Radiation parameters | |
Q11: What is the radiation protocol? | |
Q11A: Total dose (in gray) received | |___|__| |
Q11B: Boost (in Gray) | |___|___| |
Q11C: Dose per Fraction/fractionation (in Gray): 1 = 1.8 2 = 2 3 = 2.5 4 = 3 | |___| |
Q11D: Duration (in days) | |___|___| |
Q12: Discontinue treatment before the scheduled time? 1 = Yes 2 = no | |___| |
Q12A: Reason____________________________________________ |
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