Specjalności. Warunki GINEKOLOGIA ONKOLOGICZNA HEMATO-ONKOLOGIA DZIECIĘCA TRYB AMBULATORYJNY ENDOKRYNOLOGIA HOSPITALIZACJA

Katalog chemioterapii nie stanowi źródła wiedzy medycznej, a jest jedynie narzędziem sprawozdawczo-rozliczeniowym NFZ. W każdym przypadku za wdrożenie odpowiedniej terapii zgodnie z aktualną wiedzą medyczną odpowiada lekarz prowadzący. Lp. Kod kursu ENDOKRYNOLOGIA GINEKOLOGIA ONKOLOGICZNA Specjalności ONKOLOGIA HEMATO-ONKOLOGIA DZIECIĘCA Typ terapii 1 0311 X X X X X G-CSF 480 - POSTĘPOWANIE WSPOMAGAJACE HEMATOLOGIA Wariant Długość cyklu w dniach Rozpoznania kliniczne Substancje czynne Dawki 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 FILGRASTIMUM - J.M. - P - POZAJELITOWO TRYB AMBULATORYJNY Warunki ŚWIADCZENIE JEDNODNIOWE HOSPITALIZACJA Uwagi Schemat merytorycznie zweryfikowany przez 48 000 000 j.m./bezp. dz. 1 X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultanta Krajowego w dziedzinie ginekologii onkologicznej, Prof. dr hab. n. med. Macieja Krzakowskiego - Konsultanta Krajowego w dziedzinie onkologi, Prof. dr hab. n. med. Jerzego Kowalczyka w Konsultanta Krajowego Konsultant Krajowy w dziedzinie onkologii i Strona 1 z 203

C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, D00, D00.0, D00.1, D00.2, D01, D01.0, D01.1, D01.2, D01.3 D01.4, D01.5, D01.7, D01.9, D02, D02.0, D02.1, D02.2, D02.3, D02.4 D03, D03.0, D03.1, D03.2, D03.3, D03.4, D03.5, D03.6, D03.7, D03.8 D03.9, D04, D04.0, D04.1, D04.2, D04.3, D04.4, D04.5, D04.6, D04.7 D04.8, D04.9, D05, D05.0, D05.1, D05.7, D05.9, D06, D06.0, D06.1 D06.7, D06.9, D07, D07.0, D07.1, D07.2, D07.3, D07.4, D07.5, D07.6 D09, D09.0, D09.1, D09.2, D09.3, D09.7, D09.9, D10, D10.0, D10.1 D10.2, D10.3, D10.4, D10.5, D10.6, D10.7, D10.9, D11, D11.0, D11.7 D11.9, D12, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7 D12.8, D12.9, D13, D13.0, D13.1, D13.2, D13.3, D13.4, D13.5, D13.6 D13.7, D13.9, D14, D14.0, D14.1, D14.2, D14.3, D14.4, D15, D15.0 D15.1, D15.2, D15.7, D15.9, D16, D16.0, D16.1, D16.2, D16.3, D16.4 D16.5, D16.6, D16.7, D16.8, D16.9, D17, D17.0, D17.1, D17.2, D17.3 D17.4, D17.5, D17.6, D17.7, D17.9, D18, D18.0, D18.1, D19, D19.0 D19.1, D19.7, D19.9, D20, D20.0, D20.1, D21, D21.0, D21.1, D21.2 D21.3, D21.4, D21.5, D21.6, D21.9, D22, D22.0, D22.1, D22.2, D22.3 D22.4, D22.5, D22.6, D22.7, D22.9, D23, D23.0, D23.1, D23.2, D23.3 D23.4, D23.5, D23.6, D23.7, D23.9, D24, D25, D25.0, D25.1, D25.2 D25.9, D26, D26.0, D26.1, D26.7, D26.9, D27, D28, D28.0, D28.1 D28.2, D28.7, D28.9, D29, D29.0, D29.1, D29.2, D29.3, D29.4, D29.7 D29.9, D30, D30.0, D30.1, D30.2, D30.3, D30.4, D30.7, D30.9, D31 D31.0, D31.1, D31.2, D31.3, D31.4, D31.5, D31.6, D31.9, D32, D32.0 D32.1, D32.9, D33, D33.0, D33.1, D33.2, D33.3, D33.4, D33.7, D33.9 D34, D35, D35.0, D35.1, D35.2, D35.3, D35.4, D35.5, D35.6, D35.7 D35.8, D35.9, D36, D36.0, D36.1, D36.7, D36.9, D37, D37.0, D37.1 D37.2, D37.3, D37.4, D37.5, D37.6, D37.7, D37.9, D38, D38.0, D38.1 D38.2, D38.3, D38.4, D38.5, D38.6, D39, D39.0, D39.1, D39.2, D39.7 D39.9, D40, D40.0, D40.1, D40.7, D40.9, D41, D41.0, D41.1, D41.2 D41.3, D41.4, D41.7, D41.9, D42, D42.0, D42.1, D42.9, D43, D43.0 D43.1, D43.2, D43.3, D43.4, D43.7, D43.9, D44, D44.0, D44.1, D44.2 D44.3, D44.4, D44.5, D44.6, D44.7, D44.8, D44.9, D45, D46, D46.0 D46.1, D46.2, D46.3, D46.4, D46.7, D46.9, D47, D47.0, D47.1, D47.2 Strona 2 z 203

2 0312 X X X X X G-CSF 300 - POSTĘPOWANIE WSPOMAGAJACE D47.3, D47.7, D47.9, D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5 D48.6, D48.7, D48.9, D63.0, D70 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 FILGRASTIMUM - J.M. - P - POZAJELITOWO 30 000 000 j.m./bezp. dz. 1 X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultanta Krajowego w dziedzinie ginekologii onkologicznej oraz przez Prof. dr hab. n. med. Jerzego Kowalczyka Konsultant Krajowy w dziedzinie onkologii i, Prof. dr hab. n. med. Macieja Krzakowskiego - Strona 3 z 203

3 0313 X X X X X G-CSF 263 - POSTĘPOWANIE WSPOMAGAJACE C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, D00, D00.0, D00.1, D00.2, D01, D01.0, D01.1, D01.2, D01.3 D01.4, D01.5, D01.7, D01.9, D02, D02.0, D02.1, D02.2, D02.3, D02.4 D03, D03.0, D03.1, D03.2, D03.3, D03.4, D03.5, D03.6, D03.7, D03.8 D03.9, D04, D04.0, D04.1, D04.2, D04.3, D04.4, D04.5, D04.6, D04.7 D04.8, D04.9, D05, D05.0, D05.1, D05.7, D05.9, D06, D06.0, D06.1 D06.7, D06.9, D07, D07.0, D07.1, D07.2, D07.3, D07.4, D07.5, D07.6 D09, D09.0, D09.1, D09.2, D09.3, D09.7, D09.9, D10, D10.0, D10.1 D10.2, D10.3, D10.4, D10.5, D10.6, D10.7, D10.9, D11, D11.0, D11.7 D11.9, D12, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7 D12.8, D12.9, D13, D13.0, D13.1, D13.2, D13.3, D13.4, D13.5, D13.6 D13.7, D13.9, D14, D14.0, D14.1, D14.2, D14.3, D14.4, D15, D15.0 D15.1, D15.2, D15.7, D15.9, D16, D16.0, D16.1, D16.2, D16.3, D16.4 D16.5, D16.6, D16.7, D16.8, D16.9, D17, D17.0, D17.1, D17.2, D17.3 D17.4, D17.5, D17.6, D17.7, D17.9, D18, D18.0, D18.1, D19, D19.0 D19.1, D19.7, D19.9, D20, D20.0, D20.1, D21, D21.0, D21.1, D21.2 D21.3, D21.4, D21.5, D21.6, D21.9, D22, D22.0, D22.1, D22.2, D22.3 D22.4, D22.5, D22.6, D22.7, D22.9, D23, D23.0, D23.1, D23.2, D23.3 D23.4, D23.5, D23.6, D23.7, D23.9, D24, D25, D25.0, D25.1, D25.2 D25.9, D26, D26.0, D26.1, D26.7, D26.9, D27, D28, D28.0, D28.1 D28.2, D28.7, D28.9, D29, D29.0, D29.1, D29.2, D29.3, D29.4, D29.7 D29.9, D30, D30.0, D30.1, D30.2, D30.3, D30.4, D30.7, D30.9, D31 D31.0, D31.1, D31.2, D31.3, D31.4, D31.5, D31.6, D31.9, D32, D32.0 D32.1, D32.9, D33, D33.0, D33.1, D33.2, D33.3, D33.4, D33.7, D33.9 D34, D35, D35.0, D35.1, D35.2, D35.3, D35.4, D35.5, D35.6, D35.7 D35.8, D35.9, D36, D36.0, D36.1, D36.7, D36.9, D37, D37.0, D37.1 D37.2, D37.3, D37.4, D37.5, D37.6, D37.7, D37.9, D38, D38.0, D38.1 D38.2, D38.3, D38.4, D38.5, D38.6, D39, D39.0, D39.1, D39.2, D39.7 D39.9, D40, D40.0, D40.1, D40.7, D40.9, D41, D41.0, D41.1, D41.2 D41.3, D41.4, D41.7, D41.9, D42, D42.0, D42.1, D42.9, D43, D43.0 D43.1, D43.2, D43.3, D43.4, D43.7, D43.9, D44, D44.0, D44.1, D44.2 D44.3, D44.4, D44.5, D44.6, D44.7, D44.8, D44.9, D45, D46, D46.0 D46.1, D46.2, D46.3, D46.4, D46.7, D46.9, D47, D47.0, D47.1, D47.2 D47.3, D47.7, D47.9, D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5 D48.6, D48.7, D48.9, D63.0, D70 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 LENOGRASTIMUM - I.U. - P - POZAJELITOWO 33,6 I.U./bezp. dz. 1 X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultanta Krajowego w dziedzinie ginekologii onkologicznej oraz przez Prof. dr hab. n. med. Jerzego Kowalczyka w Konsultanka krajowego w dziedzinie onkologii i, Prof. dr hab. n. med. Macieja Krzakowskiego - Strona 4 z 203

