Radiotherapy Maturity Level: 2 - Ready for Review

Identifier of the diagnosis for which this radiotherapy is performed

Identifier of the relapse/progression (after FLT) for which this radiotherapy is performed

Progressive number of radotherapy episode. An EPISODE might be a single or several courses of pre-planned treatment within a consecutive time period to different sites. For example, if a patient had radiotherapy to a limb and also to the lungs for a Ewing?s sarcoma these should be entered in one episode of treatment but as separate radiotherapy courses with their respective site, total dose, and number of fractions. They will both be within one episode

Please indicate the institution in which the radiotherapeutic treatment was given

Please provide name, city and countryof the institution

Institution name

Institution address

Institution city

Institution country

Enter the date on which the first treatment (fraction) of radiotherapy was given, in a DD/MM/YYYY format. If the date is unkown or partially missed insert the year at the best of your knowledge.

Enter the full date on which the last treatment (fraction) of radiotherapy was given in a DD/MM/YYYY format.
When only a single radiation treatment/fraction was given, the start and end dates will be the same. If the date is unkown or partially missed insert the year at the best of your knowledge.

External Beam Radiation: The radiation is produced by a large machine, and the type of the machine needs to be recorded in the subsequent field. Brachytherapy: a material that is radioactive (often a fine wire or a tiny ?seed?) is placed on or in the body to give a very localized high dose of radiation. Details will be asked in the next field Metabolic or radionuclide treatment/therapy: a liquid substance is injected into the blood stream and carries radiation throughout the body with the aim of reaching tumour tissue. Also in this case, details will be asked in the subsequent field. 1 => External beam 2 => Brachytherapy 3 => Metabolic/radionuclide therapy

A detailed description of the type of machine can be found in the user's manual. If you have the name of a machine but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 =>Orthovoltage / kilovoltage usually 200 - 300kv X rays/photons 2 =>Linac (Linear Accelerator) megavoltage MV X Rays/photons 3 =>Linac (Linear Accelerator) electrons 4 => Cobalt - MV gamma rays / photons 5 => Proton Beam 6 => Other, if other specify the name -9922 => Unknown

? Surface brachytherapy - a radiation source (radioactive material) is positioned on a superficial tumour ? Interstitial brachytherapy ? a radiation source is implanted into a tumour ? Intracavitary or intraluminal brachytherapy - a radiation source is introduced in special applicators into a body cavity or lumen

1 => Surface brachytherapy 2 => Interstitial brachytherapy 3 => Intracavitary or intraluminal brachytherapy -9922=> Unknown

Specify the radioactive material (isotopes) used: If not listed, select 'Other then specify' 1 => Iridium (Ir) 2 => Gold (Au) 3 => Iodine (I) 4 => Caesium (Cs) 5 => Other -9922 => Unknown

A detailed description of the radionuclides can be found in the user's manual. If you have the name of a radionuclide but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 => Iodine-131 2 => MIBG 3 =>Yttrium 90 4 => Other -9922 => Unknown

For Metabolic/radionuclide therapy

Site' refers to the radiation therapy treatment field, i.e. the part of the body that received the radiation dose in order to treat the tumour. Required if Type of radiotherapy = 1 or 2 (External Beam, Brachytherapy)� If more than one body site was treated with radiotherapy, you can add anther site and describe; upto 5 sites are allowed by the system

RT sites are coded with a 3 tier level (see list). The first is ?Tier 1?. The first digit/s of the code, describes the large topographical body areas e.g. brain, chest, abdomen, limb. Since radiation fields often involve more than one topographical area we have added ?cervico-thoracic?, ?thoraco abdominal? and ?abdomino pelvic? areas to Tier 1. The second (Tier 2) includes subcategories of Tier 1 sites e.g. brain stem, heart, liver, upper limb. Where the information is available a third (Tier 3) of further subdivisions includes more detailed areas. When using the SurPass platform, as you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose ??Other' (.98 in tier 2) and then add in free text the name of this RT site.

Record any available details on the shielded tissue/organ (or size of shielded area).

Report laterality of the radiation. R = right, L = left, B = bilateral

If needed it is possible to add details

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Specify the total dose given to the primary radiation therapy site. If the dose is not known, write NK.

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Not known dose

Specify the total dose given to the primary radiation therapy site.

