IDEA4RC FHIR Implementation Guide
0.1.0 - CI Build 150

IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/idea4rc/ and changes regularly. See the Directory of published versions

Logical Model: RadiotherapyI4rc - Detailed Descriptions

Draft as of 2024-11-12

Definitions for the Radiotherapy logical model.

Guidance on how to interpret the contents of this table can be found here

0. Radiotherapy
Definition

Radiotherapy

ShortRadiotherapy
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Radiotherapy.episodeEventReference
Definition

EpisodeEvent element containing the data regarding the patient's cancer

ShortEpisode Event reference
Control1..1
Typehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/EpisodeEvent
Obligations
    ObligationsActor
    SHALL:handle
    SHALL:handle
    4. Radiotherapy.radiotherapy
    Definition

    Whether it was performed at the registering hospital or another hospital.

    ShortRadiotherapy
    Comments

    Yes done at the hospital; Yes done at a different hospital; Not Done; Unknown. Custom

    Control1..1
    TypeCodeableConcept
    Obligations
      ObligationsActor
      SHALL:handle
      SHALL:handle
      6. Radiotherapy.intent
      Definition

      Radiotherapy intent refers to whether the intention of treatment is to cure the patient or to treat symptoms and palliate

      ShortIntent
      Comments

      Palliative; Curative; Unknwon Palliative - 4179711 Curative - Unknown - 4129922

      Control1..1
      TypeCodeableConcept
      Obligations
        ObligationsActor
        SHALL:handle
        SHALL:handle
        8. Radiotherapy.setting
        Definition

        Whether radiotherapy is delivered as the main treatment modality (definitive) or if it is delivered before or after another treatment such as surgery

        ShortSetting
        Comments

        Preoperative; Preoperative concomitant to systemic treatment; Postoperative;Postoperative concomitant to systemic treatment; Definitive; Definitive concomitant to systemic treatment; Unknown
        Preoperative - 4059384 Preoperative concomitant to systemic treatment - Postoperative - 4058775 Postoperative concomitant to systemic treatment - Definitive - Definitive concomitant to systemic treatment - Unknown - 4129922

        Control0..1
        TypeCodeableConcept
        Obligations
          ObligationsActor
          SHALL:handle
          SHALL:handle
          10. Radiotherapy.beamQuality
          Definition

          Describes the type of radiation therapy given. If external beam, please specify if delivered with Photons (most common), electrons, carbon, or protons.

          ShortBeam quality
          Comments

          External beam RT Photons; External beam RT Electrons; External Beam RT Carbons; External Beam RT Protons; Brachytherapy interstitial endocavitary contact; Radionuclide therapy; Boron neutron capture Therapy; other; unknown External beam RT Photons - 607996 External beam RT Electrons - 4165039 External Beam RT Carbons -
          External Beam RT Protons - 4024005 Brachytherapy interstitial endocavitary contact - 4012485 Radionuclide therapy - 4161415 Boron neutron capture Therapy - 4058601 other - 4077953 Unknown - 4129922

          Control1..1
          TypeCodeableConcept
          Obligations
            ObligationsActor
            SHALL:handle
            SHALL:handle
            12. Radiotherapy.otherBeam
            Definition

            Beam quality Other; specify

            ShortBeam quality Other; specify
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Obligations
              ObligationsActor
              SHALL:handle
              14. Radiotherapy.treatmentTechnique
              Definition

              Refers to the type of radiotherapy treatment delivered

              ShortTreatment technique
              Comments

              2D; 3D; IMRT CONVENTIONAL; VMAT; Tomotherapy; SBRT; FLASH THERAPY; PASSIVE SCATTERING; SINGLE BEAM OPTIMIZATION; IMPT; OTHER; unknown 2D - 603132 3D - 4043011 IMRT CONVENTIONAL - 40480519 VMAT - 603135 Tomotherapy - 3662120 SBRT - 4215577 FLASH THERAPY - PASSIVE SCATTERING - SINGLE BEAM OPTIMIZATION - IMPT - Other - 4077990 Unknown - 4129922

              Control1..1
              TypeCodeableConcept
              Obligations
                ObligationsActor
                SHALL:handle
                SHALL:handle
                16. Radiotherapy.totalDoseTdGy
                Definition

                Refers to the total dose delivered to the patient in Gy

                ShortTotal Dose (TD) Gy
                Control1..1
                Typedecimal
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Obligations
                  ObligationsActor
                  SHALL:handle
                  SHALL:handle
                  18. Radiotherapy.fractionSizeFs
                  Definition

                  Refers to the Dose per fraction delivered to the patient.

                  ShortFraction Size (FS)
                  Control1..1
                  Typedecimal
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Obligations
                    ObligationsActor
                    SHALL:handle
                    20. Radiotherapy.numberOfFractions
                    Definition

                    Refers to the total number of fractions delivered to the patient

                    ShortNumber of fractions
                    Control1..1
                    Typedecimal
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Obligations
                      ObligationsActor
                      SHALL:handle
                      SHALL:handle
                      22. Radiotherapy.adaptiveRt
                      Definition

                      Refers to whether treatment planning was changed or adapted after the initial radiation plan was developed. This could be due to a change in the patient?s anatomy or if the tumor changed in size.

                      ShortAdaptive RT
                      Comments

                      Yes; No; Unknown. Yes - 4188539 No - 4188540 Unknown - 4129922

                      Control0..1
                      TypeCodeableConcept
                      Obligations
                        ObligationsActor
                        SHALL:handle
                        24. Radiotherapy.igrtImageGuideRadiotherapy
                        Definition

                        Refers to whether image guided radiotherapy was used for delivery of radiotherapy and to check the patient set up. This includes MV, KV, or Cone Beam CT imaging.

