A total dose of radiation is delivered to the patient in a number of even parts or treatment sessions (fractions). Although a treatment session may include several treatment portals delivered within a confined period of time, usually a few minutes, it is still considered one fraction.

Record the number of fractions of radiotherapy treatment for all courses delivered to the patient during the initial course of treatment for cancer. The initial course of treatment includes all treatments administered to the patient from diagnosis and before disease progression or recurrence.

The patient may receive more than one course of radiotherapy during the initial course of treatment. For example, radiotherapy may be administered to the primary site and the site of a distant metastasis. Record the total radiation dose for each course of treatment.

The number of fractions administered is recorded regardless of whether the course of treatment is completed as intended and regardless of the intent or timing of treatment.

The number of radiotherapy fractions recorded should include any boost.

Brachytherapy (or implants) may be delivered more than once, each treatment is recorded as a fraction.

Do not include treatment with unsealed radioisotopes.

The number of radiotherapy fractions delivered will typically be found in the radiation oncologist's summary letter for the initial course of treatment or in the radiotherapy treatment summary in the patient's medical record. 

Determining the number of fractions may require assistance from the radiation oncologist for consistent coding.

American College of Surgeons 2002. Facility Oncology Registry Data Standards (FORDS), 2009 revision. Commission on Cancer

American College of Surgeons 1998. Standards of the Commission on Cancer: Registry Operations and Data Standards (ROADS), Volume II. Commission on Cancer