Generated Narrative: StructureDefinition SystemicTreatment

NameFlagsCard.TypeDescription & Constraintsdoco
.. SystemicTreatment 0..*BaseSystemic Treatment
... diagnosisReference O1..*DiagnosisDiagnosis reference (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... episodeEvent O1..*EpisodeEventEpisode Event reference (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... systemicTreatmentHospital O1..*stringSystemicTreatment Hospital (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... typeOfSystemicTreatment O1..*CodeableConcepttype of systemic treatment (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... intent O0..*CodeableConceptIntent (O)
ObligationsActor
SHALL:handleHead and Neck
... setting O0..*CodeableConceptSetting (O)
ObligationsActor
SHALL:handleHead and Neck
... chemotherapyInfo O0..*CodeableConceptChemotherapy info (O)
ObligationsActor
SHALL:handleSarcoma
... startDateSystemicTreatment O1..*dateStart date systemic treatment (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... endDateSystemicTreatment O1..*dateEnd date systemic treatment (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... numberOfCycles O0..*QuantityNumber of cycles/ administrations (O)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... regimen O0..*CodeableConceptRegimen (O)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... startDateRegimenChanged O1..*dateStart date regimen changed (M)
ObligationsActor
SHALL:handleHead and Neck
... endDateRegimenChanged O1..*dateEnd date regimen changed (M)
ObligationsActor
SHALL:handleHead and Neck
... reasonForEndOfTreatment O1..*CodeableConceptReason for end of treatment (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma
... treatmentResponse O1..*CodeableConceptTreatment response (based on imaging alone; no recist or other criteria) (M)
ObligationsActor
SHALL:handleHead and Neck
SHALL:handleSarcoma

doco Documentation for this format
 <status value="active"/> <date value="2026-09-17T14:38:18+02:00"/> <publisher value="IDEA4RC Project"/> <contact> <name value="IDEA4RC Project"/> <telecom> <system value="url"/> <value value="https://www.idea4rc.eu/"/> </telecom> </contact> <contact> <name value="IDEA4RC Project"/> <telecom> <system value="url"/> <value value="https://www.idea4rc.eu/"/> </telecom> </contact> <description value="Systemic Treatment Maturity Level: 0 Draft"/> <jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="150"/> <display value="Europe"/> </coding> </jurisdiction> <fhirVersion value="4.0.1"/> <kind value="logical"/> <abstract value="false"/> <type value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/> <derivation value="specialization"/> <snapshot> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version"> <valueString value="4.0.1"/> </extension> <element id="SystemicTreatment"> <path value="SystemicTreatment"/> <short value="Systemic Treatment"/> <definition value="Systemic Treatment Maturity Level: 0 Draft"/> <min value="0"/> <max value="*"/> <base> <path value="Base"/> <min value="0"/> <max value="*"/> </base> <isModifier value="false"/> </element> <element id="SystemicTreatment.diagnosisReference"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.diagnosisReference"/> <short value="Diagnosis reference (M)"/> <definition value="Diagnosis reference in case the treatment was done for baseline"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.diagnosisReference"/> <min value="1"/> <max value="*"/> </base> <type> <code value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Diagnosis"/> </type> </element> <element id="SystemicTreatment.episodeEvent"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.episodeEvent"/> <short value="Episode Event reference (M)"/> <definition value="EpisodeEvent element containing the data regarding the patient's cancer"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.episodeEvent"/> <min value="1"/> <max value="*"/> </base> <type> <code value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/EpisodeEvent"/> </type> </element> <element id="SystemicTreatment.systemicTreatmentHospital"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.systemicTreatmentHospital"/> <short value="SystemicTreatment Hospital (M)"/> <definition value="In which hospital was the SystemicTreatment performed"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.systemicTreatmentHospital"/> <min value="1"/> <max value="*"/> </base> <type> <code value="string"/> </type> </element> <element id="SystemicTreatment.typeOfSystemicTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.typeOfSystemicTreatment"/> <short value="type of systemic treatment (M)"/> <definition value="Select the type of systemic treatment administered. It is possible to directly select the single treatment as appropriate."