                        ShortIGRT (image guide radiotherapy)
                        Comments

                        Yes; No; Unknown. Yes - 4188539 No - 4188540 Unknown - 4129922

                        Control0..1
                        TypeCodeableConcept
                        Obligations
                          ObligationsActor
                          SHALL:handle
                          26. Radiotherapy.startDate
                          Definition

                          Date when the first radiation treatment was delivered

                          ShortStart date
                          Control1..1
                          Typedate
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Obligations
                            ObligationsActor
                            SHALL:handle
                            SHALL:handle
                            28. Radiotherapy.endDate
                            Definition

                            Date when the last radiation treatment ended

                            ShortEnd date
                            Control1..1
                            Typedate
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Obligations
                              ObligationsActor
                              SHALL:handle
                              SHALL:handle
                              30. Radiotherapy.treatmentSites
                              Definition

                              Refers to the areas that the radiation is targeting. This could include the primary tumor , the neck lymph nodes, the ipsilateral neck and the primary, the bilateral neck and the primary, or a distant metastatic lesion

                              ShortTreatment Sites:
                              Control0..1
                              TypeBackboneElement
                              Obligations
                                ObligationsActor
                                SHALL:handle
                                32. Radiotherapy.treatmentSites.primary
                                Definition

                                Primary

                                ShortPrimary
                                Control0..1
                                Typeboolean
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Obligations
                                  ObligationsActor
                                  SHALL:handle
                                  34. Radiotherapy.treatmentSites.neck
                                  Definition

                                  Neck

                                  ShortNeck
                                  Control0..1
                                  Typeboolean
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Obligations
                                    ObligationsActor
                                    SHALL:handle
                                    36. Radiotherapy.treatmentSites.primaryAndIpsilateralNeck
                                    Definition

                                    Primary and Ipsilateral Neck

                                    ShortPrimary and Ipsilateral Neck
                                    Control1..1
                                    Typeboolean
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Obligations
                                      ObligationsActor
                                      SHALL:handle
                                      38. Radiotherapy.treatmentSites.primaryAndBilateralNeck
                                      Definition

                                      Primary and Bilateral Neck

                                      ShortPrimary and Bilateral Neck
                                      Control1..1
                                      Typeboolean
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Obligations
                                        ObligationsActor
                                        SHALL:handle
                                        40. Radiotherapy.treatmentSites.distantMetastasis
                                        Definition

                                        Distant Metastasis

                                        ShortDistant Metastasis
                                        Control1..1
                                        Typeboolean
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Obligations
                                          ObligationsActor
                                          SHALL:handle
                                          42. Radiotherapy.metastaticTreatmentSites
                                          Definition

                                          Designates which treatment sites were irradiated. Lung Vs Mediastinum Vs Bone Vs soft tissue vs liver Vs other.

                                          ShortMetastatic Treatment Sites:
                                          Control0..1
                                          TypeBackboneElement
                                          Obligations
                                            ObligationsActor
                                            SHALL:handle
                                            SHALL:handle
                                            44. Radiotherapy.metastaticTreatmentSites.lung
                                            Definition

                                            Lung

                                            ShortLung
                                            Control0..1
                                            Typeboolean
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Obligations
                                              ObligationsActor
                                              SHALL:handle
                                              SHALL:handle
                                              46. Radiotherapy.metastaticTreatmentSites.mediastinum
                                              Definition

                                              Mediastinum

                                              ShortMediastinum
                                              Control0..1
                                              Typeboolean
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Obligations
                                                ObligationsActor
                                                SHALL:handle
                                                SHALL:handle
                                                48. Radiotherapy.metastaticTreatmentSites.bone
                                                Definition

                                                Bone

                                                ShortBone
                                                Control0..1
                                                Typeboolean
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handle
                                                  SHALL:handle
                                                  50. Radiotherapy.metastaticTreatmentSites.softTissue
                                                  Definition

                                                  Soft Tissue

                                                  ShortSoft Tissue
                                                  Control0..1
                                                  Typeboolean
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:handle
                                                    SHALL:handle
                                                    52. Radiotherapy.metastaticTreatmentSites.liver
                                                    Definition

                                                    Liver

                                                    ShortLiver
                                                    Control0..1
                                                    Typeboolean
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handle
                                                      SHALL:handle
                                                      54. Radiotherapy.treatmentCompletedAsPlanned
                                                      Definition

                                                      Refers to whether patient completed all treatment as planned or if it had to be interrupted due to several reasons including toxicity, a co-morbidity preventing the delivery of radiation (pulmonary embolism, failure to thrive during RT), death due to progression of the cancer or patient decision

                                                      ShortTreatment Completed as Planned?
                                                      Comments

                                                      Completion; Toxicity; Comorbidity; Patient intolerance; Patient decision; Death; Unknown. Completion - 4058777 Toxicity - 438028 Comorbidity - 4162706 Patient intolerance - 4105297 Patients decision - Death - 4306655 Unknown - 4129922

                                                      Control1..1
                                                      TypeCodeableConcept
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:handle
                                                        SHALL:handle
                                                        56. Radiotherapy.regionalDeepHyperthemia
                                                        Definition

                                                        Regional deep hyperthemia

                                                        ShortRegional deep hyperthemia
                                                        Control1..1
                                                        TypeBackboneElement
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:handle
                                                          58. Radiotherapy.regionalDeepHyperthemia.startDate
                                                          Definition

                                                          RDH_startdate

                                                          ShortRegional deep hyperthemia
                                                          Control0..1
                                                          Typedate
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:handle
                                                            60. Radiotherapy.regionalDeepHyperthemia.endDate
                                                            Definition