External Beam Radiation Therapy (EBRT) and Brachytherapy doses are in Gy. If doses are reported in cGY, roughly two zeroes need to be deleted (e.g. 100 cGy = 1 Gy). specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

A FRACTION of radiation treatment is a single attendance for treatment; if 'not known' insert NK

A boost is an extra dose of radiotherapy directed to a smaller area inside the primary radiation field. (only if type is External Beam)

Specify radiation type of the boost. 1 => External Beam 2 => Brachytherapy -9922 => NK �

Flag indicating if a boost was given, not given or unknown

Site' refers to the radiation therapy treatment field. As you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose: ??Other' and then add in free text the name of this RT site. required if given

Report laterality of the radiation. R = right, L = left, B = bilateral

If needed it is possible to add details

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Specify the total dose given to the boost site.

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Not known dose

Specify the total dose given to the boost site.

Specify the unit of the boost in case of external beam radiotherapy as Gy. specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

A fraction of radiation treatment is a single attendance for treatment. Please specify the number of fractions given as included in the boost. If not known, insert NK.

Shielding, in some records this is called ?blocking? or ?blocks?.

Specify if shielding was used or not. Yes; No; NK �

Describe the positioning of shielding

Organs at Risk

Specify if there is available information on Dosimetry of Organs at Risk [Yes/No]

If Dosimetry on Organ at Risk is available, upload here the electronic / scanned version(s) of any relevant document(s)

Radiotherapy file(s) can be uploaded here

Notes

Radiotherapy Maturity Level: 2 - Ready for Review

Identifier of the diagnosis for which this radiotherapy is performed

Identifier of the relapse/progression (after FLT) for which this radiotherapy is performed

Progressive number of radotherapy episode. An EPISODE might be a single or several courses of pre-planned treatment within a consecutive time period to different sites. For example, if a patient had radiotherapy to a limb and also to the lungs for a Ewing?s sarcoma these should be entered in one episode of treatment but as separate radiotherapy courses with their respective site, total dose, and number of fractions. They will both be within one episode

Please indicate the institution in which the radiotherapeutic treatment was given

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).

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.

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.

Please provide name, city and countryof the institution

Institution name

Institution address

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).

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.

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.

Institution city

Institution country

Enter the date on which the first treatment (fraction) of radiotherapy was given, in a DD/MM/YYYY format. If the date is unkown or partially missed insert the year at the best of your knowledge.

Enter the full date on which the last treatment (fraction) of radiotherapy was given in a DD/MM/YYYY format.
When only a single radiation treatment/fraction was given, the start and end dates will be the same. If the date is unkown or partially missed insert the year at the best of your knowledge.

External Beam Radiation: The radiation is produced by a large machine, and the type of the machine needs to be recorded in the subsequent field. Brachytherapy: a material that is radioactive (often a fine wire or a tiny ?seed?) is placed on or in the body to give a very localized high dose of radiation. Details will be asked in the next field Metabolic or radionuclide treatment/therapy: a liquid substance is injected into the blood stream and carries radiation throughout the body with the aim of reaching tumour tissue. Also in this case, details will be asked in the subsequent field. 1 => External beam 2 => Brachytherapy 3 => Metabolic/radionuclide therapy

A detailed description of the type of machine can be found in the user's manual. If you have the name of a machine but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 =>Orthovoltage / kilovoltage usually 200 - 300kv X rays/photons 2 =>Linac (Linear Accelerator) megavoltage MV X Rays/photons 3 =>Linac (Linear Accelerator) electrons 4 => Cobalt - MV gamma rays / photons 5 => Proton Beam 6 => Other, if other specify the name -9922 => Unknown

? Surface brachytherapy - a radiation source (radioactive material) is positioned on a superficial tumour ? Interstitial brachytherapy ? a radiation source is implanted into a tumour ? Intracavitary or intraluminal brachytherapy - a radiation source is introduced in special applicators into a body cavity or lumen

1 => Surface brachytherapy 2 => Interstitial brachytherapy 3 => Intracavitary or intraluminal brachytherapy -9922=> Unknown

Specify the radioactive material (isotopes) used: If not listed, select 'Other then specify' 1 => Iridium (Ir) 2 => Gold (Au) 3 => Iodine (I) 4 => Caesium (Cs) 5 => Other -9922 => Unknown

A detailed description of the radionuclides can be found in the user's manual. If you have the name of a radionuclide but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 => Iodine-131 2 => MIBG 3 =>Yttrium 90 4 => Other -9922 => Unknown

For Metabolic/radionuclide therapy

Site' refers to the radiation therapy treatment field, i.e. the part of the body that received the radiation dose in order to treat the tumour. Required if Type of radiotherapy = 1 or 2 (External Beam, Brachytherapy)� If more than one body site was treated with radiotherapy, you can add anther site and describe; upto 5 sites are allowed by the system

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).