C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, D00, D00.0, D00.1, D00.2, D01, D01.0, D01.1, D01.2, D01.3 D01.4, D01.5, D01.7, D01.9, D02, D02.0, D02.1, D02.2, D02.3, D02.4 D03, D03.0, D03.1, D03.2, D03.3, D03.4, D03.5, D03.6, D03.7, D03.8 Strona 5 z 203

D03.9, D04, D04.0, D04.1, D04.2, D04.3, D04.4, D04.5, D04.6, D04.7 D04.8, D04.9, D05, D05.0, D05.1, D05.7, D05.9, D06, D06.0, D06.1 D06.7, D06.9, D07, D07.0, D07.1, D07.2, D07.3, D07.4, D07.5, D07.6 D09, D09.0, D09.1, D09.2, D09.3, D09.7, D09.9, D10, D10.0, D10.1 D10.2, D10.3, D10.4, D10.5, D10.6, D10.7, D10.9, D11, D11.0, D11.7 D11.9, D12, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7 D12.8, D12.9, D13, D13.0, D13.1, D13.2, D13.3, D13.4, D13.5, D13.6 D13.7, D13.9, D14, D14.0, D14.1, D14.2, D14.3, D14.4, D15, D15.0 D15.1, D15.2, D15.7, D15.9, D16, D16.0, D16.1, D16.2, D16.3, D16.4 D16.5, D16.6, D16.7, D16.8, D16.9, D17, D17.0, D17.1, D17.2, D17.3 D17.4, D17.5, D17.6, D17.7, D17.9, D18, D18.0, D18.1, D19, D19.0 D19.1, D19.7, D19.9, D20, D20.0, D20.1, D21, D21.0, D21.1, D21.2 D21.3, D21.4, D21.5, D21.6, D21.9, D22, D22.0, D22.1, D22.2, D22.3 D22.4, D22.5, D22.6, D22.7, D22.9, D23, D23.0, D23.1, D23.2, D23.3 D23.4, D23.5, D23.6, D23.7, D23.9, D24, D25, D25.0, D25.1, D25.2 D25.9, D26, D26.0, D26.1, D26.7, D26.9, D27, D28, D28.0, D28.1 D28.2, D28.7, D28.9, D29, D29.0, D29.1, D29.2, D29.3, D29.4, D29.7 D29.9, D30, D30.0, D30.1, D30.2, D30.3, D30.4, D30.7, D30.9, D31 D31.0, D31.1, D31.2, D31.3, D31.4, D31.5, D31.6, D31.9, D32, D32.0 D32.1, D32.9, D33, D33.0, D33.1, D33.2, D33.3, D33.4, D33.7, D33.9 D34, D35, D35.0, D35.1, D35.2, D35.3, D35.4, D35.5, D35.6, D35.7 D35.8, D35.9, D36, D36.0, D36.1, D36.7, D36.9, D37, D37.0, D37.1 D37.2, D37.3, D37.4, D37.5, D37.6, D37.7, D37.9, D38, D38.0, D38.1 D38.2, D38.3, D38.4, D38.5, D38.6, D39, D39.0, D39.1, D39.2, D39.7 D39.9, D40, D40.0, D40.1, D40.7, D40.9, D41, D41.0, D41.1, D41.2 D41.3, D41.4, D41.7, D41.9, D42, D42.0, D42.1, D42.9, D43, D43.0 D43.1, D43.2, D43.3, D43.4, D43.7, D43.9, D44, D44.0, D44.1, D44.2 D44.3, D44.4, D44.5, D44.6, D44.7, D44.8, D44.9, D45, D46, D46.0 D46.1, D46.2, D46.3, D46.4, D46.7, D46.9, D47, D47.0, D47.1, D47.2 D47.3, D47.7, D47.9, D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5 D63.0, D70 4 0314 X X X X X POSTĘPOWANIE WSPOMAGAJACE - EPO 1 42 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 ERYTHROPOIETINUM - J.M. - P - POZAJELITOWO 10 000 j.m./bezp. dz. 1 // 10 000 j.m./bezp. dz. 3 // 10 000 j.m./bezp. // 10 000 j.m./bezp dz. 8 // 10 000 j.m./bezp. dz. 10 // 10 000 j.m./bezp. dz. 12 // 10 000 j.m./bezp. dz. 15 // 10 000 j.m./bezp. dz. 17 // 10 000 j.m./bezp. dz. 19 // 10 000 j.m./bezp. dz. 22 10 000 j.m./bezp. dz. 24 // 10 000 j.m./bezp. dz. 26 // 10 000 j.m./bezp. dz. 29 // 10 000 j.m./bezp. dz. 31 // 10 000 j.m./bezp. dz. 33 // 10 000 j.m./bezp. dz. 36 // 10 000 j.m./bezp. dz. 38 // 10 000 j.m./bezp. dz. 40 X X X 1. Uwaga dodatkowa rozpoczęcie leczenia przy Hb poniżej 10 g/dl kontynuacja do stężenia Hb = 12 g/dl według zaleceń EORTC 2. Zgodnie z ostatnimi decyzjami amerykańskiej Agencji ds Żywności i Leków, które podkreślają zasadność stosowania czynników stymulacji erytropoezy jedynie w przypadku niedokrwistości występującej w przebiegu chemioterapii przeciwnowotworowej (nie zaleca się stosowania ww substancji w tzw niedokrwistości typu choroby przewlekłej, czyli występującej bez ścisłego związku czasowego z chemioterapią). Prof. dr hab. n. med. Macieja Krzakowskiego - Strona 6 z 203

C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, D00, D00.0, D00.1, D00.2, D01, D01.0, D01.1, D01.2, D01.3 D01.4, D01.5, D01.7, D01.9, D02, D02.0, D02.1, D02.2, D02.3, D02.4 D03, D03.0, D03.1, D03.2, D03.3, D03.4, D03.5, D03.6, D03.7, D03.8 D03.9, D04, D04.0, D04.1, D04.2, D04.3, D04.4, D04.5, D04.6, D04.7 D04.8, D04.9, D05, D05.0, D05.1, D05.7, D05.9, D06, D06.0, D06.1 D06.7, D06.9, D07, D07.0, D07.1, D07.2, D07.3, D07.4, D07.5, D07.6 D09, D09.0, D09.1, D09.2, D09.3, D09.7, D09.9, D10, D10.0, D10.1 D10.2, D10.3, D10.4, D10.5, D10.6, D10.7, D10.9, D11, D11.0, D11.7 Strona 7 z 203

