ID
10552
Beschreibung
NCT00023829 FF Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Long Term Follow-up Form Adjuvant Radiation Therapy Plus Hormone Therapy Compared With Radiation Therapy Alone in Treating Patients With Stage II or Stage III Prostate Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A56DBAD2-8C43-0FEF-E034-080020C9C0E0
Link
Stichworte
Versionen (3)
- 19.09.12 19.09.12 -
- 28.05.15 28.05.15 -
- 03.06.15 03.06.15 -
Hochgeladen am
3. Juni 2015
DOI
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Lizenz
Creative Commons BY-NC 3.0 Legacy
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NCT00023829 FF Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Long Term Follow-up Form
Instructions: Submit this form at the appropriate followup interval. Use -1 for unknown or not applicable unless otherwise specified in codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated. This form may be used after 5 years provided none of the following events have occurred since the last submitted report: change in disease status; new or continuing toxicity; new therapy for cancer, the patient expired. If any of these events have occurred, submit the standard F1 form.
- StudyEvent: FF Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Long Term Follow-up Form
Beschreibung
Medical history
Beschreibung
Patient'sVitalStatus
Datentyp
text
Beschreibung
DeathDate/LastContactDate
Datentyp
date
Beschreibung
Causeofdeath
Datentyp
text
Beschreibung
PrimaryCauseDeathOtherReasonSpecify
Datentyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960 (undefined)
- UMLS 2011AA ObjectClass
- C0030705 (Patients)
- SNOMED
- 116154003
- NCI Thesaurus ObjectClass-2
- C25251 (undefined)
- UMLS 2011AA ObjectClass-2
- C0205225 (Primary)
- SNOMED
- 63161005
- LOINC
- LA21208-6
- NCI Metathesaurus ObjectClass
- C0007465 (Cause of Death)
- SNOMED
- 16100001
- LOINC
- LA10595-9
- NCI Thesaurus Property
- C17649 (undefined)
- UMLS 2011AA Property
- C0205394 (Other)
- SNOMED
- 74964007
- LOINC
- LP21049-9
- NCI Thesaurus Property-2
- C25365 (undefined)
- UMLS 2011AA Property-2
- C0678257 (Description)
- LOINC
- LP6800-9
- NCI Thesaurus ValueDomain
- C25685 (undefined)
- UMLS 2011AA ValueDomain
- C1521902 (To specify)
Beschreibung
HASTHEPATIENTHADADOCUMENTEDCLINICALASSESSMENTFORPROSTATECANCERSINCESUBMISSIONOFTHEPREVIOUSFOLLOWUPFORM?
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704 (undefined)
- UMLS 2011AA ValueDomain
- C1527021 (Text)
- LOINC
- LP6885-0
- NCI Thesaurus ValueDomain-2
- C25180 (undefined)
- UMLS 2011AA ValueDomain-2
- C1522602 (Indicator)
Beschreibung
CancerFollow-upStatusDate
Datentyp
date
Alias
- NCI Thesaurus ObjectClass
- C2991 (undefined)
- UMLS 2011AA ObjectClass
- C0012634 (Disease)
- SNOMED
- 64572001
- LOINC
- LP21006-9
- NCI Thesaurus Property
- C25365 (undefined)
- UMLS 2011AA Property
- C0678257 (Description)
- LOINC
- LP6800-9
Beschreibung
Follow-upPSAValue(s)
Datentyp
text
Beschreibung
DateofPSAAssessment(s)
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Beschreibung
HASCLINICALDISEASESTATUSlocal,regional,distantCHANGEDSINCETHELASTREPORT?