/> <comment value="Chemotherapy - 4273629 Immunotherapy - 40310107 Targeted therapy - 912065"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.typeOfSystemicTreatment"/> <min value="1"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.intent"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.intent"/> <short value="Intent (O)"/> <definition value="Clarifies the reasons why systemic therapy is administered • Curative chemotherapy is chemotherapy administered with the goal of achieving a complete remission and preventing the recurrence of cancer. • Palliative chemotherapy refers to any chemotherapy administration that is not curative but administered simply to decrease tumor load and increase life expectancy. It has been defined also as “…treatment in circumstances where the impact of intervention is insufficient to result in major survival advantage, but does affect improvement in terms of tumor‐related symptoms…”"/> <comment value="Palliative - 4179711 Curative procedure intent - 4162591"/> <min value="0"/> <max value="*"/> <base> <path value="SystemicTreatment.intent"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.setting"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.setting"/> <short value="Setting (O)"/> <definition value="Clarifies the context / how the therapy was administered alone or in conjunction with other treatments • Neoadjuvant: treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given. Examples of neoadjuvant therapy include chemotherapy, radiation therapy, and hormone therapy. It is a type of induction therapy. • Adjuvant: additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy. • Concomitant Systemic Treatment/concurrent: A treatment that is given at the same time as another (es. Chemotherapy and radiotherapy)."/> <comment value="Neo-adjuvant - 44808409 Concomitant Systemic Treatment - 2000100028 Adjuvant - 44804498 Systemic treatment alone - 2000100029"/> <min value="0"/> <max value="*"/> <base> <path value="SystemicTreatment.setting"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.chemotherapyInfo"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.chemotherapyInfo"/> <short value="Chemotherapy info (O)"/> <definition value="Information for chemotherapy"/> <comment value="Preoperative - 4119031 Postoperative period - 4118656 Hyperthermic intraperitoneal chemotherapy - 3184898 Therapeutic - 4133895"/> <min value="0"/> <max value="*"/> <base> <path value="SystemicTreatment.chemotherapyInfo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.startDateSystemicTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.startDateSystemicTreatment"/> <short value="Start date systemic treatment (M)"/> <definition value="Specifies when systemic treatment begins"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.startDateSystemicTreatment"/> <min value="1"/> <max value="*"/> </base> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.endDateSystemicTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.endDateSystemicTreatment"/> <short value="End date systemic treatment (M)"/> <definition value="Specifies when systemic treatment ends"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.endDateSystemicTreatment"/> <min value="1"/> <max value="*"/> </base> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.numberOfCycles"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.numberOfCycles"/> <short value="Number of cycles/ administrations (O)"/> <definition value="Clarifies how many times the treatment was administered. A cycle of treatment is a period of treatment followed by a period of rest (no treatment). For example, treatment given for one week followed by three weeks of rest is one cycle of treatment. A cycle can be repeated multiple times."/> <min value="0"/> <max value="*"/> <base> <path value="SystemicTreatment.numberOfCycles"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Quantity"/> </type> </element> <element id="SystemicTreatment.regimen"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.regimen"/> <short value="Regimen (O)"/> <definition value="The regimen applied to the patient. If this is not present, or the specific regimen is not listed here, use the DrugsForTreatments entity."