ID

10570

Descripción

FIRST SITE(S) OF PROGRESSION OR RELAPSE FORM NCT00020709 S0023: Combination Chemo Plus RT With or Without Gefitinib in Treating Patients With Unresectable Stage III NSCLC Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9E343E83-5F33-119F-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9E343E83-5F33-119F-E034-080020C9C0E0

Palabras clave

Versiones (3)
  1. 19/9/12 19/9/12 -
  2. 28/5/15 28/5/15 -
  3. 3/6/15 3/6/15 -
Subido en

3 de junio de 2015

DOI

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Licencia

Creative Commons BY-NC 3.0 Legacy
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FIRST SITE(S) OF PROGRESSION OR RELAPSE FORM NCT00020709

Inglés

No Instruction available.

1 formularios  
  1. StudyEvent: FIRST SITE(S) OF PROGRESSION OR RELAPSE FORM
    1. No Instruction available.
SWOG clinical trial administrative data
Descripción

SWOG clinical trial administrative data

SWOG Patient ID
Descripción

SWOGPatientID

Tipo de datos

text

SWOG Study No.
Descripción

SWOGStudyNo.

Tipo de datos

text

Registration Step
Descripción

RegistrationStep

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C16154
UMLS 2011AA ValueDomain-2
C1704379
Patient Initials (L, F,M)
Descripción

PatientInitials

Tipo de datos

text

Institution / Affiliate
Descripción

Institution/Affiliate

Tipo de datos

text

Physician
Descripción

Physician

Tipo de datos

text

Group Name (Groups other than SWOG )
Descripción

GroupName

Tipo de datos

text

Study No. (Groups other than SWOG )
Descripción

StudyNo.

Tipo de datos

float

Pt. ID (Groups other than SWOG )
Descripción

Pt.ID

Tipo de datos

text

Patient status
Descripción

Patient status

Date of last contact or death
Descripción

Dateoflastcontactordeath

Tipo de datos

text

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ObjectClass
C47954
UMLS 2011AA ObjectClass
C1705415
NCI Thesaurus ObjectClass-2
C25551
UMLS 2011AA ObjectClass-2
C1517741
Status
Descripción

Status

Tipo de datos

text

Progression/ relapse status
Descripción

Progression/ relapse status

Date of progression or relapse
Descripción

Dateofprogressionorrelapse

Tipo de datos

text

Local Site(s) of Progression or Relapse at the time progression/relapse was detected (select all that apply)
Descripción

LocalSite(s)ofProgressionorRelapseatthetimeprogression/relapsewasdetected

Tipo de datos

text

Lung parenchyma adjacent to primary tumor
Descripción

Lungparenchymaadjacenttoprimarytumor

Tipo de datos

text

Bronchial stump
Descripción

Bronchialstump

Tipo de datos

text

Regional/Nodal Site(s) of Progression or Relapse at the time progression/relapse was detected
Descripción

Regional/NodalSite(s)ofProgressionorRelapseatthetimeprogression/relapsewasdetected

Tipo de datos

text

Ipsilateral hilar mediastinum (nodal)
Descripción

Ipsilateralhilarmediastinum(nodal)

Tipo de datos

text

Contralateral hilar mediastinum (nodal)
Descripción

Contralateralhilarmediastinum(nodal)

Tipo de datos

text

Ipsilateral pleural effusion
Descripción

Ipsilateralpleuraleffusion

Tipo de datos

text

Contralateral pleural effusion
Descripción

Contralateralpleuraleffusion

Tipo de datos

text

Ipsilateral supraclavicular lymph nodes
Descripción

Ipsilateralsupraclavicularlymphnodes

Tipo de datos

text

Contralateral supraclavicular lymph nodes
Descripción

Contralateralsupraclavicularlymphnodes

Tipo de datos

text

Distant Site(s) of Progression or Relapse at the time progression/relapse was detected
Descripción

DistantSite(s)ofProgressionorRelapseatthetimeprogression/relapsewasdetected

Tipo de datos

text

Separate lobe of the ipsilateral lung
Descripción

Separatelobeoftheipsilaterallung

Tipo de datos

text

Opposite lung
Descripción

OppositeLungInd

Tipo de datos

text

Pericardial effusion
Descripción

Pericardialeffusion

Tipo de datos

text

Brain
Descripción

BrainSiteInd

Tipo de datos

text

Leptomeninges
Descripción

Leptomeninges

Tipo de datos

text

Liver
Descripción

LiverSiteInd

Tipo de datos

text

Bone
Descripción

BoneSiteInd

Tipo de datos

text

Adrenal glands
Descripción

Adrenalglands

Tipo de datos

text

Kidney
Descripción

Kidney

Tipo de datos

text

Skin or subcutaneous
Descripción

Skinorsubcutaneous

Tipo de datos

text

Other site, specify
Descripción

Othersite,specify

Tipo de datos

text

For Local Progression or Relapse Progression/Relapse site within previous RT field? (select one )
Descripción

ForLocalProgressionorRelapseProgression/RelapsesitewithinpreviousRTfield?

