Patterns of failure:
(1) local
(2) regional
(3) distant
The pattern of failure is assigned based on the initial findings when failure was diagnosed, inclusive to 30 days (1 month) afterwards. Further progression does not change the pattern assigned.
Features of a local failure:
(1) failure of the primary tumor to regress
(2) reappearance of tumor at the primary site
(3) reappearance of tumor in regional nodes within the radiation treatment field
Features of a regional failure:
(1) appearance of tumor in regional nodes outside of the radiation treatment field
Features of a distant failure:
(1) appearance of tumor at sites reached by hematogenous dissemination
(2) malignant cells in pleural or ascitic fluid
(3) malignant cells in the CSF
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Local Failure
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Regional Failure
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Distant Failure
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Failure Group
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present
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absent or present
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absent or present
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total local
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absent or present
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absent or present
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present
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total distant
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If no failure patterns are seen then the patient is in remission.