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.

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.

RT sites are coded with a 3 tier level (see list). The first is ?Tier 1?. The first digit/s of the code, describes the large topographical body areas e.g. brain, chest, abdomen, limb. Since radiation fields often involve more than one topographical area we have added ?cervico-thoracic?, ?thoraco abdominal? and ?abdomino pelvic? areas to Tier 1. The second (Tier 2) includes subcategories of Tier 1 sites e.g. brain stem, heart, liver, upper limb. Where the information is available a third (Tier 3) of further subdivisions includes more detailed areas. When using the SurPass platform, as you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose ??Other' (.98 in tier 2) and then add in free text the name of this RT site.

Record any available details on the shielded tissue/organ (or size of shielded area).

Report laterality of the radiation. R = right, L = left, B = bilateral

If needed it is possible to add details

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Specify the total dose given to the primary radiation therapy site. If the dose is not known, write NK.

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).

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.

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.

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Not known dose

Specify the total dose given to the primary radiation therapy site.

External Beam Radiation Therapy (EBRT) and Brachytherapy doses are in Gy. If doses are reported in cGY, roughly two zeroes need to be deleted (e.g. 100 cGy = 1 Gy). specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

A FRACTION of radiation treatment is a single attendance for treatment; if 'not known' insert NK

A boost is an extra dose of radiotherapy directed to a smaller area inside the primary radiation field. (only if type is External Beam)

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).

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.

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.

Specify radiation type of the boost. 1 => External Beam 2 => Brachytherapy -9922 => NK �

Flag indicating if a boost was given, not given or unknown

Site' refers to the radiation therapy treatment field. As you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose: ??Other' and then add in free text the name of this RT site. required if given

Report laterality of the radiation. R = right, L = left, B = bilateral

If needed it is possible to add details

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Specify the total dose given to the boost site.

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).

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.

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.

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Not known dose

Specify the total dose given to the boost site.

Specify the unit of the boost in case of external beam radiotherapy as Gy. specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

A fraction of radiation treatment is a single attendance for treatment. Please specify the number of fractions given as included in the boost. If not known, insert NK.

Shielding, in some records this is called ?blocking? or ?blocks?.

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).

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.

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.

Specify if shielding was used or not. Yes; No; NK �

Describe the positioning of shielding

Organs at Risk

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).

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.

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.

Specify if there is available information on Dosimetry of Organs at Risk [Yes/No]

If Dosimetry on Organ at Risk is available, upload here the electronic / scanned version(s) of any relevant document(s)

Radiotherapy file(s) can be uploaded here

Notes

Radiotherapy Maturity Level: 2 - Ready for Review

Identifier of the diagnosis for which this radiotherapy is performed

Identifier of the relapse/progression (after FLT) for which this radiotherapy is performed

Progressive number of radotherapy episode. An EPISODE might be a single or several courses of pre-planned treatment within a consecutive time period to different sites. For example, if a patient had radiotherapy to a limb and also to the lungs for a Ewing?s sarcoma these should be entered in one episode of treatment but as separate radiotherapy courses with their respective site, total dose, and number of fractions. They will both be within one episode

Please indicate the institution in which the radiotherapeutic treatment was given

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

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

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

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).

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.

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.

Please provide name, city and countryof the institution

Institution name

Institution address

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

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

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

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).

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.

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.

Institution city

Institution country

Enter the date on which the first treatment (fraction) of radiotherapy was given, in a DD/MM/YYYY format. If the date is unkown or partially missed insert the year at the best of your knowledge.

Enter the full date on which the last treatment (fraction) of radiotherapy was given in a DD/MM/YYYY format.
When only a single radiation treatment/fraction was given, the start and end dates will be the same. If the date is unkown or partially missed insert the year at the best of your knowledge.