                                                            RDH_enddate

                                                            ShortRegional deep hyperthemia
                                                            Control0..1
                                                            Typedate
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:handle
                                                              62. Radiotherapy.clinicalTreatmentResponse
                                                              Definition

                                                              Clinical treatment response for the radiotherapy

                                                              ShortClinical treatment response
                                                              Comments

                                                              complete response; partial response; stable disease; progression; unknown Complete Remission - 32946 Partial Remission - 32947 Stable Disease - 32948 Progression - 32949

                                                              Control0..1
                                                              TypeCodeableConcept
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:handle

                                                                Guidance on how to interpret the contents of this table can be found here

                                                                0. Radiotherapy
                                                                Definition

                                                                Radiotherapy

                                                                ShortRadiotherapy
                                                                Control0..*
                                                                Is Modifierfalse
                                                                Logical ModelInstances of this logical model are not marked to be the target of a Reference
                                                                2. Radiotherapy.episodeEventReference
                                                                Definition

                                                                EpisodeEvent element containing the data regarding the patient's cancer

                                                                ShortEpisode Event reference
                                                                Control1..1
                                                                Typehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/EpisodeEvent
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:handle
                                                                  SHALL:handle
                                                                  4. Radiotherapy.radiotherapy
                                                                  Definition

                                                                  Whether it was performed at the registering hospital or another hospital.

                                                                  ShortRadiotherapy
                                                                  Comments

                                                                  Yes done at the hospital; Yes done at a different hospital; Not Done; Unknown. Custom

                                                                  Control1..1
                                                                  TypeCodeableConcept
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:handle
                                                                    SHALL:handle
                                                                    6. Radiotherapy.intent
                                                                    Definition

                                                                    Radiotherapy intent refers to whether the intention of treatment is to cure the patient or to treat symptoms and palliate

                                                                    ShortIntent
                                                                    Comments

                                                                    Palliative; Curative; Unknwon Palliative - 4179711 Curative - Unknown - 4129922

                                                                    Control1..1
                                                                    TypeCodeableConcept
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:handle
                                                                      SHALL:handle
                                                                      8. Radiotherapy.setting
                                                                      Definition

                                                                      Whether radiotherapy is delivered as the main treatment modality (definitive) or if it is delivered before or after another treatment such as surgery

                                                                      ShortSetting
                                                                      Comments

                                                                      Preoperative; Preoperative concomitant to systemic treatment; Postoperative;Postoperative concomitant to systemic treatment; Definitive; Definitive concomitant to systemic treatment; Unknown
                                                                      Preoperative - 4059384 Preoperative concomitant to systemic treatment - Postoperative - 4058775 Postoperative concomitant to systemic treatment - Definitive - Definitive concomitant to systemic treatment - Unknown - 4129922

                                                                      Control0..1
                                                                      TypeCodeableConcept
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:handle
                                                                        SHALL:handle
                                                                        10. Radiotherapy.beamQuality
                                                                        Definition

                                                                        Describes the type of radiation therapy given. If external beam, please specify if delivered with Photons (most common), electrons, carbon, or protons.

                                                                        ShortBeam quality
                                                                        Comments

                                                                        External beam RT Photons; External beam RT Electrons; External Beam RT Carbons; External Beam RT Protons; Brachytherapy interstitial endocavitary contact; Radionuclide therapy; Boron neutron capture Therapy; other; unknown External beam RT Photons - 607996 External beam RT Electrons - 4165039 External Beam RT Carbons -
                                                                        External Beam RT Protons - 4024005 Brachytherapy interstitial endocavitary contact - 4012485 Radionuclide therapy - 4161415 Boron neutron capture Therapy - 4058601 other - 4077953 Unknown - 4129922

                                                                        Control1..1
                                                                        TypeCodeableConcept
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:handle
                                                                          SHALL:handle
                                                                          12. Radiotherapy.otherBeam
                                                                          Definition

                                                                          Beam quality Other; specify

                                                                          ShortBeam quality Other; specify
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:handle
                                                                            14. Radiotherapy.treatmentTechnique
                                                                            Definition

                                                                            Refers to the type of radiotherapy treatment delivered

                                                                            ShortTreatment technique
                                                                            Comments

                                                                            2D; 3D; IMRT CONVENTIONAL; VMAT; Tomotherapy; SBRT; FLASH THERAPY; PASSIVE SCATTERING; SINGLE BEAM OPTIMIZATION; IMPT; OTHER; unknown 2D - 603132 3D - 4043011 IMRT CONVENTIONAL - 40480519 VMAT - 603135 Tomotherapy - 3662120 SBRT - 4215577 FLASH THERAPY - PASSIVE SCATTERING - SINGLE BEAM OPTIMIZATION - IMPT - Other - 4077990 Unknown - 4129922

                                                                            Control1..1
                                                                            TypeCodeableConcept
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handle
                                                                              SHALL:handle
                                                                              16. Radiotherapy.totalDoseTdGy
                                                                              Definition

                                                                              Refers to the total dose delivered to the patient in Gy

                                                                              ShortTotal Dose (TD) Gy
                                                                              Control1..1
                                                                              Typedecimal
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:handle
                                                                                SHALL:handle
                                                                                18. Radiotherapy.fractionSizeFs
                                                                                Definition

                                                                                Refers to the Dose per fraction delivered to the patient.

                                                                                ShortFraction Size (FS)
                                                                                Control1..1
                                                                                Typedecimal
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handle
                                                                                  20. Radiotherapy.numberOfFractions
                                                                                  Definition

                                                                                  Refers to the total number of fractions delivered to the patient

                                                                                  ShortNumber of fractions
                                                                                  Control1..1
                                                                                  Typedecimal
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:handle
                                                                                    SHALL:handle
                                                                                    22. Radiotherapy.adaptiveRt
                                                                                    Definition

                                                                                    Refers to whether treatment planning was changed or adapted after the initial radiation plan was developed. This could be due to a change in the patient?s anatomy or if the tumor changed in size.