5 0314 X X X X X POSTĘPOWANIE WSPOMAGAJACE - DARBEPOETYNA ALFA D11.9, D12, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7 D12.8, D12.9, D13, D13.0, D13.1, D13.2, D13.3, D13.4, D13.5, D13.6 D13.7, D13.9, D14, D14.0, D14.1, D14.2, D14.3, D14.4, D15, D15.0 D15.1, D15.2, D15.7, D15.9, D16, D16.0, D16.1, D16.2, D16.3, D16.4 D16.5, D16.6, D16.7, D16.8, D16.9, D17, D17.0, D17.1, D17.2, D17.3 D17.4, D17.5, D17.6, D17.7, D17.9, D18, D18.0, D18.1, D19, D19.0 D19.1, D19.7, D19.9, D20, D20.0, D20.1, D21, D21.0, D21.1, D21.2 D21.3, D21.4, D21.5, D21.6, D21.9, D22, D22.0, D22.1, D22.2, D22.3 D22.4, D22.5, D22.6, D22.7, D22.9, D23, D23.0, D23.1, D23.2, D23.3 D23.4, D23.5, D23.6, D23.7, D23.9, D24, D25, D25.0, D25.1, D25.2 D25.9, D26, D26.0, D26.1, D26.7, D26.9, D27, D28, D28.0, D28.1 D28.2, D28.7, D28.9, D29, D29.0, D29.1, D29.2, D29.3, D29.4, D29.7 D29.9, D30, D30.0, D30.1, D30.2, D30.3, D30.4, D30.7, D30.9, D31 D31.0, D31.1, D31.2, D31.3, D31.4, D31.5, D31.6, D31.9, D32, D32.0 D32.1, D32.9, D33, D33.0, D33.1, D33.2, D33.3, D33.4, D33.7, D33.9 D34, D35, D35.0, D35.1, D35.2, D35.3, D35.4, D35.5, D35.6, D35.7 D35.8, D35.9, D36, D36.0, D36.1, D36.7, D36.9, D37, D37.0, D37.1 D37.2, D37.3, D37.4, D37.5, D37.6, D37.7, D37.9, D38, D38.0, D38.1 D38.2, D38.3, D38.4, D38.5, D38.6, D39, D39.0, D39.1, D39.2, D39.7 D39.9, D40, D40.0, D40.1, D40.7, D40.9, D41, D41.0, D41.1, D41.2 D41.3, D41.4, D41.7, D41.9, D42, D42.0, D42.1, D42.9, D43, D43.0 D43.1, D43.2, D43.3, D43.4, D43.7, D43.9, D44, D44.0, D44.1, D44.2 D44.3, D44.4, D44.5, D44.6, D44.7, D44.8, D44.9, D45, D46, D46.0 D46.1, D46.2, D46.3, D46.4, D46.7, D46.9, D47, D47.0, D47.1, D47.2 D47.3, D47.7, D47.9, D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5 D48.6, D48.7, D48.9, D63.0 2 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 DARBEPOETIN ALFA - MG - P - POZAJELITOWO 0,0068 mg/kg dz. 1 X X X 1. Uwaga dodatkowa rozpoczęcie leczenia przy Hb poniżej 10 g/dl kontynuacja do stężenia Hb = 12 g/dl według zaleceń EORTC Zgodnie z ostatnimi decyzjami amerykańskiej Agencji ds Żywności i Leków, które podkreślaj zasadność stosowania czynników stymulacji erytropoezy jedynie w przypadku niedokrwistości występującej w przebiegu chemioterapii przeciwnowotworowej (nie zalec się stosowania ww substancji w tzw. niedokrwistości typu choroby przewlekłej, czyli występującej bez ścisłego związku czasowego z chemioterapią). Prof. dr hab. n. med. Macieja Krzakowskiego - Strona 8 z 203

C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, D00, D00.0, D00.1, D00.2, D01, D01.0, D01.1, D01.2, D01.3 D01.4, D01.5, D01.7, D01.9, D02, D02.0, D02.1, D02.2, D02.3, D02.4 D03, D03.0, D03.1, D03.2, D03.3, D03.4, D03.5, D03.6, D03.7, D03.8 D03.9, D04, D04.0, D04.1, D04.2, D04.3, D04.4, D04.5, D04.6, D04.7 D04.8, D04.9, D05, D05.0, D05.1, D05.7, D05.9, D06, D06.0, D06.1 D06.7, D06.9, D07, D07.0, D07.1, D07.2, D07.3, D07.4, D07.5, D07.6 D09, D09.0, D09.1, D09.2, D09.3, D09.7, D09.9, D10, D10.0, D10.1 D10.2, D10.3, D10.4, D10.5, D10.6, D10.7, D10.9, D11, D11.0, D11.7 D11.9, D12, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7 D12.8, D12.9, D13, D13.0, D13.1, D13.2, D13.3, D13.4, D13.5, D13.6 D13.7, D13.9, D14, D14.0, D14.1, D14.2, D14.3, D14.4, D15, D15.0 D15.1, D15.2, D15.7, D15.9, D16, D16.0, D16.1, D16.2, D16.3, D16.4 D16.5, D16.6, D16.7, D16.8, D16.9, D17, D17.0, D17.1, D17.2, D17.3 D17.4, D17.5, D17.6, D17.7, D17.9, D18, D18.0, D18.1, D19, D19.0 D19.1, D19.7, D19.9, D20, D20.0, D20.1, D21, D21.0, D21.1, D21.2 D21.3, D21.4, D21.5, D21.6, D21.9, D22, D22.0, D22.1, D22.2, D22.3 D22.4, D22.5, D22.6, D22.7, D22.9, D23, D23.0, D23.1, D23.2, D23.3 Strona 9 z 203

D23.4, D23.5, D23.6, D23.7, D23.9, D24, D25, D25.0, D25.1, D25.2 D25.9, D26, D26.0, D26.1, D26.7, D26.9, D27, D28, D28.0, D28.1 D28.2, D28.7, D28.9, D29, D29.0, D29.1, D29.2, D29.3, D29.4, D29.7 D29.9, D30, D30.0, D30.1, D30.2, D30.3, D30.4, D30.7, D30.9, D31 D31.0, D31.1, D31.2, D31.3, D31.4, D31.5, D31.6, D31.9, D32, D32.0 D32.1, D32.9, D33, D33.0, D33.1, D33.2, D33.3, D33.4, D33.7, D33.9 D34, D35, D35.0, D35.1, D35.2, D35.3, D35.4, D35.5, D35.6, D35.7 D35.8, D35.9, D36, D36.0, D36.1, D36.7, D36.9, D37, D37.0, D37.1 D37.2, D37.3, D37.4, D37.5, D37.6, D37.7, D37.9, D38, D38.0, D38.1 D38.2, D38.3, D38.4, D38.5, D38.6, D39, D39.0, D39.1, D39.2, D39.7 D39.9, D40, D40.0, D40.1, D40.7, D40.9, D41, D41.0, D41.1, D41.2 D41.3, D41.4, D41.7, D41.9, D42, D42.0, D42.1, D42.9, D43, D43.0 D43.1, D43.2, D43.3, D43.4, D43.7, D43.9, D44, D44.0, D44.1, D44.2 D44.3, D44.4, D44.5, D44.6, D44.7, D44.8, D44.9, D45, D46, D46.0 D46.1, D46.2, D46.3, D46.4, D46.7, D46.9, D47, D47.0, D47.1, D47.2 D47.3, D47.7, D47.9, D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5 D48.6, D48.7, D48.9, D63.0 6 0478 CHEMIOTERAPIA NIESTANDARDOWA 1 1 WSKAZANE WE WNIOSKU NA WSKAZANE WE WNIOSKU NA 7 0548 X X LECZENIE WSPOMAGAJACE 1 28 C16, C16.0, C16.1, C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9 C17, C17.0, C17.1, C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1 C18.2, C18.3, C18.4, C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20 C25, C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9, C26 C26.0, C26.1, C26.8, C26.9, C34, C34.0, C34.1, C34.2, C34.3, C34.8 C34.9, C80, E34, E34.0, E34.1, E34.2, E34.3, E34.4, E34.5, E34.8 E34.9 8 0577 X X LECZENIE OBJAWÓW KLINICZNYCH RAKOWIAKA 9 0577 X X LECZENIE OBJAWÓW KLINICZNYCH RAKOWIAKA 10 0607 X X X X X G-CSF FILGRASTIMUM DOTYCZY MOBILIZACJI KOMÓREK MACIERZYSTYCH FILGRASTIMUM 480MCG 1 14 C16, C16.0, C16.1, C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9 C17, C17.0, C17.1, C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1 C18.2, C18.3, C18.4, C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20 C25, C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9, C26 C26.0, C26.1, C26.8, C26.9, C34, C34.0, C34.1, C34.2, C34.3, C34.8 C34.9, E34, E34.0, E34.1, E34.2, E34.3, E34.4, E34.5, E34.8, E34.9 2 28 C16, C16.0, C16.1, C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9 C17, C17.0, C17.1, C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1 C18.2, C18.3, C18.4, C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20 C25, C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9, C26 C26.0, C26.1, C26.8, C26.9, C34, C34.0, C34.1, C34.2, C34.3, C34.8 C34.9, E34, E34.0, E34.1, E34.2, E34.3, E34.4, E34.5, E34.8, E34.9 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 OCTREOTIDUM - MG - P - POZAJELITOWO LANREOTIDUM - MG - P - POZAJELITOWO LANREOTIDUM - MG - P - POZAJELITOWO FILGRASTIMUM - J.M. - P - POZAJELITOWO 30 mg/bezp. dz. 1 X X X Guzy neuroendokrynne muszą być Prof. dr hab. n. med. Macieja Krzakowskiego - rozpoznawane i leczone w klinicznych ośrodkach endokrynologii oraz ośrodkach oraz Prof. dr hab. n. med. Beaty Kos onkologii, które stale współpracują z ośrodkami Kudła - KlinikaEndokrynologii, Katedrą endokrynologii W przypadku leczenia progresj Patofizjologii i Endokrynologii w Zabrzu oraz pacjentów z hormonalnie czynnymi guzami płuc przed zastosowaniem schematu u danego pacjenta należy spełnić 3 punkty opracowane na podstawie Deklaracji Helsińskiej z 1964 roku - stosowny tekst poniz tabeli schematów Uwaga dodatkowa - (również rozpoczecie leczenia od analogów krótko dzialajacych łącznie z octreotidum LAR) 30 mg/bezp. dz. 1 X X X Guzy neuroendokrynne muszą być Prof. dr hab. n. med. Macieja Krzakowskiego - rozpoznawane i leczone w klinicznych ośrodkach endokrynologii oraz ośrodkach onkologii, które stale współpracują z ośrodkami endokrynologii W przypadku leczenia progresj oraz pacjentów z hormonalnie czynnymi guzami płuc przed zastosowaniem schematu u danego pacjenta należy spełnić 3 punkty opracowane na podstawie Deklaracji Helsińskiej z 1964 roku - stosowny tekst poniz tabeli schematów Uwaga dodatkowa - (również rozpoczecie leczenia od analogów krótko 120 mg/bezp. dz. 1 X X X Guzy neuroendokrynne muszą być rozpoznawane i leczone w klinicznych ośrodkach endokrynologii oraz ośrodkach onkologii, które stale współpracują z ośrodkami endokrynologii Prof. dr hab. n. med. Macieja Krzakowskiego - 96 000 000 j.m./bezp. dz. 1 X X przez Dyrektora Instytutu hematologii i Transfuzjologii - Profesora dr hab. n. med. Krzysztofa Warzochę, oraz Panią Beatę Kos- Kudła - Kierownik Kliniki Endokrynologii Samodzielny Publiczny Szpital Kliniczny Nr 1 im. Prof. Stanisława Szyszko w Zabrzu Strona 10 z 203

