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Packageil.core.fhir.r4
Resource TypePlanDefinition
IdPlanDefinition-chemotherapy.json
FHIR VersionR4

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Narrative

Note: links and images are rebased to the (stated) source

National Comprehensive Cancer Network

Chemotherapy Order Template

Kidney Cancer

Gemcitabine/CARBOplatin

KDN5

INDICATION:

Metastatic or Relapsed – Collecting Duct/Medullary Subtypes

REFERENCES:

  1. NCCN Guidelines® for Kidney Cancer. V.3.2015.
  2. Oudard S, et al. J Urol. 2007;177(5):1698-702. a

NCCN SUPPORTIVE CARE:

  1. Emetic Risk:
    Day 1Moderate
    Day 8Low
  2. Fever Neutropenia Risk:
    Refer to NCCN Guidelines for Myeloid Growth Factors. V.2.2014

CHEMOTHERAPY REGIMEN

21-day cycle for 6 cycles

  • Gemcitabine 1250 mg/m2 IV over 30 minutes on Days 1 and 8
  • CARBOplatin AUC 5 IV over 30 minutes on Day 1

Source1

{
  "resourceType": "PlanDefinition",
  "id": "chemotherapy",
  "meta": {
    "profile": [
      "http://fhir.health.gov.il/StructureDefinition/il-core-plan-definition"
    ]
  },
  "text": {
    "status": "additional",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "ActivityDefinition",
      "id": "1111",
      "status": "draft",
      "productCodeableConcept": {
        "coding": [
          {
            "code": "12574",
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "display": "gemcitabine"
          }
        ],
        "text": "gemcitabine"
      },
      "dosage": [
        {
          "text": "1250 mg/m² IV over 30 minutes",
          "timing": {
            "repeat": {
              "duration": 30,
              "durationUnit": "min"
            }
          },
          "route": {
            "text": "IV"
          },
          "doseAndRate": [
            {
              "type": {
                "coding": [
                  {
                    "code": "ordered",
                    "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "display": "Ordered"
                  }
                ]
              },
              "doseQuantity": {
                "value": 1250,
                "unit": "mg/m²"
              }
            }
          ]
        }
      ]
    },
    {
      "resourceType": "ActivityDefinition",
      "id": "2222",
      "status": "draft",
      "productCodeableConcept": {
        "coding": [
          {
            "code": "40048",
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "display": "Carboplatin"
          }
        ],
        "text": "CARBOplatin"
      },
      "dosage": [
        {
          "text": "AUC 5 IV over 30 minutes",
          "timing": {
            "repeat": {
              "duration": 30,
              "durationUnit": "min"
            }
          },
          "route": {
            "text": "IV"
          },
          "doseAndRate": [
            {
              "type": {
                "coding": [
                  {
                    "code": "ordered",
                    "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "display": "Ordered"
                  }
                ]
              }
            }
          ]
        }
      ]
    }
  ],
  "identifier": [
    {
      "system": "http://mockup.org/ordertemplates",
      "value": "KDN5"
    }
  ],
  "version": "1",
  "title": "Gemcitabine/CARBOplatin",
  "type": {
    "text": "Chemotherapy Order Template"
  },
  "status": "draft",
  "experimental": true,
  "publisher": "National Comprehensive Cancer Network, Inc.",
  "subjectReference": {
    "reference": "Patient/patient-israel"
  },
  "useContext": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString": "A"
        }
      ],
      "code": {
        "code": "treamentSetting-or-diseaseStatus",
        "system": "http://http://fhir.community-emr.co.il/fhir/CodeSystem/indications"
      },
      "valueCodeableConcept": {
        "text": "Metastatic"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString": "A"
        }
      ],
      "code": {
        "code": "disease-or-histology",
        "system": "http://http://fhir.community-emr.co.il/fhir/CodeSystem/indications"
      },
      "valueCodeableConcept": {
        "text": "Collecting Duct/Medullary Subtypes"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString": "A"
        }
      ],
      "code": {
        "code": "focus",
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type"
      },
      "valueCodeableConcept": {
        "text": "Kidney Cancer"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString": "B"
        }
      ],
      "code": {
        "code": "treatmentSetting-or-diseaseStatus",
        "system": "http://http://fhir.community-emr.co.il/fhir/CodeSystem/indications"
      },
      "valueCodeableConcept": {
        "text": "Relapsed"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString": "B"
        }
      ],
      "code": {
        "code": "disease-or-histology",
        "system": "http://http://fhir.community-emr.co.il/fhir/CodeSystem/indications"
      },
      "valueCodeableConcept": {
        "text": "Collecting Duct/Medullary Subtypes"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString": "B"
        }
      ],
      "code": {
        "code": "focus",
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type"
      },
      "valueCodeableConcept": {
        "text": "Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"
      }
    }
  ],
  "copyright": "All rights reserved.",
  "approvalDate": "2016-07-27",
  "lastReviewDate": "2016-07-27",
  "author": [
    {
      "name": "Lee Surprenant"
    }
  ],
  "relatedArtifact": [
    {
      "type": "derived-from",
      "display": "NCCN Guidelines for Kidney Cancer. V.2.2016",
      "url": "http://www.http://fhir.community-emr.co.il/professionals/physician_gls/PDF/kidney.pdf"
    },
    {
      "type": "citation",
      "citation": "Oudard S, et al. J Urol. 2007;177(5):1698-702",
      "url": "http://www.ncbi.nlm.nih.gov/pubmed/17437788"
    }
  ],
  "action": [
    {
      "selectionBehavior": "exactly-one",
      "action": [
        {
          "selectionBehavior": "all",
          "action": [
            {
              "groupingBehavior": "sentence-group",
              "selectionBehavior": "exactly-one",
              "action": [
                {
                  "id": "cycle-definition-1",
                  "textEquivalent": "21-day cycle for 6 cycles",
                  "timingTiming": {
                    "repeat": {
                      "count": 6,
                      "duration": 21,
                      "durationUnit": "d"
                    }
                  },
                  "action": [
                    {
                      "id": "action-1",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
                          "extension": [
                            {
                              "url": "day",
                              "valueInteger": 1
                            },
                            {
                              "url": "day",
                              "valueInteger": 8
                            }
                          ]
                        }
                      ],
                      "textEquivalent": "Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8",
                      "definitionCanonical": "#1111"
                    },
                    {
                      "id": "action-2",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
                          "extension": [
                            {
                              "url": "day",
                              "valueInteger": 1
                            }
                          ]
                        }
                      ],
                      "textEquivalent": "CARBOplatin AUC 5 IV over 30 minutes on Day 1",
                      "relatedAction": [
                        {
                          "actionId": "action-1",
                          "relationship": "concurrent-with-start"
                        }
                      ],
                      "definitionCanonical": "#2222"
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}