/> <comment value="Doxorubicin and Ifosfamide - 35806965 Ifosfamide and Paclitaxel - 35805248 doxorubicin and vincristine - 2000100054 Epirubicin monotherapy - 35804228 Etoposide monotherapy - 35803691 Gemcitabine monotherapy - 35804135 Ifosfamide and Gemcitabine - 35806435 gemcitabine and vincristine - 2000100055 high dose cisplatin - 2000100056 Ifosfamide monotherapy - 35804542 ifosfamide and etoposide - 2000100057 Irinotecan liposomal monotherapy - 35805368 Lenvatinib monotherapy - 35805795 Methotrexate monotherapy - 35804095 Nivolumab monotherapy - 35803677 ADT (other androgen deprivation therapy) - 35806821 Oxaliplatin monotherapy - 35805078 Paclitaxel monotherapy - 35804166 Gemcitabine and Paclitaxel - 35804158 Ifosfamide and Paclitaxel - 35805248 Paclitaxel and Trastuzumab (TH) - 35804201 Paclitaxel and Vinorelbine - 35101452 Pembrolizumab monotherapy - 35803678 Sorafenib monotherapy - 35803487 Trastuzumab emtansine monotherapy (TDM1) - 35805230 Trastuzumab monotherapy - 35804222 Vinorelbine monotherapy - 35804241 weekly carboplatin - 2000100058 weekly cisplatin - 2000100059 Epirubicin and Ifosfamide - 35806948 Vincristine and Doxorubicin and Ifosfamide - 2000100060 Vincristine, Actinomycin D, Ifosfamide ( VAI) - 35805452 Docetaxel and Gemcitabine - 35803577 Dacarbazine and Doxorubicin - 35806964 Methotrexate and Doxorubicin and Cisplatin - 2000100061 Methotrexate and Doxorubicin and Ifosfamide - 2000100062 Doxorubicin and Cisplatin and Ifosfamide - 2000100063 Cisplatin and Doxorubicin - 35804819 Methotrexate and Vinorelbine - 2000100064 Ifosfamide and Etoposide (IE) - 35805454 Vincristine and Doxorubicin and Cyclophosphamide - 2000100065 Cyclophosphamide and Etoposide - 35806476 Doxorubicin and Ifosfamide and Dacarbazine - 2000100066 Dacarbazine and Gemcitabine - 35806969 Cyclophosphamide and Topotecan - 35805453 Irinotecan and Vincristine - 2000100067 Irinotecan and Temozolomide - 35805455 Busulfan and Melphalan - 35804000 TNF and Melphalan - 2000100068 Cyclophosphamide and Vinorelbine - 2000100069 Vincristine, Ifosfamide, Doxorubicin, Etoposide (VIDE) - 35805451 Pazopanib monotherapy - 35805690 Regorafenib monotherapy - 35804569 high dose Ifosfamide - 2000100070"/> <min value="0"/> <max value="*"/> <base> <path value="SystemicTreatment.regimen"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.startDateRegimenChanged"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.startDateRegimenChanged"/> <short value="Start date regimen changed (M)"/> <definition value="Specifies when the new systemic treatment begins, if a combination please specify the start of the first drug"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.startDateRegimenChanged"/> <min value="1"/> <max value="*"/> </base> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.endDateRegimenChanged"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.endDateRegimenChanged"/> <short value="End date regimen changed (M)"/> <definition value="Specifies when the new systemic treatment ends,if a combination please specify the end of the last drug"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.endDateRegimenChanged"/> <min value="1"/> <max value="*"/> </base> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.reasonForEndOfTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.reasonForEndOfTreatment"/> <short value="Reason for end of treatment (M)"/> <definition value="Clarifies the reasons why the treatment ended or was interrupted"/> <comment value="Completed successfully - 44788181 Chemotherapy changed acute chemotherapy toxicity - 4162594 Treatment ended due to comorbidity - 2000100030 Intolerance to drug - 4240582 Procedure discontinued by patient - 37017062 Death - 4306655"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.reasonForEndOfTreatment"/> <min value="1"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.treatmentResponse"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/SystemicTreatment|1.0.0"/> </extension> </extension> <path value="SystemicTreatment.treatmentResponse"/> <short value="Treatment response (based on imaging alone; no recist or other criteria) (M)"/> <definition value="Measures how well a cancer patient responds to treatment. RECIST criteria should not be applied. The definition of Complete response; Partial response; Stable disease; Progression, should be based on the clinical judgement based on imaging. Only when setting=neoadiuvant or palliative"/> <comment value="Complete Remission - 32946 Partial Remission - 32947 Stable Disease - 32948 Progression - 32949 Not applicable - 4294169 (Not usable in OMOP)"/> <min value="1"/> <max value="*"/> <base> <path value="SystemicTreatment.treatmentResponse"/> <min value="1"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> </element> </snapshot> <differential> <element id="SystemicTreatment"> <path value="SystemicTreatment"/> <short value="Systemic Treatment"/> <definition value="Systemic Treatment Maturity Level: 0 Draft"/> </element> <element id="SystemicTreatment.diagnosisReference"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.diagnosisReference"/> <short value="Diagnosis reference (M)"/> <definition value="Diagnosis reference in case the treatment was done for baseline"/> <min value="1"/> <max value="*"/> <type> <code