放疗前小结,放疗后总结
武警广东总队医院肿瘤治疗中心
放疗前小结
姓名_____________性别_______年龄________放疗ID_________________一.诊断:
1.主要诊断及分期_________________________________T______N_______M_______分期___________2.次要诊断_____________________________________________________________________________二.治疗计划:单纯放疗综合治疗
1.放疗方式:根治性姑息性辅助性2.放疗程式:连续分段超分割其它3.放疗装置:直加
60Co深部X线Cf252其它
4.放疗剂量:原发灶DT___________Gy区域淋巴结DT_____________Gy转移灶DT___________Gy
5.放疗设计:__________________________________________________________________________________________________________________________________________________________________________6.放疗(前.中.后)配合治疗:手术、化疗、热疗、后装、激光、中医药、增敏、生物学治疗、其它诊疗经过:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________三.放疗注意事项:_______________________________________________________________________________
_______________________________________________________________________________
医师签名:__________________
年月日
武警广东总队医院肿瘤治疗中心
放疗后总结
姓名_____________性别_______年龄________放疗ID_________________入院诊断____________________________________________T______N_______M_______分期____________出院诊断___________________________________________________________________________________治疗时间________________年__________月_________日至________________年_________月_________日单纯放疗综合治疗
放疗方式:根治性姑息性辅助性放疗程式:连续分段超分割其它
放疗装置:直加60Co深部X线Cf252其它
放疗剂量:原发灶DT___________Gy/___________次/___________天
区域淋巴结DT___________Gy/___________次/___________天转移灶DT___________Gy/___________次/___________天照射部位:(盖形体轮廓章并用红笔标记放疗区域)
放疗(前.中.后)配合治疗:手术、化疗、热疗、后装、激光、中医药、增敏、生物学治疗、其它
诊疗经过:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________治疗效果:原发灶:全消、残留、不变、恶化区域淋巴结:全消、残留、不变、恶化转移灶:全消、残留、不变、恶化放疗结束医嘱:
医师签名:__________________
年月日
扩展阅读：放疗前小结,放疗后总结2
武警广东总队医院肿瘤治疗中心
放疗前小结
姓名_____________性别_______年龄________
1.主要诊断及分期_________________________________T______N_______M_______分期___________2.次要诊断__________________________________________放疗ID_________________
一.诊断:___________________________________二.治疗计划:单纯放疗综合治疗
1.放疗方式:根治性姑息性辅助性2.放疗程式:连续分段超分割其它
3.放疗装置:直加60Co深部X线Cf252其它
4.放疗剂量:原发灶DT___________Gy区域淋巴结DT_____________Gy转移灶DT___________Gy
5.放疗设计:__________________________________________________________________________________________________________________________________________________________________________6.放疗(前.中.后)配合治疗:手术、化疗、热疗、后装、激光、中医药、增敏、生物学治疗、其它诊疗经过:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________三.放疗注意事项:_______________________________________________________________________________
_______________________________________________________________________________
医师签名:__________________
年月日
武警广东总队医院肿瘤治疗中心
放疗后总结
姓名_____________性别_______年龄________放疗ID_________________入院诊断____________________________________________T______N_______M_______分期____________出院诊断___________________________________________________________________________________治疗时间________________年__________月_________日至________________年_________月_________日单纯放疗综合治疗
放疗方式:根治性姑息性辅助性放疗程式:连续分段超分割其它
放疗装置:直加60Co深部X线Cf252其它
放疗剂量:原发灶DT___________Gy/___________次/___________天
区域淋巴结DT___________Gy/___________次/___________天转移灶DT___________Gy/___________次/___________天照射部位:(盖形体轮廓章并用红笔标记放疗区域)
放疗(前.中.后)配合治疗:手术、化疗、热疗、后装、激光、中医药、增敏、生物学治疗、其它
诊疗经过:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________治疗效果:原发灶:全消、残留、不变、恶化区域淋巴结:全消、残留、不变、恶化转移灶:全消、残留、不变、恶化放疗结束医嘱:
医师签名:__________________
年月日
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