11 0608 X X X X X G-CSF FILGRASTIMUM 300 MCG DOTYCZY MOBILIZACJI KOMÓREK MACIERZYSTYCH C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, Z51.2 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 FILGRASTIMUM - J.M. - P - POZAJELITOWO 60 000 000 j.m./bezp. dz. 1 X X przez Dyrektora Instytutu hematologii i Transfuzjologii - Profesora dr hab. n. med. Krzysztofa Warzochę, oraz Panią Beatę Kos- Kudła - Kierownik Kliniki Endokrynologii Samodzielny Publiczny Szpital Kliniczny Nr 1 im. Prof. Stanisława Szyszko w Zabrzu Strona 11 z 203

12 0609 X X X X X POSTĘPOWANIE WSPOMAGAJĄCE - MOBILIZACJA KOMÓREK MACIERZYSTYCH G-CSF C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, Z51.2 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 FILGRASTIMUM - J.M. - P - POZAJELITOWO 52 600 000 j.m./bezp. dz. 1 X X przez Dyrektora Instytutu hematologii i Transfuzjologii - Profesora dr hab. n. med. Krzysztofa Warzochę, oraz Panią Beatę Kos- Kudła - Kierownik Kliniki Endokrynologii Strona 12 z 203

C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 Samodzielny Publiczny Szpital Kliniczny Nr 1 im. Prof. Stanisława Szyszko w Zabrzu Strona 13 z 203

C92.5, C92.7, C92.9, C93, C93.0, C93.1, C93.2, C93.7, C93.9, C94 C94.0, C94.1, C94.2, C94.3, C94.4, C94.5, C94.7, C95, C95.0, C95.1 C95.2, C95.7, C95.9, C96, C96.0, C96.1, C96.2, C96.3, C96.7, C96.9 C97, Z51.2 W nawiązaniu do stanowiska Ministerstwa Zdrowia oraz zasad etycznych ujętych w Deklaracji Helsińskiej z 1964 r. (z poźn. zm.), w przypadku zastosowania produktu leczniczego poza wskazaniami rejestracyjnymi, Narodowy Fundusz Zdrowia wymaga od świadczeniodawcy: a) wcześniejszego sprawdzenia, czy istnieją inne opcjonalne sposoby postępowania o udowodnionej efektywności w danym wskazaniu, b) wcześniejszego uzyskania pisemnej, świadomej zgody pacjenta (zgodnie z załączonym wzorem) na wdrożenie u niego leczenia poza wskazaniami rejestracyjnymi, c) prowadzenia monitorowania stanu zdrowia pacjenta; we wszystkich przypadkach nowe informacje dotyczące efektywności leku oraz stanu zdrowia pacjenta powinny zostać zapisane. Strona 14 z 203