                                                                                    ShortAdaptive RT
                                                                                    Comments

                                                                                    Yes; No; Unknown. Yes - 4188539 No - 4188540 Unknown - 4129922

                                                                                    Control0..1
                                                                                    TypeCodeableConcept
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:handle
                                                                                      24. Radiotherapy.igrtImageGuideRadiotherapy
                                                                                      Definition

                                                                                      Refers to whether image guided radiotherapy was used for delivery of radiotherapy and to check the patient set up. This includes MV, KV, or Cone Beam CT imaging.

                                                                                      ShortIGRT (image guide radiotherapy)
                                                                                      Comments

                                                                                      Yes; No; Unknown. Yes - 4188539 No - 4188540 Unknown - 4129922

                                                                                      Control0..1
                                                                                      TypeCodeableConcept
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:handle
                                                                                        26. Radiotherapy.startDate
                                                                                        Definition

                                                                                        Date when the first radiation treatment was delivered

                                                                                        ShortStart date
                                                                                        Control1..1
                                                                                        Typedate
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:handle
                                                                                          SHALL:handle
                                                                                          28. Radiotherapy.endDate
                                                                                          Definition

                                                                                          Date when the last radiation treatment ended

                                                                                          ShortEnd date
                                                                                          Control1..1
                                                                                          Typedate
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:handle
                                                                                            SHALL:handle
                                                                                            30. Radiotherapy.treatmentSites
                                                                                            Definition

                                                                                            Refers to the areas that the radiation is targeting. This could include the primary tumor , the neck lymph nodes, the ipsilateral neck and the primary, the bilateral neck and the primary, or a distant metastatic lesion

                                                                                            ShortTreatment Sites:
                                                                                            Control0..1
                                                                                            TypeBackboneElement
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:handle
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              32. Radiotherapy.treatmentSites.modifierExtension
                                                                                              Definition

                                                                                              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).

                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              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.

                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              34. Radiotherapy.treatmentSites.primary
                                                                                              Definition

                                                                                              Primary

                                                                                              ShortPrimary
                                                                                              Control0..1
                                                                                              Typeboolean
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:handle
                                                                                                36. Radiotherapy.treatmentSites.neck
                                                                                                Definition

                                                                                                Neck

                                                                                                ShortNeck
                                                                                                Control0..1
                                                                                                Typeboolean
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:handle
                                                                                                  38. Radiotherapy.treatmentSites.primaryAndIpsilateralNeck
                                                                                                  Definition

                                                                                                  Primary and Ipsilateral Neck

                                                                                                  ShortPrimary and Ipsilateral Neck
                                                                                                  Control1..1
                                                                                                  Typeboolean
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:handle
                                                                                                    40. Radiotherapy.treatmentSites.primaryAndBilateralNeck
                                                                                                    Definition

                                                                                                    Primary and Bilateral Neck

                                                                                                    ShortPrimary and Bilateral Neck
                                                                                                    Control1..1
                                                                                                    Typeboolean
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:handle
                                                                                                      42. Radiotherapy.treatmentSites.distantMetastasis
                                                                                                      Definition

                                                                                                      Distant Metastasis

                                                                                                      ShortDistant Metastasis
                                                                                                      Control1..1
                                                                                                      Typeboolean
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:handle
                                                                                                        44. Radiotherapy.metastaticTreatmentSites
                                                                                                        Definition

                                                                                                        Designates which treatment sites were irradiated. Lung Vs Mediastinum Vs Bone Vs soft tissue vs liver Vs other.

                                                                                                        ShortMetastatic Treatment Sites:
                                                                                                        Control0..1
                                                                                                        TypeBackboneElement
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:handle
                                                                                                          SHALL:handle
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          46. Radiotherapy.metastaticTreatmentSites.modifierExtension
                                                                                                          Definition

                                                                                                          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).

                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                          Comments

                                                                                                          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.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          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.

                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          48. Radiotherapy.metastaticTreatmentSites.lung
                                                                                                          Definition

                                                                                                          Lung

                                                                                                          ShortLung
                                                                                                          Control0..1
                                                                                                          Typeboolean
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:handle
                                                                                                            SHALL:handle
                                                                                                            50. Radiotherapy.metastaticTreatmentSites.mediastinum
                                                                                                            Definition

                                                                                                            Mediastinum

                                                                                                            ShortMediastinum
                                                                                                            Control0..1
                                                                                                            Typeboolean
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:handle
                                                                                                              SHALL:handle
                                                                                                              52. Radiotherapy.metastaticTreatmentSites.bone
                                                                                                              Definition

                                                                                                              Bone

                                                                                                              ShortBone
                                                                                                              Control0..1
                                                                                                              Typeboolean
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:handle
                                                                                                                SHALL:handle
                                                                                                                54. Radiotherapy.metastaticTreatmentSites.softTissue
                                                                                                                Definition

                                                                                                                Soft Tissue

                                                                                                                ShortSoft Tissue
                                                                                                                Control0..1
                                                                                                                Typeboolean
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Obligations
                                                                                                                  ObligationsActor
                                                                                                                  SHALL:handle
                                                                                                                  SHALL:handle
                                                                                                                  56. Radiotherapy.metastaticTreatmentSites.liver
                                                                                                                  Definition

