| (a) A child is defined for the purpose of this section
as an individual who is not physiologically mature as determined by
the physician using the appropriate medical parameters.
(b) Head and neck.
(1) Early reactions.
(A) Reduced and sticky saliva, loss of taste and appetite,
altered sense of smell, nausea.
(B) Sore throat, difficulty swallowing, weight loss,
fatigue.
(C) Skin changes: redness, irritation, scaliness, blistering
or ulceration, color change, thickening, hair loss.
(D) Hoarseness, cough, loss of voice, and swelling
of airway.
(E) Blockage and crusting of nasal passages.
(F) Inflammation of ear canal, feeling of "stopped
up" ear, hearing loss, dizziness.
(G) Dry and irritable eye(s).
(H) In children, these reactions are likely to be intensified
by chemotherapy before, during or after radiation therapy.
(I) In children, depression of blood count leading
to increased risk of infection and/or bleeding is more common.
(2) Late reactions.
(A) Dry mouth and altered sense, or loss, of taste.
(B) Tooth decay and gum changes.
(C) Bone damage, especially in jaws.
(D) Stiffness and limitation of jaw movement.
(E) Changes in skin texture and/or coloration, permanent
hair loss, and scarring of skin.
(F) Swelling of tissues, particularly under the chin.
(G) Throat damage causing hoarseness, pain or difficulty
breathing or swallowing.
(H) Eye damage causing dry eye(s), cataract, loss of
vision, or loss of eye(s).
(I) Ear damage causing dryness of ear canal, fluid
collection in middle ear, hearing loss.
(J) Brain, spinal cord or nerve damage causing alteration
of thinking ability or memory, and/or loss of strength, feeling or
coordination in any part of the body.
(K) Pituitary or thyroid gland damage requiring long-term
hormone replacement therapy.
(L) In children, there may be additional late reactions.
(i) Disturbance of bone and tissue growth.
(ii) Bone damage to face causing abnormal development.
(iii) Brain damage causing a loss of intellectual ability,
learning capacity, and reduced intelligence quotient (IQ).
(iv) Second cancers developing in the irradiated area.
(c) Central nervous system.
(1) Early reactions.
(A) Skin and scalp reaction with redness, irritation,
scaliness, blistering, ulceration, change in color, thickening, hair
loss.
(B) Nausea, vomiting, headaches.
(C) Fatigue, drowsiness.
(D) Altered sense of taste or smell.
(E) Inflammation of ear canal, feeling of "stopped-up"
ear, hearing loss, dizziness.
(F) Depression of blood count leading to increased
risk of infection and/or bleeding.
(G) In children, these reactions are likely to be intensified
by chemotherapy before, during or after radiation therapy.
(H) In children, depression of blood count leading
to increased risk of infection and/or bleeding is more common.
(2) Late reactions.
(A) Permanent hair loss of variable degrees, altered
regrowth, texture and color of hair.
(B) Persistent drowsiness and tiredness.
(C) Brain damage causing a loss of some degree of thinking
ability or memory, or personality changes.
(D) Scarring of skin.
(E) Spinal cord or nerve damage causing loss of strength,
feeling or coordination in any part of the body.
(F) Damage to eye(s), or optic nerve(s) causing loss
of vision.
(G) Ear damage causing dryness of ear canal, fluid
collection in middle ear, hearing loss.
(H) Pituitary gland damage requiring long-term hormone
replacement therapy.
(I) In children, there may be additional late reactions.
(i) Disturbances of bone and tissue growth.
(ii) Bone damage to spine, causing stunting of growth,
curvature and/or reduction in height.
(iii) Bone damage to face, or pelvis causing stunting
of bone growth and/or abnormal development.
(iv) Brain damage causing a loss of intellectual ability,
learning capacity, and reduced intelligence quotient (IQ).
(v) Second cancers developing in the irradiated area.
(d) Thorax.
(1) Early reactions.
(A) Skin changes: redness, irritation, scaliness, ulceration,
change in color, thickening, hair loss.
(B) Inflammation of esophagus causing pain on swallowing,
heartburn, or sense of obstruction.
(C) Loss of appetite, nausea, vomiting.
(D) Weight loss, weakness, vomiting.
(E) Inflammation of the lung with pain, fever and cough.
(F) Inflammation of the heart sac with chest pain and
palpitations.
(G) Bleeding or creation of a fistula resulting from
tumor destruction.
(H) Depression of blood count leading to increased
risk of infection and/or bleeding.
(I) Intermittent electric shock-like feelings in the
lower spine or legs on bending the neck.
(J) In children, these reactions are likely to be intensified
by chemotherapy before, during or after radiation therapy.
(K) In children, depression of blood count leading
to increased risk of infection and/or bleeding is more common.
(2) Late reactions.
(A) Changes in skin texture and/or coloration, permanent
hair loss and scarring of skin.
(B) Lung scarring or shrinkage causing shortness of
breath.
(C) Narrowing of esophagus causing swallowing problems.
(D) Constriction of heart sac which may require surgical
correction.
(E) Damage to heart muscle or arteries leading to heart
failure.
(F) Fracture of ribs.
(G) Nerve damage causing pain, loss of strength or
feeling in arms.
(H) Spinal cord damage causing loss of strength or
feeling in arms and legs, and/or loss of control of bladder and rectum.
(I) In children, there may be additional late reactions.
(i) Disturbances of bone and tissue growth.
(ii) Bone damage to spine, causing stunting of growth,
curvature and/or reduction in height.
(iii) Underdevelopment or absence of development of
female breast.
(iv) Second cancers developing in the irradiated area.
(e) Breast.
(1) Early reactions.
(A) Skin changes: redness, irritation, scaliness, blistering,
ulceration, coloration, thickening, and hair loss.
(B) Breast changes including swelling, tightness, or
tenderness.
(C) Inflammation of the esophagus causing pain or swallowing,
heartburn, or sense of obstruction.
(D) Lung inflammation with cough.
(E) Inflammation of heart sac with chest pain and palpitations.
(2) Late reactions.
(A) Changes in skin texture and/or coloration, permanent
hair loss, scarring of skin.
(B) Breast changes including thickening, firmness,
tenderness, shrinkage.
(C) Swelling of arm.
(D) Stiffness and discomfort in shoulder joint.
(E) Rib or lung damage causing pain, fracture, cough,
shortness of breath.
(F) Nerve damage causing pain, loss of strength or
feeling in arm.
(G) Damage to heart muscle or arteries or heart sac
leading to heart failure.
(f) Abdomen.
(1) Early reactions.
(A) Skin changes: redness, irritation, scaliness, ulceration,
coloration, thickening, hair loss.
(B) Loss of appetite, nausea, vomiting.
(C) Weight loss, weakness, fatigue.
(D) Inflammation of stomach causing indigestion, heartburn,
and ulcers.
(E) Inflammation of bowel causing cramping and diarrhea.
(F) Depression of blood count leading to increased
risk of infections and/or bleeding.
(G) In children, these reactions are likely to be intensified
by chemotherapy before, during and after radiation therapy.
Cont'd... |