Katalog chemioterapii nie stanowi źródła wiedzy medycznej, a jest jedynie narzędziem sprawozdawczo-rozliczeniowym NFZ. W każdym przypadku za wdrożenie odpowiedniej terapii zgodnie z aktualną wiedzą medyczną odpowiada lekarz prowadzący. Lp. Kod kursu ENDOKRYNOLOGIA GINEKOLOGIA ONKOLOGICZNA Specjalności ONKOLOGIA HEMATO-ONKOLOGIA DZIECIĘCA HEMATOLOGIA Typ terapii 1 0073 X X M - CIĄŻOWA CHOROBA TROFOBLASTYCZNA, PRZYPADKI Z KORZYSTNYMI CZYNNIKAMI 2 0074 X X ML CIĄŻOWA CHOROBA TROFOBLASTYCZNA 3 0075 X X DACT CIĄŻOWA CHOROBA TROFOBLASTYCZNA 4 0076 X X EMA-CE CIĄŻOWA CHOROBA TROFOBLASTYCZNA (PRZYPADKI Z NIEKORZYSTNYMI CZYNNIKAMI ROKOWNICZYMI) 5 0076 X X EMA-CE CIĄŻOWA CHOROBA TROFOBLASTYCZNA (PRZYPADKI Z NIEKORZYSTNYMI CZYNNIKAMI ROKOWNICZYMI) 6 0077 X X EMA-CO - CIĄŻOWA CHOROBA TROFOBLASTYCZNA 7 0077 X X EMA-CO - CIĄŻOWA CHOROBA TROFOBLASTYCZNA Wariant Długość cyklu w dniach Rozpoznania kliniczne Substancje czynne Dawki 1 14 C58, D39.1 METHOTREXATUM - MG - P - POZAJELITOWO 8 0115 X X X PEB - GUZY ZARODKOWE 1 21 C48, C48.0, C48.8, C56, C57, C57.9, C62, C62.0, C62.1, C62.9 C63, C63.0, C63.1, C63.2, C63.7, C63.8, C63.9, D48, D48.0, D48.1 0,4 mg/kg dz. 1 // 0,4 mg/kg dz. 2 // 0,4 mg/kg dz. 3 // 0,4 mg/kg dz. 4 // 0,4 mg/kg 1 14 C58, D39.1 CALCII FOLINAS - MG - P - POZAJELITOWO 7,5 mg/m2 dz. 2 // 7,5 mg/m2 dz. 4 // 7,5 mg/m2 dz. 6 // 7,5 mg/m2 dz. 8 METHOTREXATUM - MG - P - 1 mg/kg dz. 1 // 1 mg/kg dz. 3 // 1 mg/kg POZAJELITOWO // 1 mg/kg dz. 7 1 14 C58 DACTINOMYCINUM - MG - P - 0,01 mg/kg dz. 1 // 0,01 mg/kg dz. 2 // 0,01 POZAJELITOWO mg/kg dz. 3 // 0,01 mg/kg dz. 4 // 0,01 mg/kg TRYB AMBULATORYJNY Warunki ŚWIADCZENIE JEDNODNIOWE HOSPITALIZACJA Uwagi Schemat merytorycznie zweryfikowany przez X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 7Prof. dr hab. n. med. Macieja Krzakowskiego - X X X Dawka Metotreksatu to1mg/kg, maksymalnie mg X X X DAKCTINOMYCINUM - import docelowy Prof. dr hab. n. med. Macieja Krzakowskiego - 1 14 C58, D39.1 DACTINOMYCINUM - MG - P - 0,5 mg/bezp. dz. 1 // 0,5 mg/bezp. dz. 2 X X X DAKCTINOMYCINUM - import docelowy doc. dr. hab. n. med. Mariusza Bidzińskiego CALCII FOLINAS - MG - P - POZAJELITOWO 30 mg/bezp. dz. 2 // 30 mg/bezp. dz. 3 // 30 Konsultant Krajowy w dziedzinie ginekologii mg/bezp. dz. 4 onkologicznej ETOPOSIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 100 mg/m2 dz. 8 CISPLATINUM - MG - P - POZAJELITOWO 80 mg/m2 dz. 8 METHOTREXATUM - MG - P - 500 mg/m2 dz. 1 2 14 C58, D39.1 DACTINOMYCINUM - MG - P - 0,5 mg/bezp. dz. 1 // 0,5 mg/bezp. dz. 2 X X X DAKCTINOMYCINUM - import docelowy doc. dr. hab. n. med. Mariusza Bidzińskiego CALCII FOLINAS - MG - O - DOUSTNIE 30 mg/bezp. dz. 2 // 30 mg/bezp. dz. 3 // 30 Konsultant Krajowy w dziedzinie ginekologii mg/bezp. dz. 4 onkologicznej ETOPOSIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 100 mg/m2 dz. 8 CISPLATINUM - MG - P - POZAJELITOWO 80 mg/m2 dz. 8 METHOTREXATUM - MG - P - 500 mg/m2 dz. 1 2 14 C58, D39.1 VINCRISTINUM - MG - P - POZAJELITOWO 1 mg/m2 dz. 8 X X X DAKCTINOMYCINUM - import docelowy doc. dr. hab. n. med. Mariusza Bidzińskiego DACTINOMYCINUM - MG - P - 0,5 mg/bezp. dz. 1 // 0,5 mg/bezp. dz. 2 CALCII FOLINAS - MG - O - DOUSTNIE 30 mg/bezp. dz. 2 // 30 mg/bezp. dz. 3 ETOPOSIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 CYCLOPHOSPHAMIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 600 mg/m2 dz. 8 METHOTREXATUM - MG - P - 300 mg/m2 dz. 1 Konsultant Krajowy w dziedzinie ginekologii onkologicznej 3 14 C58, D39.1 VINCRISTINUM - MG - P - POZAJELITOWO 1 mg/m2 dz. 8 X X X DAKCTINOMYCINUM - import docelowy doc. dr. hab. n. med. Mariusza Bidzińskiego DACTINOMYCINUM - MG - P - 0,5 mg/bezp. dz. 1 // 0,5 mg/bezp. dz. 2 Konsultant Krajowy w dziedzinie ginekologii CALCII FOLINAS - MG - P - POZAJELITOWO 30 mg/bezp. dz. 2 // 30 mg/bezp. dz. 3 onkologicznej ETOPOSIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 CYCLOPHOSPHAMIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 600 mg/m2 dz. 8 METHOTREXATUM - MG - P - 300 mg/m2 dz. 1 D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 BLEOMYCIN SULPHATE - MG - P - 15 mg/m2 dz. 1 // 15 mg/m2 dz. 8 // 15 mg/m2 POZAJELITOWO dz. 15 ETOPOSIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 100 // 100 mg/m2 dz. 4 // 100 mg/m2 CISPLATINUM - MG - P - POZAJELITOWO 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 dz. 3 // 20 mg/m2 dz. 4 // 20 mg/m2 X X Prof. dr hab. n. med. Macieja Krzakowskiego -, Prof. dr hab. n. med. Jerzego Kowalczyka Konsultant Krajowy w dziedzinie onkologii i 9 0115 X X X PEB - GUZY ZARODKOWE 2 21 C48, C48.0, C48.8, C56, C57, C57.9, C62, C62.0, C62.1, C62.9 C63, C63.0, C63.1, C63.2, C63.7, C63.8, C63.9, D48, D48.0, D48.1 D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 10 0116 X X X VIP - GUZY ZARODKOWE 1 21 C48, C48.0, C48.8, C56, C57, C57.9, C62, C62.0, C62.1, C62.9 C63, C63.0, C63.1, C63.2, C63.7, C63.8, C63.9, D48, D48.0, D48.1 D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 BLEOMYCIN SULPHATE - MG - P - 30 mg/bezp. dz. 1 // 30 mg/bezp. dz. 8 // 30 POZAJELITOWO mg/bezp. dz. 15 ETOPOSIDUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 100 // 100 mg/m2 dz. 4 // 100 mg/m2 CISPLATINUM - MG - P - POZAJELITOWO MESNUM - MG - P - POZAJELITOWO ETOPOSIDUM - MG - P - POZAJELITOWO CISPLATINUM - MG - P - POZAJELITOWO 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 dz. 3 // 20 mg/m2 dz. 4 // 20 mg/m2 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 75 mg/m2 dz. 1 // 75 mg/m2 dz. 2 // 75 mg/m2 dz. 3 // 75 mg/m2 dz. 4 // 75 mg/m2 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 dz. 3 // 20 mg/m2 dz. 4 // 20 mg/m2 X X Prof. dr hab. n. med. Macieja Krzakowskiego -, Prof. dr hab. n. med. Jerzego Kowalczyka Konsultant Krajowy w dziedzinie onkologii i oraz doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 11 0118 X X ABK - GUZY ZARODKOWE 1 1 C48, C48.0, C48.8, C56, C57, C57.9, C62, C62.0, C62.1, C62.9 C63, C63.0, C63.1, C63.2, C63.7, C63.8, C63.9, D48, D48.0, D48.1 D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 12 0135 X X X FU+LV - INNE RZADKIE NOWOTWORY 1 28 D48, D48.0, D48.1, D48.2, D48.3, D48.4, (RAKI PRZEWODU POKARMOWEGO, RAKI D48.5, D48.6, D48.7, D48.9 NARZĄDU RODNEGO) IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 DOXORUBICINUM - MG - P - 60 mg/m2 dz. 1 POZAJELITOWO BLEOMYCIN SULPHATE - MG - P - 30 mg/m2 dz. 1 POZAJELITOWO CARBOPLATINUM - MG - P - 600 mg/m2 dz. 1 POZAJELITOWO CALCII FOLINAS - MG - P - POZAJELITOWO 25 mg/m2 dz. 1 // 25 mg/m2 dz. 2 // 25 mg/m2 dz. 3 // 25 mg/m2 dz. 4 // 25 mg/m2 oraz doc. dr. hab. n. Strona 15 z 203

13 0136 X X X DP - INNE RZADKIE NOWOTWORY (RAKI PRZEWODU POKARMOWEGO, RAKI NARZĄDU RODNEGO) 14 0137 X X X FAM - INNE RZADKIE NOWOTWORY (RAKI PRZEWODU POKARMOWEGO, RAKI NARZĄDU RODNEGO). 1 21 D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 1 42 D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 FLUOROURACILUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO CISPLATINUM - MG - P - POZAJELITOWO MITOMYCINUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO FLUOROURACILUM - MG - P - POZAJELITOWO 425 mg/m2 dz. 1 // 425 mg/m2 dz. 2 // 425 // 425 mg/m2 dz. 4 // 425 mg/m2 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 dz. 3 30 mg/m2 dz. 1 // 30 mg/m2 dz. 2 // 30 mg/m2 dz. 3 4 mg/m2 dz. 1 // 4 mg/m2 dz. 2 // 4 mg/m2 dz. 3 20 mg/bezp. dz. 1 // 20 mg/bezp. dz. 2 // 20 mg/bezp. dz. 3 // 20 mg/bezp. dz. 22 // 20 mg/bezp. dz. 23 // 20 mg/bezp. dz. 24 500 mg/m2 dz. 1 // 500 mg/m2 dz. 2 // 500 // 500 mg/m2 dz. 22 // 500 mg/m2 dz. 23 // 500 mg/m2 dz. 24 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 100 500 mg/m2 dz. 1 // 500 mg/m2 dz. 2 // 500 30 mg/m2 dz. 1 // 30 mg/m2 dz. 2 // 30 mg/m2 dz. 3 med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej oraz doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant oraz doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 15 0138 X X X PFF+LV - INNE RZADKIE NOWOTWORY (RAKI PRZEWODU POKARMOWEGO, RAKI NARZĄDU RODNEGO) 1 21 D48, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5, D48.6, D48.7, D48.9 CALCII FOLINAS - MG - P - POZAJELITOWO FLUOROURACILUM - MG - P - oraz doc. dr. hab. n. POZAJELITOWO med. Mariusza Bidzińskiego Konsultant CISPLATINUM - MG - P - POZAJELITOWO Krajowy w dziedzinie ginekologii onkologicznej EPIRUBICINUM - MG - P - POZAJELITOWO 50 mg/m2 dz. 1 16 0145 X X DOX - MIĘDZYBŁONIAK 1 21 C45, C45.0, C45.1, C45.2, C45.7, C45.9 DOXORUBICINUM - MG - P - 60 mg/m2 dz. 1 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego 17 0146 X X DDP- MIĘDZYBŁONIAK 1 21 C45, C45.0, C45.1, C45.2, C45.7, C45.9 CISPLATINUM - MG - P - POZAJELITOWO 80 mg/m2 dz. 1 X X X Prof. dr hab. n. med. Macieja Krzakowskiego - 18 0152 X X AP - MIĘSAK KOŚCI TKANEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 19 0153 X X IFX-MIĘSAK KOŚCI TKANEK MIEKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 20 0154 X X AP3-MIĘSAK KOŚCI TKANEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C45, C45.0 C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7 C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6 C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1 C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1 C54.2, C54.3, C54.8, C54.9 21 0155 X X ADIC - MIĘSAK KOŚCI TKANEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 22 0156 X X ADM - MIĘSAK KOŚCI TKANEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 23 0157 X X IF07- MIĘSAK KOŚCI TKANEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 DOXORUBICINUM - MG - P - POZAJELITOWO CISPLATINUM - MG - P - POZAJELITOWO MESNUM - MG - P - POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO CISPLATINUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO 50 mg/m2 dz. 1 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii 100 mg/m2 dz. 1 onkologicznej 3 000 mg/m2 dz. 1 X X X Prof. dr hab. n. med. Macieja Krzakowskiego - 5 000 mg/m2 dz. 1 25 mg/m2 dz. 1 // 25 mg/m2 dz. 2 // 25 mg/m2 dz. 3 30 mg/m2 dz. 1 // 30 mg/m2 dz. 2 // 30 mg/m2 dz. 3 15 mg/m2 dz. 1 // 15 mg/m2 dz. 2 // 15 mg/m2 dz. 3 // 15 mg/m2 dz. 4 // 15 mg/m2 DACARBAZINUM - MG - P - POZAJELITOWO 150 mg/m2 dz. 1 // 150 mg/m2 dz. 2 // 150 // 150 mg/m2 dz. 4 // 150 mg/m2 DOXORUBICINUM - MG - P - POZAJELITOWO MESNUM - MG - P - POZAJELITOWO X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 75 mg/m2 dz. 1 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 2 200 mg/bezp. dz. 1 // 2 200 mg/bezp. dz. 2 // 2 200 mg/bezp. dz. 3 // 2 200 mg/bezp. dz. 4 // 2 200 mg/bezp. // 2 200 mg/bezp. dz. 6 // 2 200 mg/bezp. dz. 7 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej Strona 16 z 203