                                                                                                                  Liver

                                                                                                                  ShortLiver
                                                                                                                  Control0..1
                                                                                                                  Typeboolean
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:handle
                                                                                                                    SHALL:handle
                                                                                                                    58. Radiotherapy.treatmentCompletedAsPlanned
                                                                                                                    Definition

                                                                                                                    Refers to whether patient completed all treatment as planned or if it had to be interrupted due to several reasons including toxicity, a co-morbidity preventing the delivery of radiation (pulmonary embolism, failure to thrive during RT), death due to progression of the cancer or patient decision

                                                                                                                    ShortTreatment Completed as Planned?
                                                                                                                    Comments

                                                                                                                    Completion; Toxicity; Comorbidity; Patient intolerance; Patient decision; Death; Unknown. Completion - 4058777 Toxicity - 438028 Comorbidity - 4162706 Patient intolerance - 4105297 Patients decision - Death - 4306655 Unknown - 4129922

                                                                                                                    Control1..1
                                                                                                                    TypeCodeableConcept
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:handle
                                                                                                                      SHALL:handle
                                                                                                                      60. Radiotherapy.regionalDeepHyperthemia
                                                                                                                      Definition

                                                                                                                      Regional deep hyperthemia

                                                                                                                      ShortRegional deep hyperthemia
                                                                                                                      Control1..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:handle
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        62. Radiotherapy.regionalDeepHyperthemia.modifierExtension
                                                                                                                        Definition

                                                                                                                        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).

                                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                        Comments

                                                                                                                        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.

                                                                                                                        Control0..*
                                                                                                                        TypeExtension
                                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        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.

                                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        64. Radiotherapy.regionalDeepHyperthemia.startDate
                                                                                                                        Definition

                                                                                                                        RDH_startdate

                                                                                                                        ShortRegional deep hyperthemia
                                                                                                                        Control0..1
                                                                                                                        Typedate
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Obligations
                                                                                                                          ObligationsActor
                                                                                                                          SHALL:handle
                                                                                                                          66. Radiotherapy.regionalDeepHyperthemia.endDate
                                                                                                                          Definition

                                                                                                                          RDH_enddate

                                                                                                                          ShortRegional deep hyperthemia
                                                                                                                          Control0..1
                                                                                                                          Typedate
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:handle
                                                                                                                            68. Radiotherapy.clinicalTreatmentResponse
                                                                                                                            Definition

                                                                                                                            Clinical treatment response for the radiotherapy

                                                                                                                            ShortClinical treatment response
                                                                                                                            Comments

                                                                                                                            complete response; partial response; stable disease; progression; unknown Complete Remission - 32946 Partial Remission - 32947 Stable Disease - 32948 Progression - 32949

                                                                                                                            Control0..1
                                                                                                                            TypeCodeableConcept
                                                                                                                            Obligations
                                                                                                                              ObligationsActor
                                                                                                                              SHALL:handle

                                                                                                                              Guidance on how to interpret the contents of this table can be found here

                                                                                                                              0. Radiotherapy
                                                                                                                              Definition

                                                                                                                              Radiotherapy

                                                                                                                              ShortRadiotherapy
                                                                                                                              Control0..*
                                                                                                                              Is Modifierfalse
                                                                                                                              Logical ModelInstances of this logical model are not marked to be the target of a Reference
                                                                                                                              2. Radiotherapy.episodeEventReference
                                                                                                                              Definition

                                                                                                                              EpisodeEvent element containing the data regarding the patient's cancer

                                                                                                                              ShortEpisode Event reference
                                                                                                                              Control1..1
                                                                                                                              Typehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/EpisodeEvent
                                                                                                                              Obligations
                                                                                                                                ObligationsActor
                                                                                                                                SHALL:handle
                                                                                                                                SHALL:handle
                                                                                                                                4. Radiotherapy.radiotherapy
                                                                                                                                Definition

                                                                                                                                Whether it was performed at the registering hospital or another hospital.

                                                                                                                                ShortRadiotherapy
                                                                                                                                Comments

                                                                                                                                Yes done at the hospital; Yes done at a different hospital; Not Done; Unknown. Custom

                                                                                                                                Control1..1
                                                                                                                                TypeCodeableConcept
                                                                                                                                Obligations
                                                                                                                                  ObligationsActor
                                                                                                                                  SHALL:handle
                                                                                                                                  SHALL:handle
                                                                                                                                  6. Radiotherapy.intent
                                                                                                                                  Definition

                                                                                                                                  Radiotherapy intent refers to whether the intention of treatment is to cure the patient or to treat symptoms and palliate

                                                                                                                                  ShortIntent
                                                                                                                                  Comments

                                                                                                                                  Palliative; Curative; Unknwon Palliative - 4179711 Curative - Unknown - 4129922

                                                                                                                                  Control1..1
                                                                                                                                  TypeCodeableConcept
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:handle
                                                                                                                                    SHALL:handle
                                                                                                                                    8. Radiotherapy.setting
                                                                                                                                    Definition

                                                                                                                                    Whether radiotherapy is delivered as the main treatment modality (definitive) or if it is delivered before or after another treatment such as surgery

                                                                                                                                    ShortSetting
                                                                                                                                    Comments

                                                                                                                                    Preoperative; Preoperative concomitant to systemic treatment; Postoperative;Postoperative concomitant to systemic treatment; Definitive; Definitive concomitant to systemic treatment; Unknown
                                                                                                                                    Preoperative - 4059384 Preoperative concomitant to systemic treatment - Postoperative - 4058775 Postoperative concomitant to systemic treatment - Definitive - Definitive concomitant to systemic treatment - Unknown - 4129922

                                                                                                                                    Control0..1
                                                                                                                                    TypeCodeableConcept
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActor
                                                                                                                                      SHALL:handle
                                                                                                                                      SHALL:handle
                                                                                                                                      10. Radiotherapy.beamQuality
                                                                                                                                      Definition

                                                                                                                                      Describes the type of radiation therapy given. If external beam, please specify if delivered with Photons (most common), electrons, carbon, or protons.

