療方式:根治性姑息性輔助性放療程式:連續(xù)分段超分割其它

放療裝置:直加60Co深部X線Cf252其它

放療劑量:原發(fā)灶DT___________Gy/___________次/___________天

區(qū)域淋巴結(jié)DT___________Gy/___________次/___________天轉(zhuǎn)移灶DT___________Gy/___________次/___________天照射部位:(蓋形體輪廓章并用紅筆標(biāo)記放療區(qū)域)

放療(前.中.后)配合治療:手術(shù)、化療、熱療、后裝、激光、中醫(yī)藥、增敏、生物學(xué)治療、其它

診療經(jīng)過:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________治療效果:原發(fā)灶:全消、殘留、不變、惡化區(qū)域淋巴結(jié):全消、殘留、不變、惡化轉(zhuǎn)移灶:全消、殘留、不變、惡化放療結(jié)束醫(yī)囑:

醫(yī)師簽名:__________________

年月日

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