Appendix I Materials for Clinical Applications

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Long-Term Follow-Up Guidelinesfor Survivors of Childhood, Adolescent, and Young Adult CancersVersion 2013Copyright 2013 Children s Oncology GroupAll rights reserved worldwideAppendix IMaterials for Clinical ApplicationsCOG LTFU guidelines 8 Page 2 Version October 2013 ContentsContentsReference Materials 3Abbreviations4Chemotherapy Agents7Summary of Cancer Treatment8Instructions9Summary Form Template (Abbreviated)11Summary Form Template (Comprehensive)12Summary Form Key14Patient-Specific Guideline Identification Tool23Instructions24Patient-Specific Guideline Identification Tool (version )25Section Number Comparison COG LTFU guidelines Version vs Reference Guide36Contents37Determining Applicability of Radiation Sections for Specific Patients Based on Exposure30Radiation Dose Calculation Examples39Radiation Fields Defined40Radiation Fields by Anatomic Region41Guideline Radiation Section Numbers by Anatomic Region42Total Body Irradiation43Skin, Bones, Soft Tissues44Brain/Neuroendocrine Axis, Cranium, Face, Eye, Ear45Oral Cavity46Neck/Thyroid47Breast48Lungs49Hea rt50Spleen 51Esophagus52Liver53Bowel54Kidneys55Blad der/Urinary Tract56Female Reproductive System57Male Reproductive System58Musculoskeletal System (Growth Problems, Radiation-Induced Fracture)59Musculoskeletal

COG LTFU Guidelines 8 – Page 2 Version 4.0 – October 2013 – Contents Contents Reference Materials 3 Abbreviations 4 Chemotherapy Agents 7 Summary of Cancer Treatment 8 Instructions 9 Summary Form Template (Abbreviated) 11 Summary Form Template (Comprehensive) 12 Summary Form Key 14 Patient-Specific Guideline Identification Tool 23 Instructions 24 Patient-Specific Guideline …

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