                                                                                                                                      ShortBeam quality
                                                                                                                                      Comments

                                                                                                                                      External beam RT Photons; External beam RT Electrons; External Beam RT Carbons; External Beam RT Protons; Brachytherapy interstitial endocavitary contact; Radionuclide therapy; Boron neutron capture Therapy; other; unknown External beam RT Photons - 607996 External beam RT Electrons - 4165039 External Beam RT Carbons -
                                                                                                                                      External Beam RT Protons - 4024005 Brachytherapy interstitial endocavitary contact - 4012485 Radionuclide therapy - 4161415 Boron neutron capture Therapy - 4058601 other - 4077953 Unknown - 4129922

                                                                                                                                      Control1..1
                                                                                                                                      TypeCodeableConcept
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActor
                                                                                                                                        SHALL:handle
                                                                                                                                        SHALL:handle
                                                                                                                                        12. Radiotherapy.otherBeam
                                                                                                                                        Definition

                                                                                                                                        Beam quality Other; specify

                                                                                                                                        ShortBeam quality Other; specify
                                                                                                                                        Control0..1
                                                                                                                                        Typestring
                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActor
                                                                                                                                          SHALL:handle
                                                                                                                                          14. Radiotherapy.treatmentTechnique
                                                                                                                                          Definition

                                                                                                                                          Refers to the type of radiotherapy treatment delivered

                                                                                                                                          ShortTreatment technique
                                                                                                                                          Comments

                                                                                                                                          2D; 3D; IMRT CONVENTIONAL; VMAT; Tomotherapy; SBRT; FLASH THERAPY; PASSIVE SCATTERING; SINGLE BEAM OPTIMIZATION; IMPT; OTHER; unknown 2D - 603132 3D - 4043011 IMRT CONVENTIONAL - 40480519 VMAT - 603135 Tomotherapy - 3662120 SBRT - 4215577 FLASH THERAPY - PASSIVE SCATTERING - SINGLE BEAM OPTIMIZATION - IMPT - Other - 4077990 Unknown - 4129922

                                                                                                                                          Control1..1
                                                                                                                                          TypeCodeableConcept
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            SHALL:handle
                                                                                                                                            SHALL:handle
                                                                                                                                            16. Radiotherapy.totalDoseTdGy
                                                                                                                                            Definition

                                                                                                                                            Refers to the total dose delivered to the patient in Gy

                                                                                                                                            ShortTotal Dose (TD) Gy
                                                                                                                                            Control1..1
                                                                                                                                            Typedecimal
                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActor
                                                                                                                                              SHALL:handle
                                                                                                                                              SHALL:handle
                                                                                                                                              18. Radiotherapy.fractionSizeFs
                                                                                                                                              Definition

                                                                                                                                              Refers to the Dose per fraction delivered to the patient.

                                                                                                                                              ShortFraction Size (FS)
                                                                                                                                              Control1..1
                                                                                                                                              Typedecimal
                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActor
                                                                                                                                                SHALL:handle
                                                                                                                                                20. Radiotherapy.numberOfFractions
                                                                                                                                                Definition

                                                                                                                                                Refers to the total number of fractions delivered to the patient

                                                                                                                                                ShortNumber of fractions
                                                                                                                                                Control1..1
                                                                                                                                                Typedecimal
                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActor
                                                                                                                                                  SHALL:handle
                                                                                                                                                  SHALL:handle
                                                                                                                                                  22. Radiotherapy.adaptiveRt
                                                                                                                                                  Definition

                                                                                                                                                  Refers to whether treatment planning was changed or adapted after the initial radiation plan was developed. This could be due to a change in the patient?s anatomy or if the tumor changed in size.

                                                                                                                                                  ShortAdaptive RT
                                                                                                                                                  Comments

                                                                                                                                                  Yes; No; Unknown. Yes - 4188539 No - 4188540 Unknown - 4129922

                                                                                                                                                  Control0..1
                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:handle
                                                                                                                                                    24. Radiotherapy.igrtImageGuideRadiotherapy
                                                                                                                                                    Definition

                                                                                                                                                    Refers to whether image guided radiotherapy was used for delivery of radiotherapy and to check the patient set up. This includes MV, KV, or Cone Beam CT imaging.

                                                                                                                                                    ShortIGRT (image guide radiotherapy)
                                                                                                                                                    Comments

                                                                                                                                                    Yes; No; Unknown. Yes - 4188539 No - 4188540 Unknown - 4129922

                                                                                                                                                    Control0..1
                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActor
                                                                                                                                                      SHALL:handle
                                                                                                                                                      26. Radiotherapy.startDate
                                                                                                                                                      Definition

                                                                                                                                                      Date when the first radiation treatment was delivered

                                                                                                                                                      ShortStart date
                                                                                                                                                      Control1..1
                                                                                                                                                      Typedate
                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                      Obligations
                                                                                                                                                        ObligationsActor
                                                                                                                                                        SHALL:handle
                                                                                                                                                        SHALL:handle
                                                                                                                                                        28. Radiotherapy.endDate
                                                                                                                                                        Definition

                                                                                                                                                        Date when the last radiation treatment ended

                                                                                                                                                        ShortEnd date
                                                                                                                                                        Control1..1
                                                                                                                                                        Typedate
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActor
                                                                                                                                                          SHALL:handle
                                                                                                                                                          SHALL:handle
                                                                                                                                                          30. Radiotherapy.treatmentSites
                                                                                                                                                          Definition

                                                                                                                                                          Refers to the areas that the radiation is targeting. This could include the primary tumor , the neck lymph nodes, the ipsilateral neck and the primary, the bilateral neck and the primary, or a distant metastatic lesion

                                                                                                                                                          ShortTreatment Sites:
                                                                                                                                                          Control0..1
                                                                                                                                                          TypeBackboneElement
                                                                                                                                                          Obligations
                                                                                                                                                            ObligationsActor
                                                                                                                                                            SHALL:handle
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            32. Radiotherapy.treatmentSites.id
                                                                                                                                                            Definition

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

                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                            Control0..1
                                                                                                                                                            Typestring
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                            Summaryfalse
                                                                                                                                                            34. Radiotherapy.treatmentSites.extension
                                                                                                                                                            Definition

                                                                                                                                                            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.

