ID
10572
Description
S0023 LUNG CARCINOMA FOLLOW UP 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=9CB6D1D2-A964-34E4-E034-080020C9C0E0
Link
Keywords
Versions (3)
- 9/19/12 9/19/12 -
- 5/28/15 5/28/15 -
- 6/3/15 6/3/15 -
Uploaded on
June 3, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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S0023 LUNG CARCINOMA FOLLOW UP FORM NCT00020709
No Instruction available.
- StudyEvent: S0023 LUNG CARCINOMA FOLLOW UP FORM
Description
Vital Status
Description
Disease Follow Up Status
Description
Hasthepatienthadadocumentedclinicalassessmentforthiscancersincesubmissionofthepreviousfollow-upform?
Data type
text
Description
IfYes,DateofLastClinicalAssessment:
Data type
text
Description
Hasthepatientdevelopedafirstrelapseorprogressionthathasnotbeenpreviouslyreported?
Data type
text
Description
IfYes,DateofRelapseorProgression:
Data type
text
Description
Ifyes,pleasesubmittheLungCarcinomaFirstSite(s)ofProgressionorRelapseForm.
Data type
text
Description
Notice Of New Primary
Description
Hasanewprimarycancerormyelodysplasticsyndrome(MDS)beendiagnosedthathasnotbeenpreviouslyreported?
Data type
text
Description
IfYes,DateofDiagnosis:
Data type
text
Description
NewPrimarySite:
Data type
text
Description
Non-protocol Treatment
Description
Hasthepatientreceivedanynon-protocolcancertherapy(priortoprogression/relapse)notpreviouslyreported?
Data type
text
Description
IfYes,DateofFirstNon-ProtocolTherapy:
Data type
text
Description
Agents:
Data type
text
Description
Long Term Toxicity
Description
Hasthepatientexperienced(priortotreatmentforprogressionorrelapseorasecondprimary,andpriortonon-protocoltreatment)anysevere(grade=>3)longtermtoxicitythathasnotbeenpreviouslyreported?
Data type
text
Description
IfYes,ToxicitiesandGrades:
Data type
text
Description
Notes
Similar models
No Instruction available.
- StudyEvent: S0023 LUNG CARCINOMA FOLLOW UP FORM
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain)
C1704379 (UMLS 2011AA ValueDomain)