C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 24 0158 X X IF03 - MIĘSAK KOŚCI TKANEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 25 0159 X X VAC - MIĘSAK KOŚCI TAKNEK MIĘKKICH 1 21 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 26 0160 X X X VAC - MIĘSAKI TKANEK MIĘKKICH 1 28 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 27 0161 X X VACA - MIĘSAKI TKANEK MIĘKKICH 1 28 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 28 0162 X X CYVADIC WG PINEDO - MIĘSAK TKANEK MIĘKKICH, MIĘDZYBŁONIAK, CZERNIAK C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9 C54, C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 29 0163 X X X VCR - MIĘSAK TKANEK MIĘKKICH 1 7 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 30 0164 X X MAI - MIĘSAK TKANEK MIĘKKICH 1 28 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 31 0165 X X CI.V.ADIC - MIĘSAK TKANEK MIĘKKICH 1 21 C45, C45.0, C45.1, C45.2, C45.7, C46, C46.0, C46.1, C46.2, C46.3 C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4, C47.5 IFOSFAMIDUM - MG - P - POZAJELITOWO MESNUM - MG - P - POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO VINCRISTINUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO CYCLOPHOSPHAMIDUM - MG - P - POZAJELITOWO VINCRISTINUM - MG - P - POZAJELITOWO DACTINOMYCINUM - MG - P - POZAJELITOWO CYCLOPHOSPHAMIDUM - MG - P - POZAJELITOWO VINCRISTINUM - MG - P - POZAJELITOWO DACTINOMYCINUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO CYCLOPHOSPHAMIDUM - MG - P - POZAJELITOWO 1 700 mg/m2 dz. 1 // 1 700 mg/m2 dz. 2 // 1 700 // 1 700 mg/m2 dz. 4 // 1 700 mg/m2 // 1 700 mg/m2 dz. 6 // 1 700 mg/m2 dz. 7 3 900 mg/bezp. dz. 1 // 3 900 mg/bezp. dz. 2 // X X X doc. dr. hab. n. med. Mariusza Bidzińskiego 3 900 mg/bezp. dz. 3 Konsultant Krajowy w dziedzinie ginekologii onkologicznej 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 1,4 mg/m2 dz. 1 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii 45 mg/m2 dz. 1 // 45 mg/m2 dz. 2 onkologicznej 800 mg/m2 dz. 1 // 800 mg/m2 dz. 2 1,5 mg/m2 dz. 1 mg/kg X X DACTINOMYCINUM - import docelowy Prof. dr hab. n. med. Jerzego Kowalczyka oraz przez dr hab. n. med. Mariusza Bidzińskiego konsultanta krajowego w dziedzinie ginekologii onkologicznej 0,015 mg/kg dz. 1 // 0,015 mg/kg dz. 2 // 0,015 mg/kg dz. 3 // 0,015 mg/kg dz. 4 // 0,015 200 mg/m2 dz. 1 // 200 mg/m2 dz. 2 // 200 // 200 mg/m2 dz. 4 // 200 mg/m2 1,5 mg/m2 dz. 1 X X DACTINOMYCINUM - import docelowy Prof. dr hab. n. med. Jerzego Kowalczyka 0,015 mg/kg dz. 1 // 0,015 mg/kg dz. 2 // 0,015 mg/kg dz. 3 // 0,015 mg/kg dz. 4 // 0,015 mg/kg 60 mg/m2 dz. 1 200 mg/m2 dz. 1 // 200 mg/m2 dz. 2 // 200 // 200 mg/m2 dz. 4 // 200 mg/m2 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 1 28 C43, C43.0, C43.1, C43.2, C43.3, C43.4, VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 C43.5, C43.6, C43.7, C43.8 C43.9, C45, C45.0, C45.1, C45.2, C45.7, DOXORUBICINUM - MG - P - 50 mg/m2 dz. 2 C45.9, C46, C46.0, C46.1 POZAJELITOWO C46.2, C46.3, C46.7, C46.8, C46.9, C47, DACARBAZINUM - MG - P - POZAJELITOWO 250 mg/m2 dz. 1 // 250 mg/m2 dz. 2 // 250 C47.0, C47.1, C47.2, C47.3 // 250 mg/m2 dz. 4 // 250 mg/m2 C47.4, C47.5, C47.6, C47.8, C47.9, C48, CYCLOPHOSPHAMIDUM - MG - P - 500 mg/m2 dz. 2 C48.0, C48.1, C48.2, C48.8 POZAJELITOWO VINCRISTINUM - MG - P - POZAJELITOWO MESNUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 3 000 mg/m2 dz. 1 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii 50 mg/m2 dz. 1 onkologicznej 5 000 mg/m2 dz. 1 VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 // 1,5 mg/m2 dz. 8 // 1,5 mg/m2 dz. 15 DOXORUBICINUM - MG - P - 50 mg/m2 dz. 2 POZAJELITOWO X X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej Strona 17 z 203