value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Diagnosis"/> </type> </element> <element id="SystemicTreatment.episodeEvent"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.episodeEvent"/> <short value="Episode Event reference (M)"/> <definition value="EpisodeEvent element containing the data regarding the patient's cancer"/> <min value="1"/> <max value="*"/> <type> <code value="http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/EpisodeEvent"/> </type> </element> <element id="SystemicTreatment.systemicTreatmentHospital"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.systemicTreatmentHospital"/> <short value="SystemicTreatment Hospital (M)"/> <definition value="In which hospital was the SystemicTreatment performed"/> <min value="1"/> <max value="*"/> <type> <code value="string"/> </type> </element> <element id="SystemicTreatment.typeOfSystemicTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.typeOfSystemicTreatment"/> <short value="type of systemic treatment (M)"/> <definition value="Select the type of systemic treatment administered. It is possible to directly select the single treatment as appropriate."/> <comment value="Chemotherapy - 4273629 Immunotherapy - 40310107 Targeted therapy - 912065"/> <min value="1"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.intent"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <path value="SystemicTreatment.intent"/> <short value="Intent (O)"/> <definition value="Clarifies the reasons why systemic therapy is administered • Curative chemotherapy is chemotherapy administered with the goal of achieving a complete remission and preventing the recurrence of cancer. • Palliative chemotherapy refers to any chemotherapy administration that is not curative but administered simply to decrease tumor load and increase life expectancy. It has been defined also as “…treatment in circumstances where the impact of intervention is insufficient to result in major survival advantage, but does affect improvement in terms of tumor‐related symptoms…”"/> <comment value="Palliative - 4179711 Curative procedure intent - 4162591"/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.setting"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <path value="SystemicTreatment.setting"/> <short value="Setting (O)"/> <definition value="Clarifies the context / how the therapy was administered alone or in conjunction with other treatments • Neoadjuvant: treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given. Examples of neoadjuvant therapy include chemotherapy, radiation therapy, and hormone therapy. It is a type of induction therapy. • Adjuvant: additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy. • Concomitant Systemic Treatment/concurrent: A treatment that is given at the same time as another (es. Chemotherapy and radiotherapy)."/> <comment value="Neo-adjuvant - 44808409 Concomitant Systemic Treatment - 2000100028 Adjuvant - 44804498 Systemic treatment alone - 2000100029"/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.chemotherapyInfo"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.chemotherapyInfo"/> <short value="Chemotherapy info (O)"/> <definition value="Information for chemotherapy"/> <comment value="Preoperative - 4119031 Postoperative period - 4118656 Hyperthermic intraperitoneal chemotherapy - 3184898 Therapeutic - 4133895"/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.startDateSystemicTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.startDateSystemicTreatment"/> <short value="Start date systemic treatment (M)"/> <definition value="Specifies when systemic treatment begins"/> <min value="1"/> <max value="*"/> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.endDateSystemicTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.endDateSystemicTreatment"/> <short value="End date systemic treatment (M)"/> <definition value="Specifies when systemic treatment ends"/> <min value="1"/> <max value="*"/> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.numberOfCycles"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.numberOfCycles"/> <short value="Number of cycles/ administrations (O)"/> <definition value="Clarifies how many times the treatment was administered. A cycle of treatment is a period of treatment followed by a period of rest (no treatment). For example, treatment given for one week followed by three weeks of rest is one cycle of treatment. A cycle can be repeated multiple times."/> <min value="0"/> <max value="*"/> <type> <code value="Quantity"/> </type> </element> <element id="SystemicTreatment.regimen"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.regimen"/> <short value="Regimen (O)"/> <definition value="The regimen applied to the patient. If this is not present, or the specific regimen is not listed here, use the DrugsForTreatments entity."