Tipo de datos

text

For Regional Progression or Relapse Progression/Relapse site within previous RT field? (select one)
Descripción

ForRegionalProgressionorRelapseProgression/RelapsesitewithinpreviousRTfield?

Tipo de datos

text

Notes
Descripción

Notes

Notes
Descripción

Notes

Tipo de datos

text

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No Instruction available.

1 formularios
  1. StudyEvent: FIRST SITE(S) OF PROGRESSION OR RELAPSE FORM
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
SWOG clinical trial administrative data
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain-2)
C1704379 (UMLS 2011AA ValueDomain-2)
PatientInitials
Item
Patient Initials (L, F,M)
text
Institution/Affiliate
Item
Institution / Affiliate
text
Physician
Item
Physician
text
GroupName
Item
Group Name (Groups other than SWOG )
text
StudyNo.
Item
Study No. (Groups other than SWOG )
float
Pt.ID
Item
Pt. ID (Groups other than SWOG )
text
Item Group
Patient status
Dateoflastcontactordeath
Item
Date of last contact or death
text
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C47954 (NCI Thesaurus ObjectClass)
C1705415 (UMLS 2011AA ObjectClass)
C25551 (NCI Thesaurus ObjectClass-2)
C1517741 (UMLS 2011AA ObjectClass-2)
Item
Status
text
CL.1
Code List
Status
CL Item
Alive2005416 (Alive)
CL Item
Dead2005417 (Dead)
Item Group
Progression/ relapse status
Dateofprogressionorrelapse
Item
Date of progression or relapse
text
LocalSite(s)ofProgressionorRelapseatthetimeprogression/relapsewasdetected
Item
Local Site(s) of Progression or Relapse at the time progression/relapse was detected (select all that apply)
text
Lungparenchymaadjacenttoprimarytumor
Item
Lung parenchyma adjacent to primary tumor
text
Bronchialstump
Item
Bronchial stump
text
Regional/NodalSite(s)ofProgressionorRelapseatthetimeprogression/relapsewasdetected
Item
Regional/Nodal Site(s) of Progression or Relapse at the time progression/relapse was detected
text
Ipsilateralhilarmediastinum(nodal)
Item
Ipsilateral hilar mediastinum (nodal)
text
Contralateralhilarmediastinum(nodal)
Item
Contralateral hilar mediastinum (nodal)
text
Ipsilateralpleuraleffusion
Item
Ipsilateral pleural effusion
text
Contralateralpleuraleffusion
Item
Contralateral pleural effusion
text
Ipsilateralsupraclavicularlymphnodes
Item
Ipsilateral supraclavicular lymph nodes
text
Contralateralsupraclavicularlymphnodes
Item
Contralateral supraclavicular lymph nodes
text
DistantSite(s)ofProgressionorRelapseatthetimeprogression/relapsewasdetected
Item
Distant Site(s) of Progression or Relapse at the time progression/relapse was detected
text
Separatelobeoftheipsilaterallung
Item
Separate lobe of the ipsilateral lung
text
OppositeLungInd
Item
Opposite lung
text
Pericardialeffusion
Item
Pericardial effusion
text
BrainSiteInd
Item
Brain
text
Leptomeninges
Item
Leptomeninges
text
LiverSiteInd
Item
Liver
text
BoneSiteInd
Item
Bone
text
Adrenalglands
Item
Adrenal glands
text
Kidney
Item
Kidney
text
Skinorsubcutaneous
Item
Skin or subcutaneous
text
Othersite,specify
Item
Other site, specify
text
Item
For Local Progression or Relapse Progression/Relapse site within previous RT field? (select one )
text
CL.2
Code List
For Local Progression or Relapse Progression/Relapse site within previous RT field? (select one )
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Not Applicable (Not Applicable)
Item
For Regional Progression or Relapse Progression/Relapse site within previous RT field? (select one)
text
CL.3
Code List
For Regional Progression or Relapse Progression/Relapse site within previous RT field? (select one)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Not Applicable (Not Applicable)
Item Group
Notes
Notes
Item
Notes
text
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