                                                                                                                                                            ShortAdditional content defined by implementations
                                                                                                                                                            Comments

                                                                                                                                                            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.

                                                                                                                                                            Control0..*
                                                                                                                                                            TypeExtension
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Summaryfalse
                                                                                                                                                            Alternate Namesextensions, user content
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                            SlicingThis element introduces a set of slices on Radiotherapy.treatmentSites.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                            • value @ url
                                                                                                                                                            • 36. Radiotherapy.treatmentSites.modifierExtension
                                                                                                                                                              Definition

                                                                                                                                                              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).

                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                              Comments

                                                                                                                                                              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.

                                                                                                                                                              Control0..*
                                                                                                                                                              TypeExtension
                                                                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              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.

                                                                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                              38. Radiotherapy.treatmentSites.primary
                                                                                                                                                              Definition

                                                                                                                                                              Primary

                                                                                                                                                              ShortPrimary
                                                                                                                                                              Control0..1
                                                                                                                                                              Typeboolean
                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                              Obligations
                                                                                                                                                                ObligationsActor
                                                                                                                                                                SHALL:handle
                                                                                                                                                                40. Radiotherapy.treatmentSites.neck
                                                                                                                                                                Definition

                                                                                                                                                                Neck

                                                                                                                                                                ShortNeck
                                                                                                                                                                Control0..1
                                                                                                                                                                Typeboolean
                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                Obligations
                                                                                                                                                                  ObligationsActor
                                                                                                                                                                  SHALL:handle
                                                                                                                                                                  42. Radiotherapy.treatmentSites.primaryAndIpsilateralNeck
                                                                                                                                                                  Definition

                                                                                                                                                                  Primary and Ipsilateral Neck

                                                                                                                                                                  ShortPrimary and Ipsilateral Neck
                                                                                                                                                                  Control1..1
                                                                                                                                                                  Typeboolean
                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                  Obligations
                                                                                                                                                                    ObligationsActor
                                                                                                                                                                    SHALL:handle
                                                                                                                                                                    44. Radiotherapy.treatmentSites.primaryAndBilateralNeck
                                                                                                                                                                    Definition

                                                                                                                                                                    Primary and Bilateral Neck

                                                                                                                                                                    ShortPrimary and Bilateral Neck
                                                                                                                                                                    Control1..1
                                                                                                                                                                    Typeboolean
                                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                    Obligations
                                                                                                                                                                      ObligationsActor
                                                                                                                                                                      SHALL:handle
                                                                                                                                                                      46. Radiotherapy.treatmentSites.distantMetastasis
                                                                                                                                                                      Definition

                                                                                                                                                                      Distant Metastasis

                                                                                                                                                                      ShortDistant Metastasis
                                                                                                                                                                      Control1..1
                                                                                                                                                                      Typeboolean
                                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                      Obligations
                                                                                                                                                                        ObligationsActor
                                                                                                                                                                        SHALL:handle
                                                                                                                                                                        48. Radiotherapy.metastaticTreatmentSites
                                                                                                                                                                        Definition

                                                                                                                                                                        Designates which treatment sites were irradiated. Lung Vs Mediastinum Vs Bone Vs soft tissue vs liver Vs other.

                                                                                                                                                                        ShortMetastatic Treatment Sites:
                                                                                                                                                                        Control0..1
                                                                                                                                                                        TypeBackboneElement
                                                                                                                                                                        Obligations
                                                                                                                                                                          ObligationsActor
                                                                                                                                                                          SHALL:handle
                                                                                                                                                                          SHALL:handle
                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          50. Radiotherapy.metastaticTreatmentSites.id
                                                                                                                                                                          Definition

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

                                                                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                                                                          Control0..1
                                                                                                                                                                          Typestring
                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                          Summaryfalse
                                                                                                                                                                          52. Radiotherapy.metastaticTreatmentSites.extension
                                                                                                                                                                          Definition

                                                                                                                                                                          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.

                                                                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                                                                          Comments

                                                                                                                                                                          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.

                                                                                                                                                                          Control0..*
                                                                                                                                                                          TypeExtension
                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                          Summaryfalse
                                                                                                                                                                          Alternate Namesextensions, user content
                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                          SlicingThis element introduces a set of slices on Radiotherapy.metastaticTreatmentSites.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                          • value @ url
                                                                                                                                                                          • 54. Radiotherapy.metastaticTreatmentSites.modifierExtension
                                                                                                                                                                            Definition

                                                                                                                                                                            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).

                                                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                            Comments

                                                                                                                                                                            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.

                                                                                                                                                                            Control0..*
                                                                                                                                                                            TypeExtension
                                                                                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            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.