/> <comment value="Doxorubicin and Ifosfamide - 35806965 Ifosfamide and Paclitaxel - 35805248 doxorubicin and vincristine - 2000100054 Epirubicin monotherapy - 35804228 Etoposide monotherapy - 35803691 Gemcitabine monotherapy - 35804135 Ifosfamide and Gemcitabine - 35806435 gemcitabine and vincristine - 2000100055 high dose cisplatin - 2000100056 Ifosfamide monotherapy - 35804542 ifosfamide and etoposide - 2000100057 Irinotecan liposomal monotherapy - 35805368 Lenvatinib monotherapy - 35805795 Methotrexate monotherapy - 35804095 Nivolumab monotherapy - 35803677 ADT (other androgen deprivation therapy) - 35806821 Oxaliplatin monotherapy - 35805078 Paclitaxel monotherapy - 35804166 Gemcitabine and Paclitaxel - 35804158 Ifosfamide and Paclitaxel - 35805248 Paclitaxel and Trastuzumab (TH) - 35804201 Paclitaxel and Vinorelbine - 35101452 Pembrolizumab monotherapy - 35803678 Sorafenib monotherapy - 35803487 Trastuzumab emtansine monotherapy (TDM1) - 35805230 Trastuzumab monotherapy - 35804222 Vinorelbine monotherapy - 35804241 weekly carboplatin - 2000100058 weekly cisplatin - 2000100059 Epirubicin and Ifosfamide - 35806948 Vincristine and Doxorubicin and Ifosfamide - 2000100060 Vincristine, Actinomycin D, Ifosfamide ( VAI) - 35805452 Docetaxel and Gemcitabine - 35803577 Dacarbazine and Doxorubicin - 35806964 Methotrexate and Doxorubicin and Cisplatin - 2000100061 Methotrexate and Doxorubicin and Ifosfamide - 2000100062 Doxorubicin and Cisplatin and Ifosfamide - 2000100063 Cisplatin and Doxorubicin - 35804819 Methotrexate and Vinorelbine - 2000100064 Ifosfamide and Etoposide (IE) - 35805454 Vincristine and Doxorubicin and Cyclophosphamide - 2000100065 Cyclophosphamide and Etoposide - 35806476 Doxorubicin and Ifosfamide and Dacarbazine - 2000100066 Dacarbazine and Gemcitabine - 35806969 Cyclophosphamide and Topotecan - 35805453 Irinotecan and Vincristine - 2000100067 Irinotecan and Temozolomide - 35805455 Busulfan and Melphalan - 35804000 TNF and Melphalan - 2000100068 Cyclophosphamide and Vinorelbine - 2000100069 Vincristine, Ifosfamide, Doxorubicin, Etoposide (VIDE) - 35805451 Pazopanib monotherapy - 35805690 Regorafenib monotherapy - 35804569 high dose Ifosfamide - 2000100070"/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.startDateRegimenChanged"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <path value="SystemicTreatment.startDateRegimenChanged"/> <short value="Start date regimen changed (M)"/> <definition value="Specifies when the new systemic treatment begins, if a combination please specify the start of the first drug"/> <min value="1"/> <max value="*"/> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.endDateRegimenChanged"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <path value="SystemicTreatment.endDateRegimenChanged"/> <short value="End date regimen changed (M)"/> <definition value="Specifies when the new systemic treatment ends,if a combination please specify the end of the last drug"/> <min value="1"/> <max value="*"/> <type> <code value="date"/> </type> </element> <element id="SystemicTreatment.reasonForEndOfTreatment"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.reasonForEndOfTreatment"/> <short value="Reason for end of treatment (M)"/> <definition value="Clarifies the reasons why the treatment ended or was interrupted"/> <comment value="Completed successfully - 44788181 Chemotherapy changed acute chemotherapy toxicity - 4162594 Treatment ended due to comorbidity - 2000100030 Intolerance to drug - 4240582 Procedure discontinued by patient - 37017062 Death - 4306655"/> <min value="1"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> <element id="SystemicTreatment.treatmentResponse"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-headneck-i4rc"/> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle"/> </extension> <extension url="actor"> <valueCanonical value="http://hl7.eu/fhir/ig/idea4rc/actor-sarcoma-i4rc"/> </extension> </extension> <path value="SystemicTreatment.treatmentResponse"/> <short value="Treatment response (based on imaging alone; no recist or other criteria) (M)"/> <definition value="Measures how well a cancer patient responds to treatment. RECIST criteria should not be applied. The definition of Complete response; Partial response; Stable disease; Progression, should be based on the clinical judgement based on imaging. Only when setting=neoadiuvant or palliative"/> <comment value="Complete Remission - 32946 Partial Remission - 32947 Stable Disease - 32948 Progression - 32949 Not applicable - 4294169 (Not usable in OMOP)"/> <min value="1"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> </element> </differential> </StructureDefinition>