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- UMLS 2011AA ValueDomain
- C1512699 (Yes, No, or Unknown Response)
Beschreibung
NewCancerDiagnosisAnatomicSite
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C13717 (undefined)
- UMLS 2011AA ValueDomain
- C1515974 (Anatomic Site)
- NCI Thesaurus ObjectClass
- C25586 (undefined)
- UMLS 2011AA ObjectClass
- C0205314 (New)
- SNOMED
- 7147002
- LOINC
- LA9039-4
- NCI Thesaurus ObjectClass-2
- C9305 (undefined)
- UMLS 2011AA ObjectClass-2
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- NCI Thesaurus Property
- C15220 (undefined)
- UMLS 2011AA Property
- C0011900 (Diagnosis)
- SNOMED
- 439401001
- LOINC
- LP30831-9
Beschreibung
NewPrimaryCancerDate
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Beschreibung
RENAL/GENITOURINARYTOXICITYADVERSEEVENTREPORTS(AER)
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704 (undefined)
- UMLS 2011AA ValueDomain
- C1527021 (Text)
- LOINC
- LP6885-0
- NCI Thesaurus ValueDomain-2
- C25180 (undefined)
- UMLS 2011AA ValueDomain-2
- C1522602 (Indicator)
Beschreibung
URINARYINCONTINENCE,SeverityGrade
Datentyp
text
Beschreibung
URINARYINCONTINENCE,Attribution
Datentyp
text
Beschreibung
Specifyifothercause(urinaryincontinence,attribution)
Datentyp
text
Beschreibung
URINARYINCONTINENCE,AERBeginDate
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Beschreibung
URINARYFREQUENCY/URGENCY,SeverityGrade
Datentyp
text
Beschreibung
URINARYFREQUENCY/URGENCY,Attribution
Datentyp
text
Beschreibung
Specifyifothercause(urinaryfrequency/urgency,attribution)
Datentyp
text
Beschreibung
URINARYFREQUENCY/URGENCY,AERBeginDate
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Beschreibung
ERECTILEIMPOTENCE,SeverityGrade
Datentyp
text
Beschreibung
ERECTILEIMPOTENCE,Attribution
Datentyp
text
Beschreibung
Specifyifothercause(erectileimpotence,attribution)
Datentyp
text
Beschreibung
ERECTILEIMPOTENCE,AERBeginDate
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Beschreibung
NEWORCONTINUINGTOXICITY(>=SeverityGrade3)SINCETHELASTREPORT?
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704 (undefined)
- UMLS 2011AA ValueDomain
- C1527021 (Text)
- LOINC
- LP6885-0
- NCI Thesaurus ValueDomain-2
- C25180 (undefined)
- UMLS 2011AA ValueDomain-2
- C1522602 (Indicator)
Beschreibung
DIDTHEPATIENTRECEIVEANYNON-PROTOCOLPROSTATECANCERTHERAPYSINCETHELASTFOLLOW-UP?
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704 (undefined)
- UMLS 2011AA ValueDomain
- C1527021 (Text)
- LOINC
- LP6885-0
- NCI Thesaurus ValueDomain-2
- C25180 (undefined)
- UMLS 2011AA ValueDomain-2
- C1522602 (Indicator)
Beschreibung
Comments
Datentyp
text
Beschreibung
Signature
Datentyp
text
Beschreibung
Date
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Beschreibung
Ccrr Module For Ff Radiation Therapy Oncology Group Phase Iii Randomized Study Of Adjuvant Therapy For High Risk Pt3no Prostate Cancer Long Term Follow-up Form
Ähnliche Modelle
Instructions: Submit this form at the appropriate followup interval. Use -1 for unknown or not applicable unless otherwise specified in codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated. This form may be used after 5 years provided none of the following events have occurred since the last submitted report: change in disease status; new or continuing toxicity; new therapy for cancer, the patient expired. If any of these events have occurred, submit the standard F1 form.
- StudyEvent: FF Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Long Term Follow-up Form
C0237753 (UMLS 2011AA ValueDomain)
C0439673 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C25251 (NCI Thesaurus ObjectClass-2)
C0205225 (UMLS 2011AA ObjectClass-2)
C0007465 (NCI Metathesaurus ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0012634 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1515974 (UMLS 2011AA ValueDomain)
C25586 (NCI Thesaurus ObjectClass)
C0205314 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C0549184 (UMLS 2011AA)
C0005682 (UMLS 2011AA)
C0006104 (UMLS 2011AA)
C0555952 (UMLS 2011AA)
C1522619 (UMLS 2011AA)
C1704242 (UMLS 2011AA)
C0023884 (UMLS 2011AA)
C0024109 (UMLS 2011AA)
C0025202 (UMLS 2011AA)
C0030274 (UMLS 2011AA)
C0022646 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain-2)
C1522602 (UMLS 2011AA ValueDomain-2)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
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