External Beam Radiation: The radiation is produced by a large machine, and the type of the machine needs to be recorded in the subsequent field. Brachytherapy: a material that is radioactive (often a fine wire or a tiny ?seed?) is placed on or in the body to give a very localized high dose of radiation. Details will be asked in the next field Metabolic or radionuclide treatment/therapy: a liquid substance is injected into the blood stream and carries radiation throughout the body with the aim of reaching tumour tissue. Also in this case, details will be asked in the subsequent field. 1 => External beam 2 => Brachytherapy 3 => Metabolic/radionuclide therapy

A detailed description of the type of machine can be found in the user's manual. If you have the name of a machine but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 =>Orthovoltage / kilovoltage usually 200 - 300kv X rays/photons 2 =>Linac (Linear Accelerator) megavoltage MV X Rays/photons 3 =>Linac (Linear Accelerator) electrons 4 => Cobalt - MV gamma rays / photons 5 => Proton Beam 6 => Other, if other specify the name -9922 => Unknown

? Surface brachytherapy - a radiation source (radioactive material) is positioned on a superficial tumour ? Interstitial brachytherapy ? a radiation source is implanted into a tumour ? Intracavitary or intraluminal brachytherapy - a radiation source is introduced in special applicators into a body cavity or lumen

1 => Surface brachytherapy 2 => Interstitial brachytherapy 3 => Intracavitary or intraluminal brachytherapy -9922=> Unknown

Specify the radioactive material (isotopes) used: If not listed, select 'Other then specify' 1 => Iridium (Ir) 2 => Gold (Au) 3 => Iodine (I) 4 => Caesium (Cs) 5 => Other -9922 => Unknown

A detailed description of the radionuclides can be found in the user's manual. If you have the name of a radionuclide but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 => Iodine-131 2 => MIBG 3 =>Yttrium 90 4 => Other -9922 => Unknown

For Metabolic/radionuclide therapy

Site' refers to the radiation therapy treatment field, i.e. the part of the body that received the radiation dose in order to treat the tumour. Required if Type of radiotherapy = 1 or 2 (External Beam, Brachytherapy)� If more than one body site was treated with radiotherapy, you can add anther site and describe; upto 5 sites are allowed by the system

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

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

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

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).

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.

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.

RT sites are coded with a 3 tier level (see list). The first is ?Tier 1?. The first digit/s of the code, describes the large topographical body areas e.g. brain, chest, abdomen, limb. Since radiation fields often involve more than one topographical area we have added ?cervico-thoracic?, ?thoraco abdominal? and ?abdomino pelvic? areas to Tier 1. The second (Tier 2) includes subcategories of Tier 1 sites e.g. brain stem, heart, liver, upper limb. Where the information is available a third (Tier 3) of further subdivisions includes more detailed areas. When using the SurPass platform, as you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose ??Other' (.98 in tier 2) and then add in free text the name of this RT site.

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

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

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

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Record any available details on the shielded tissue/organ (or size of shielded area).

Report laterality of the radiation. R = right, L = left, B = bilateral

If needed it is possible to add details

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Specify the total dose given to the primary radiation therapy site. If the dose is not known, write NK.

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

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

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

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).

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.

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.

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Not known dose

Specify the total dose given to the primary radiation therapy site.

External Beam Radiation Therapy (EBRT) and Brachytherapy doses are in Gy. If doses are reported in cGY, roughly two zeroes need to be deleted (e.g. 100 cGy = 1 Gy). specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

A FRACTION of radiation treatment is a single attendance for treatment; if 'not known' insert NK

A boost is an extra dose of radiotherapy directed to a smaller area inside the primary radiation field. (only if type is External Beam)

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

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

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

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).

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.

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.

Specify radiation type of the boost. 1 => External Beam 2 => Brachytherapy -9922 => NK �

Flag indicating if a boost was given, not given or unknown

Site' refers to the radiation therapy treatment field. As you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose: ??Other' and then add in free text the name of this RT site. required if given

Report laterality of the radiation. R = right, L = left, B = bilateral

If needed it is possible to add details

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Specify the total dose given to the boost site.

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

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

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

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).

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.

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.

Check in case of incomplete doses

Specify reasons of incomplete estimated doses

Not known dose

Specify the total dose given to the boost site.

Specify the unit of the boost in case of external beam radiotherapy as Gy. specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

A fraction of radiation treatment is a single attendance for treatment. Please specify the number of fractions given as included in the boost. If not known, insert NK.

Shielding, in some records this is called ?blocking? or ?blocks?.

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

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

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

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).

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.

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.

Specify if shielding was used or not. Yes; No; NK �

Describe the positioning of shielding

Organs at Risk

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

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

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

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).

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.

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.

Specify if there is available information on Dosimetry of Organs at Risk [Yes/No]

If Dosimetry on Organ at Risk is available, upload here the electronic / scanned version(s) of any relevant document(s)

Radiotherapy file(s) can be uploaded here

Notes