C47.6, C47.8, C47.9, C48, C48.0, C48.1, DACARBAZINUM - MG - P - POZAJELITOWO 250 mg/m2 dz. 1 // 250 mg/m2 dz. 2 // 250 C48.2, C48.8, C49, C49.0 // 250 mg/m2 dz. 4 // 250 mg/m2 C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, CYCLOPHOSPHAMIDUM - MG - P - 500 mg/m2 dz. 2 C49.8, C49.9, C54, C54.0 POZAJELITOWO C54.1, C54.2, C54.3, C54.8, C54.9 32 0166 X X X 12VAD - MIĘSAK TKANEK MIĘKKICH 1 15 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 MESNUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 C46.3, C46.7, C46.8, C46.9, C47, C47.0, VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 // 1,5 mg/m2 dz. 8 // 1,5 C47.1, C47.2, C47.3, C47.4 mg/m2 dz. 15 C47.5, C47.6, C47.8, C47.9, C48, C48.0, DOXORUBICINUM - MG - P - 40 mg/m2 dz. 1 // 40 mg/m2 dz. 2 C48.1, C48.2, C48.8, C49 POZAJELITOWO C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 33 0167 X X MIĘSAK TKANEK MIĘKKICH 1 1 C45, C45.0, C45.1, C45.2, C45.7, C45.9, DOXORUBICINUM - MG - P - C46, C46.0, C46.1, C46.2 POZAJELITOWO C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 34 0168 X X MIĘSAK TKANEK MIĘKKICH IFOSFAMIDUM 1 21 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 35 0169 X X MIĘSAKI TAKNEK MIĘKKICH 1 21 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C49, C49.0 C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54, C54.0 C54.1, C54.2, C54.3, C54.8, C54.9 36 0170 X X MAID - MIĘSAK TKANEK MIĘKKICH 1 21 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 37 0171 X X X VAIA - MIĘSAK TKANEK MIĘKKICH 1 24 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 IFOSFAMIDUM - MG - P - POZAJELITOWO MESNUM - MG - P - POZAJELITOWO DOXORUBICINUM - MG - P - POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 75 mg/m2 dz. 1 X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii onkologicznej 8 000 mg/m2 dz. 1 X X schemat należy powtarzac co 3 tygodnie Prof. dr hab. n. med. Macieja Krzakowskiego - 6 000 mg/m2 dz. 1 // 2 500 mg/m2 dz. 2 X X X schemat należy powtarzac co 3 tygodnie doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultant Krajowy w dziedzinie ginekologii 50 mg/m2 dz. 1 onkologicznej 5 000 mg/m2 dz. 1 MESNUM - MG - P - POZAJELITOWO 1 500 mg/m2 dz. 1 // 1 500 mg/m2 dz. 2 // 1 500 // 1 500 mg/m2 dz. 4 DOXORUBICINUM - MG - P - 15 mg/m2 dz. 1 // 15 mg/m2 dz. 2 // 15 mg/m2 POZAJELITOWO dz. 3 // 15 mg/m2 dz. 4 DACARBAZINUM - MG - P - POZAJELITOWO 250 mg/m2 dz. 1 // 250 mg/m2 dz. 2 // 250 // 250 mg/m2 dz. 4 IFOSFAMIDUM - MG - P - POZAJELITOWO 2 500 mg/m2 dz. 1 // 2 500 mg/m2 dz. 2 // 2 500 MESNUM - MG - P - POZAJELITOWO 3 600 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 // 3 000 mg/m2 dz. 4 // 3 600 mg/m2 dz. 21 // 3 000 mg/m2 dz. 22 // 3 000 mg/m2 dz. 23 // 3 000 mg/m2 dz. 24 X X X Prof. dr hab. n. med. Macieja Krzakowskiego - X X DACTINOMYCINUM - import docelowy Uwaga Prof. dr hab. n. med. Jerzego Kowalczyka dodatkowa cały kurs 7 tygodni C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 38 0172 X X X IVA - MIĘSAK TKANEK MIĘKKICH 1 15 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 39 0173 X X IVADO - MIĘSAK TKANEK MIĘKKICH 1 3 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, C48.1, C48.2, C48.8, C49 C54, C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 40 0174 X X CAV - MIĘSAK TKANEK MIĘKKICH I MIĘSAK 1 3 C40, C40.0, C40.1, C40.2, C40.3, C40.8, EWINGA C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 // 1,5 mg/m2 dz. 8 // 1,5 mg/m2 dz. 15 // 1,5 mg/m2 dz. 22 DACTINOMYCINUM - MG - P - 1,5 mg/m2 dz. 1 POZAJELITOWO DOXORUBICINUM - MG - P - 40 mg/m2 dz. 21 // 40 mg/m2 dz. 22 POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 mg/m2 dz. 21 // 3 000 mg/m2 dz. 22 MESNUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 2 // 3 000 // 3 000 mg/m2 dz. 4 VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 // 1,5 mg/m2 dz. 8 // 1,5 mg/m2 dz. 15 DACTINOMYCINUM - MG - P - 3 600 mg/m2 dz. 1 POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 MESNUM - MG - P - POZAJELITOWO VINCRISTINUM - MG - P - POZAJELITOWO 3 000 1,5 mg/m2 dz. 1 X Prof. dr hab. n. med. Jerzego Kowalczyka DACTINOMYCINUM - MG - P - 0,75 mg/m2 dz. 1 // 0,75 mg/m2 dz. 2 POZAJELITOWO DOXORUBICINUM - MG - P - 60 mg/m2 dz. 1 POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 MESNUM - MG - P - POZAJELITOWO 750 mg/m2 dz. 1 // 750 mg/m2 dz. 2 // 750 VINCRISTINUM - MG - P - POZAJELITOWO 2 mg/m2 dz. 1 DOXORUBICINUM - MG - P - 25 mg/m2 dz. 1 // 25 mg/m2 dz. 2 // 25 mg/m2 POZAJELITOWO dz. 3 CYCLOPHOSPHAMIDUM - MG - P - 1 200 mg/m2 dz. 1 POZAJELITOWO Strona 18 z 203

41 0175 X X ETIF - MIĘSAK TKANEK MIĘKKICH I MIĘSAK EWINGA 42 0176 X X ADM+IF - MIĘSAK TKANEK MIĘKKICH I MIĘSAK EWINGA 1 6 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 1 4 C40, C40.0, C40.1, C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1 C41.2, C41.3, C41.4, C41.8, C41.9, C45, C45.0, C45.1, C45.2, C45.7 C45.9, C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47 MESNUM - MG - P - POZAJELITOWO ETOPOSIDUM - MG - P - POZAJELITOWO IFOSFAMIDUM - MG - P - POZAJELITOWO 1 800 mg/m2 dz. 1 // 1 800 mg/m2 dz. 2 // 1 800 // 1 800 mg/m2 dz. 4 // 1 800 mg/m2 // 1 800 mg/m2 dz. 6 100 mg/m2 dz. 1 // 100 mg/m2 dz. 2 // 100 // 100 mg/m2 dz. 4 // 100 mg/m2 1 800 mg/m2 dz. 1 // 1 800 mg/m2 dz. 2 // 1 800 // 1 800 mg/m2 dz. 4 // 1 800 mg/m2 MESNUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 // 3 000 mg/m2 dz. 4 DOXORUBICINUM - MG - P - 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 POZAJELITOWO dz. 3 IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 C47.0, C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48 C48.0, C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4 C49.5, C49.6, C49.8, C49.9, C54, C54.0, C54.1, C54.2, C54.3, C54.8 C54.9 43 0177 X X VAIA - MIĘSAK TKANEK MIĘKKICH 1 5 C45, C45.0, C45.1, C45.2, C45.7, C45.9, C46, C46.0, C46.1, C46.2 MESNUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 // 3 000 C46.3, C46.7, C46.8, C46.9, C47, C47.0, VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, DACTINOMYCINUM - MG - P - 0,015 mg/kg dz. 1 // 0,015 mg/kg dz. 2 // 0,015 C48.1, C48.2, C48.8, C49 POZAJELITOWO mg/kg dz. 3 // 0,015 mg/kg dz. 4 // 0,015 mg/kg C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, DOXORUBICINUM - MG - P - 60 mg/m2 dz. 1 C49.6, C49.8, C49.9, C54 POZAJELITOWO C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 IFOSFAMIDUM - MG - P - POZAJELITOWO 3 000 mg/m2 dz. 1 // 3 000 mg/m2 dz. 2 44 0178 X X ICARET - MIĘSAK TKANEK MIĘKKICH 1 4 C45, C45.0, C45.1, C45.2, C45.7, C45.9, MESNUM - MG - P - POZAJELITOWO 1 500 mg/m2 dz. 1 // 1 500 mg/m2 dz. 2 // C46, C46.0, C46.1, C46.2 1 500 // 1 500 mg/m2 dz. 4 C46.3, C46.7, C46.8, C46.9, C47, C47.0, ETOPOSIDUM - MG - P - POZAJELITOWO 150 mg/m2 dz. 1 // 150 mg/m2 dz. 2 // 150 C47.1, C47.2, C47.3, C47.4 C47.5, C47.6, C47.8, C47.9, C48, C48.0, IFOSFAMIDUM - MG - P - POZAJELITOWO 1 500 mg/m2 dz. 1 // 1 500 mg/m2 dz. 2 // C48.1, C48.2, C48.8, C49 1 500 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, CARBOPLATINUM - MG - P - 300 mg/m2 dz. 1 C49.6, C49.8, C49.9, C54 POZAJELITOWO C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 45 0179 X X CEV - MIĘSAK TKANEK MIĘKKICH 1 1 C45, C45.0, C45.1, C45.2, C45.7, C45.9, VINCRISTINUM - MG - P - POZAJELITOWO C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, CARBOPLATINUM - MG - P - 500 mg/m2 dz. 1 C47.1, C47.2, C47.3, C47.4 POZAJELITOWO C47.5, C47.6, C47.8, C47.9, C48, C48.0, EPIRUBICINUM - MG - P - POZAJELITOWO 150 mg/m2 dz. 1 C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 46 0180 X X I 3VE - MIESAK TKANEK MIĘKKICH 1 15 C45, C45.0, C45.1, C45.2, C45.7, C45.9, MESNUM - MG - P - POZAJELITOWO C46, C46.0, C46.1, C46.2 C46.3, C46.7, C46.8, C46.9, C47, C47.0, VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 // 1,5 mg/m2 dz. 8 // 1,5 C47.1, C47.2, C47.3, C47.4 mg/m2 dz. 15 C47.5, C47.6, C47.8, C47.9, C48, C48.0, ETOPOSIDUM - MG - P - POZAJELITOWO 450 mg/m2 dz. 1 C48.1, C48.2, C48.8, C49 C49.0, C49.1, C49.2, C49.3, C49.4, C49.5, IFOSFAMIDUM - MG - P - POZAJELITOWO 9 000 mg/m2 dz. 1 C49.6, C49.8, C49.9, C54 C54.0, C54.1, C54.2, C54.3, C54.8, C54.9 47 0221 X X BEP - NOWOTWORY ZARODKOWE I 1 21 C56 BLEOMYCIN SULPHATE - MG - P - 30 mg/bezp. dz. 1 // 30 mg/bezp. dz. 8 // 30 POZAGONADALNE JAJNIKA POZAJELITOWO mg/bezp. dz. 15 48 0221 X X BEP - NOWOTWORY ZARODKOWE I POZAGONADALNE JAJNIKA ETOPOSIDUM - MG - P - POZAJELITOWO X X DACTINOMYCINUM - import docelowy Prof. dr hab. n. med. Jerzego Kowalczyka 1,5 mg/m2 dz. 1 10 000 mg/m2 dz. 1 120 mg/m2 dz. 1 // 120 mg/m2 dz. 2 // 120 // 120 mg/m2 dz. 4 // 120 mg/m2 X X X Prof. dr hab. n. med. Macieja Krzakowskiego - CISPLATINUM - MG - P - POZAJELITOWO 100 mg/m2 dz. 1 2 21 C56 ETOPOSIDUM - MG - O - DOUSTNIE (ORAL 120 mg/m2 dz. 1 // 120 mg/m2 dz. 2 // 120 X X X Prof. dr hab. n. med. Macieja Krzakowskiego - PER MOUTH) // 120 mg/m2 dz. 4 // 120 mg/m2 BLEOMYCIN SULPHATE - MG - P - 30 mg/bezp. dz. 1 // 30 mg/bezp. dz. 8 // 30 POZAJELITOWO mg/bezp. dz. 15 CISPLATINUM - MG - P - POZAJELITOWO 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 dz. 3 // 20 mg/m2 dz. 4 // 20 mg/m2 49 0222 X X PVB1 - NOWOTWORY ZARODKOWE I POZAGONADALNE JAJNIKA 50 0223 X X VAC1 - NOWOTWORY ZARODKOWE I POZAGONADALNE JAJNIKA 51 0311 X X X X X G-CSF 480 - POSTĘPOWANIE WSPOMAGAJACE 1 21 C56 VINBLASTINUM - MG - P - POZAJELITOWO 6 mg/m2 dz. 1 // 6 mg/m2 dz. 2 X X X doc. dr. hab. n. med. Mariusza Bidzińskiego BLEOMYCIN SULPHATE - MG - P - 15 mg/m2 dz. 1 // 15 mg/m2 dz. 8 Konsultanta Krajowego w dziedzinie ginekologii CISPLATINUM - MG - P - POZAJELITOWO 20 mg/m2 dz. 1 // 20 mg/m2 dz. 2 // 20 mg/m2 onkologicznej oraz przez Prof. dr hab. n. med. dz. 3 // 20 mg/m2 dz. 4 // 20 mg/m2 Jerzego Kowalczyka Konsultant Krajowy w dziedzinie onkologii i 1 28 C56 VINCRISTINUM - MG - P - POZAJELITOWO 1,5 mg/m2 dz. 1 // 1,5 mg/m2 dz. 15 X X X DACTINOMYCINUM - import docelowy, Dawka Prof. dr hab. n. med. Macieja Krzakowskiego - 1 1 C00, C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9 C01, C02, C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03 DACTINOMYCINUM - MG - P - 0,5 mg/m2 dz. 1 // 0,5 mg/m2 CYCLOPHOSPHAMIDUM - MG - P - 150 mg/m2 dz. 1 // 150 mg/m2 dz. 2 // 150 POZAJELITOWO // 150 mg/m2 dz. 4 // 150 mg/m2 FILGRASTIMUM - J.M. - P - POZAJELITOWO VCR powinna być 1,5 mg/m2, a max jednorazowo 2 mg 48 000 000 j.m./bezp. dz. 1 X X doc. dr. hab. n. med. Mariusza Bidzińskiego Konsultanta Krajowego w dziedzinie ginekologii onkologicznej, Prof. dr hab. n. med. Macieja Krzakowskiego - Konsultanta Krajowego w Strona 19 z 203

