Vital Status
Patient'sVitalStatus
text
DeathDate/LastContactDate
date
Causeofdeath
text
DeathReason,Specify
text
ProtocolTreatmentArmAssignmentText
text
Induction
TreatmentStartDate
date
TreatmentEndDate
date
AgentTotalDose
float
RTBeginDate
date
RTEndDate
date
RTTotalDose
float
DoseModification(Change)
text
RTInterruptionsInd
text
RTInterruptionsReason
text
Consolidation
TotalCourseNumber
float
Non-ProtocolTherapyInd,DuringTreatment
boolean
OffTreatmentReason
text
OffTreatmentReason,ComplicatingDisease
text
OffTreatmentReason,Other
text
Comments
Comments
text
InvestigatorSignature
text
InvestigatorSignatureDate
date
Ccrr Module For Treatment Form