Cancer survivor ≥5 years post-completion of curative-intent oncology treatment that inclu...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-IATROGENIC-CRANIAL-RT-LATE-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-GBM`
Sources	`SRC-COG` `SRC-NCCN-BCELL-2025` `SRC-NCCN-CNS-2025`

Red Flag Origin

Definition	Cancer survivor ≥5 years post-completion of curative-intent oncology treatment that included cranial radiotherapy — most commonly pediatric ALL (whole-brain RT or craniospinal), pediatric brain tumor (medulloblastoma, ependymoma, low-grade glioma), prophylactic cranial irradiation (PCI) in SCLC, primary CNS lymphoma RT, head-and-neck RT with brain in field. Three principal late-effect domains: (1) secondary CNS tumors — meningioma (highest incidence, latency 15-30y, cumulative 1-3% at 30y), high-grade glioma, low-grade glioma; (2) endocrine sequelae from hypothalamic-pituitary axis injury — growth hormone deficiency, thyroid dysfunction (hypothyroidism from indirect or direct neck-field exposure), gonadal dysfunction, ACTH deficiency; (3) neurocognitive late effects — attention deficits, processing speed, executive dysfunction, dementia risk in older survivors. Surveillance cadence per...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "survivor_5y_post_cranial_radiotherapy",
      "value": true
    },
    {
      "finding": "survivor_pediatric_cranial_rt_late_effect",
      "value": true
    },
    {
      "finding": "survivor_prophylactic_cranial_irradiation_late_effect",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Cancer-survivor late-effects RedFlag for prior cranial radiotherapy ≥5y ago. Three surveillance domains: secondary CNS tumors (meningioma highest incidence), endocrine sequelae (HP-axis), neurocognitive. Annual neuro exam + endocrine panel + brain MRI q1-3y if symptomatic per COG-LTFU. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications

IND-IATROGENIC-CRANIAL-RT-LATE-PREVENTION-OBSERVATION - IND-IATROGENIC-CRANIAL-RT-LATE-PREVENTION-OBSERVATION
IND-IATROGENIC-CRANIAL-RT-LATE-PREVENTION-SURVEILLANCE - IND-IATROGENIC-CRANIAL-RT-LATE-PREVENTION-SURVEILLANCE