                                                                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                            56. Radiotherapy.metastaticTreatmentSites.lung
                                                                                                                                                                            Definition

                                                                                                                                                                            Lung

                                                                                                                                                                            ShortLung
                                                                                                                                                                            Control0..1
                                                                                                                                                                            Typeboolean
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Obligations
                                                                                                                                                                              ObligationsActor
                                                                                                                                                                              SHALL:handle
                                                                                                                                                                              SHALL:handle
                                                                                                                                                                              58. Radiotherapy.metastaticTreatmentSites.mediastinum
                                                                                                                                                                              Definition

                                                                                                                                                                              Mediastinum

                                                                                                                                                                              ShortMediastinum
                                                                                                                                                                              Control0..1
                                                                                                                                                                              Typeboolean
                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                              Obligations
                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                SHALL:handle
                                                                                                                                                                                SHALL:handle
                                                                                                                                                                                60. Radiotherapy.metastaticTreatmentSites.bone
                                                                                                                                                                                Definition

                                                                                                                                                                                Bone

                                                                                                                                                                                ShortBone
                                                                                                                                                                                Control0..1
                                                                                                                                                                                Typeboolean
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Obligations
                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                  SHALL:handle
                                                                                                                                                                                  SHALL:handle
                                                                                                                                                                                  62. Radiotherapy.metastaticTreatmentSites.softTissue
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Soft Tissue

                                                                                                                                                                                  ShortSoft Tissue
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  Typeboolean
                                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                  Obligations
                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                    SHALL:handle
                                                                                                                                                                                    SHALL:handle
                                                                                                                                                                                    64. Radiotherapy.metastaticTreatmentSites.liver
                                                                                                                                                                                    Definition

                                                                                                                                                                                    Liver

                                                                                                                                                                                    ShortLiver
                                                                                                                                                                                    Control0..1
                                                                                                                                                                                    Typeboolean
                                                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                    Obligations
                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                      SHALL:handle
                                                                                                                                                                                      SHALL:handle
                                                                                                                                                                                      66. Radiotherapy.treatmentCompletedAsPlanned
                                                                                                                                                                                      Definition

                                                                                                                                                                                      Refers to whether patient completed all treatment as planned or if it had to be interrupted due to several reasons including toxicity, a co-morbidity preventing the delivery of radiation (pulmonary embolism, failure to thrive during RT), death due to progression of the cancer or patient decision

                                                                                                                                                                                      ShortTreatment Completed as Planned?
                                                                                                                                                                                      Comments

                                                                                                                                                                                      Completion; Toxicity; Comorbidity; Patient intolerance; Patient decision; Death; Unknown. Completion - 4058777 Toxicity - 438028 Comorbidity - 4162706 Patient intolerance - 4105297 Patients decision - Death - 4306655 Unknown - 4129922

                                                                                                                                                                                      Control1..1
                                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                                      Obligations
                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                        SHALL:handle
                                                                                                                                                                                        SHALL:handle
                                                                                                                                                                                        68. Radiotherapy.regionalDeepHyperthemia
                                                                                                                                                                                        Definition

                                                                                                                                                                                        Regional deep hyperthemia

                                                                                                                                                                                        ShortRegional deep hyperthemia
                                                                                                                                                                                        Control1..1
                                                                                                                                                                                        TypeBackboneElement
                                                                                                                                                                                        Obligations
                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                          SHALL:handle
                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          70. Radiotherapy.regionalDeepHyperthemia.id
                                                                                                                                                                                          Definition

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

                                                                                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                                                                                          Control0..1
                                                                                                                                                                                          Typestring
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                          72. Radiotherapy.regionalDeepHyperthemia.extension
                                                                                                                                                                                          Definition

                                                                                                                                                                                          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.

                                                                                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                                                                                          Comments

                                                                                                                                                                                          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.

                                                                                                                                                                                          Control0..*
                                                                                                                                                                                          TypeExtension
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                          Alternate Namesextensions, user content
                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                          SlicingThis element introduces a set of slices on Radiotherapy.regionalDeepHyperthemia.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                          • value @ url
                                                                                                                                                                                          • 74. Radiotherapy.regionalDeepHyperthemia.modifierExtension
                                                                                                                                                                                            Definition

                                                                                                                                                                                            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).

                                                                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                            Comments

                                                                                                                                                                                            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.

                                                                                                                                                                                            Control0..*
                                                                                                                                                                                            TypeExtension
                                                                                                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                                            Summarytrue
                                                                                                                                                                                            Requirements

                                                                                                                                                                                            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.

                                                                                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                            76. Radiotherapy.regionalDeepHyperthemia.startDate
                                                                                                                                                                                            Definition

                                                                                                                                                                                            RDH_startdate

                                                                                                                                                                                            ShortRegional deep hyperthemia
                                                                                                                                                                                            Control0..1
                                                                                                                                                                                            Typedate
                                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                            Obligations
                                                                                                                                                                                              ObligationsActor
                                                                                                                                                                                              SHALL:handle
                                                                                                                                                                                              78. Radiotherapy.regionalDeepHyperthemia.endDate
                                                                                                                                                                                              Definition

                                                                                                                                                                                              RDH_enddate

                                                                                                                                                                                              ShortRegional deep hyperthemia
                                                                                                                                                                                              Control0..1
                                                                                                                                                                                              Typedate
                                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                              Obligations
                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                SHALL:handle
                                                                                                                                                                                                80. Radiotherapy.clinicalTreatmentResponse
                                                                                                                                                                                                Definition

                                                                                                                                                                                                Clinical treatment response for the radiotherapy

                                                                                                                                                                                                ShortClinical treatment response
                                                                                                                                                                                                Comments

                                                                                                                                                                                                complete response; partial response; stable disease; progression; unknown Complete Remission - 32946 Partial Remission - 32947 Stable Disease - 32948 Progression - 32949

                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                                Obligations
                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                  SHALL:handle