C03.0, C03.1, C03.9, C04, C04.0, C04.1, C04.8, C04.9, C05, C05.0 C05.1, C05.2, C05.8, C05.9, C06, C06.0, C06.1, C06.2, C06.8, C06.9 C07, C08, C08.0, C08.1, C08.8, C08.9, C09, C09.0, C09.1, C09.8 C09.9, C10, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11 C11.0, C11.1, C11.2, C11.3, C11.8, C11.9, C12, C13, C13.0, C13.1 C13.2, C13.8, C13.9, C14, C14.0, C14.1, C14.2, C14.8, C15, C15.0 C15.1, C15.2, C15.3, C15.4, C15.5, C15.8, C15.9, C16, C16.0, C16.1 C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17, C17.0, C17.1 C17.2, C17.3, C17.8, C17.9, C18, C18.0, C18.1, C18.2, C18.3, C18.4 C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21, C21.0, C21.1 C21.2, C21.8, C22, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.9 C23, C24, C24.0, C24.1, C24.8, C24.9, C25, C25.0, C25.1, C25.2 C25.3, C25.4, C25.7, C25.8, C25.9, C26, C26.0, C26.1, C26.8, C26.9 C30, C30.0, C30.1, C31, C31.0, C31.1, C31.2, C31.3, C31.8, C31.9 C32, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34, C34.0 C34.1, C34.2, C34.3, C34.8, C34.9, C37, C38, C38.0, C38.1, C38.2 C38.3, C38.4, C38.8, C39, C39.0, C39.8, C39.9, C40, C40.0, C40.1 C40.2, C40.3, C40.8, C40.9, C41, C41.0, C41.1, C41.2, C41.3, C41.4 C41.8, C41.9, C43, C43.0, C43.1, C43.2, C43.3, C43.4, C43.5, C43.6 C43.7, C43.8, C43.9, C44, C44.0, C44.1, C44.2, C44.3, C44.4, C44.5 C44.6, C44.7, C44.8, C44.9, C45, C45.0, C45.1, C45.2, C45.7, C45.9 C46, C46.0, C46.1, C46.2, C46.3, C46.7, C46.8, C46.9, C47, C47.0 C47.1, C47.2, C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48, C48.0 C48.1, C48.2, C48.8, C49, C49.0, C49.1, C49.2, C49.3, C49.4, C49.5 C49.6, C49.8, C49.9, C50, C50.0, C50.1, C50.2, C50.3, C50.4, C50.5 C50.6, C50.8, C50.9, C51, C51.0, C51.1, C51.2, C51.8, C51.9, C52 C53, C53.0, C53.1, C53.8, C53.9, C54, C54.0, C54.1, C54.2, C54.3 C54.8, C54.9, C55, C56, C57, C57.0, C57.1, C57.2, C57.3, C57.4 C57.7, C57.8, C57.9, C58, C60, C60.0, C60.1, C60.2, C60.8, C60.9 C61, C62, C62.0, C62.1, C62.9, C63, C63.0, C63.1, C63.2, C63.7 C63.8, C63.9, C64, C65, C66, C67, C67.0, C67.1, C67.2, C67.3 C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68, C68.0, C68.1, C68.8 C68.9, C69, C69.0, C69.1, C69.2, C69.3, C69.4, C69.5, C69.6, C69.8 C69.9, C70, C70.0, C70.1, C70.9, C71, C71.0, C71.1, C71.2, C71.3 C71.4, C71.5, C71.6, C71.7, C71.8, C71.9, C72, C72.0, C72.1, C72.2 C72.3, C72.4, C72.5, C72.8, C72.9, C73, C74, C74.0, C74.1, C74.9 C75, C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76 C76.0, C76.1, C76.2, C76.3, C76.4, C76.5, C76.7, C76.8, C77, C77.0 C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78, C78.0, C78.1 C78.2, C78.3, C78.4, C78.5, C78.6, C78.7, C78.8, C79, C79.0, C79.1 C79.2, C79.3, C79.4, C79.5, C79.6, C79.7, C79.8, C80, C81, C81.0 C81.1, C81.2, C81.3, C81.7, C81.9, C82, C82.0, C82.1, C82.2, C82.7 C82.9, C83, C83.0, C83.1, C83.2, C83.3, C83.4, C83.5, C83.6, C83.7 C83.8, C83.9, C84, C84.0, C84.1, C84.2, C84.3, C84.4, C84.5, C85 C85.0, C85.1, C85.7, C85.9, C88, C88.0, C88.1, C88.2, C88.3, C88.7 C88.9, C90, C90.0, C90.1, C90.2, C91, C91.0, C91.1, C91.2, C91.3 C91.4, C91.5, C91.7, C91.9, C92, C92.0, C92.1, C92.2, C92.3, C92.4 dziedzinie onkologi, Prof. dr hab. n. med. Jerzego Kowalczyka w Konsultanta Krajowego Konsultant Krajowy w dziedzinie onkologii i Strona 20 z 203