Chemotherapy Maturity Level: 2 - Ready for Review

Identifier of the diagnosis for which this chemotherapy is performed

Please report the date of the first chemotherapy given. If the date is unkown or partially missed insert the year at the best of your knowledge.

Please report the date of the last chemotherapy given. If the date is unkown or partially missed insert the year at the best of your knowledge.

Please indicate the institution in which all or most of the chemotherapeutic treatment was given

Please provide name, city and countryof the institution

Institution name

Institution address

Institution city

Institution country

Information about the product(s) administered

In this section, any of the 'antineoplastic and immunostimulating agents' received by the survivor should be reported, Drugs names are reported based on the ATC code listed under L01 to L04 in Appendix. Synonyms are included. When you start typing the name of the drug, the possible options will automatically suggested by the system. Up to 20 drugs are allowed into the system. The variable acronym changes based on the ordinal cmulative number of drugs received (e.g. FN_1, FN_2, FN_3, ?)

Dose received of each drug for this administration

Report the total cumulative dose received of each drug.

Flag indicating if the dose was not calculated or it was not known

Specify if the cumulative dose reported has been all calculated on real data or estimated based on the expected dose prescribed by the protocol. If some part of the calculation was based on estimated values, the whole field should be 'estimated'

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Report the total cumulative dose received of each drug.

If the dose was calculated, please report the measure unit of the calculation 1 => mg/m2 2 => gr/m2 3 => UI/m2 4 => NK 5 => NC (not calculated)

Report 'yes' if the survivor was treated with steroids for at least 4 weeks continuously 1 => Yes 2 => No -9922 => NK

Intrathecal injections

Please state if the survivor received any therapeutic intrathecal injections 1 => Yes 2 => No -9922 => NK

Report the total number of injections

Please report the names of drugs injected intrathecal

Report any other chemothrapeutic treatments that are not included in the ATC code

If yes, describe treatments

Chemotherapy Maturity Level: 2 - Ready for Review

Identifier of the diagnosis for which this chemotherapy is performed

Please report the date of the first chemotherapy given. If the date is unkown or partially missed insert the year at the best of your knowledge.

Please report the date of the last chemotherapy given. If the date is unkown or partially missed insert the year at the best of your knowledge.

Please indicate the institution in which all or most of the chemotherapeutic treatment was given

Please provide name, city and countryof the institution

Institution name

Institution address

Institution city

Institution country

Information about the product(s) administered

In this section, any of the 'antineoplastic and immunostimulating agents' received by the survivor should be reported, Drugs names are reported based on the ATC code listed under L01 to L04 in Appendix. Synonyms are included. When you start typing the name of the drug, the possible options will automatically suggested by the system. Up to 20 drugs are allowed into the system. The variable acronym changes based on the ordinal cmulative number of drugs received (e.g. FN_1, FN_2, FN_3, ?)

Dose received of each drug for this administration

Report the total cumulative dose received of each drug.

Flag indicating if the dose was not calculated or it was not known

Specify if the cumulative dose reported has been all calculated on real data or estimated based on the expected dose prescribed by the protocol. If some part of the calculation was based on estimated values, the whole field should be 'estimated'

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Report the total cumulative dose received of each drug.

If the dose was calculated, please report the measure unit of the calculation 1 => mg/m2 2 => gr/m2 3 => UI/m2 4 => NK 5 => NC (not calculated)

Report 'yes' if the survivor was treated with steroids for at least 4 weeks continuously 1 => Yes 2 => No -9922 => NK

Intrathecal injections

Please state if the survivor received any therapeutic intrathecal injections 1 => Yes 2 => No -9922 => NK

Report the total number of injections

Please report the names of drugs injected intrathecal

Report any other chemothrapeutic treatments that are not included in the ATC code

If yes, describe treatments

Chemotherapy Maturity Level: 2 - Ready for Review

Identifier of the diagnosis for which this chemotherapy is performed

Please report the date of the first chemotherapy given. If the date is unkown or partially missed insert the year at the best of your knowledge.

Please report the date of the last chemotherapy given. If the date is unkown or partially missed insert the year at the best of your knowledge.

Please indicate the institution in which all or most of the chemotherapeutic treatment was given

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Please provide name, city and countryof the institution

Institution name

Institution address

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Institution city

Institution country

Information about the product(s) administered

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

In this section, any of the 'antineoplastic and immunostimulating agents' received by the survivor should be reported, Drugs names are reported based on the ATC code listed under L01 to L04 in Appendix. Synonyms are included. When you start typing the name of the drug, the possible options will automatically suggested by the system. Up to 20 drugs are allowed into the system. The variable acronym changes based on the ordinal cmulative number of drugs received (e.g. FN_1, FN_2, FN_3, ?)

Dose received of each drug for this administration

Report the total cumulative dose received of each drug.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Flag indicating if the dose was not calculated or it was not known

Specify if the cumulative dose reported has been all calculated on real data or estimated based on the expected dose prescribed by the protocol. If some part of the calculation was based on estimated values, the whole field should be 'estimated'

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Report the total cumulative dose received of each drug.

If the dose was calculated, please report the measure unit of the calculation 1 => mg/m2 2 => gr/m2 3 => UI/m2 4 => NK 5 => NC (not calculated)

Report 'yes' if the survivor was treated with steroids for at least 4 weeks continuously 1 => Yes 2 => No -9922 => NK

Intrathecal injections

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Please state if the survivor received any therapeutic intrathecal injections 1 => Yes 2 => No -9922 => NK

Report the total number of injections

Please report the names of drugs injected intrathecal

Report any other chemothrapeutic treatments that are not included in the ATC code

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

If yes, describe treatments