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ID

10574

Description

RADIOTHERAPY SUBMISSION FORM - LUNG 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=9CA62D43-501A-361C-E034-080020C9C0E0

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-501A-361C-E034-080020C9C0E0

Mots-clés

  1. 19/09/2012 19/09/2012 -
  2. 28/05/2015 28/05/2015 -
  3. 03/06/2015 03/06/2015 -
Téléchargé le

3 juin 2015

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy

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    RADIOTHERAPY SUBMISSION FORM - LUNG NCT00020709

    No Instruction available.

    1. StudyEvent: RADIOTHERAPY SUBMISSION FORM - LUNG
      1. No Instruction available.
    SWOG clinical trial administrative data
    Description

    SWOG clinical trial administrative data

    SWOG Study No.
    Description

    SWOGStudyNo.

    Type de données

    text

    Registration Step
    Description

    RegistrationStep

    Type de données

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ValueDomain-2
    C16154 (undefined)
    UMLS 2011AA ValueDomain-2
    C1704379 (Treatment Step)
    SWOG Patient ID
    Description

    SWOGPatientID

    Type de données

    text

    Patient Initials (L, F M)
    Description

    PatientInitials

    Type de données

    text

    Institution / Affiliate
    Description

    Institution/Affiliate

    Type de données

    text

    Investigator
    Description

    Investigator

    Type de données

    text

    RADIOTHERAPY documentation
    Description

    RADIOTHERAPY documentation

    RT Facility
    Description

    RTFacility

    Type de données

    text

    RT Physician
    Description

    RTPhysician

    Type de données

    text

    Radiation Therapy End Date (month, day, year )
    Description

    RTEndDate

    Type de données

    date

    Required Materials (if not enclosed, explain in Notes)
    Description

    RequiredMaterials

    Type de données

    text

    Dose Volume Histogram
    Description

    DoseVolumeHistogram

    Type de données

    text

    Enclosed
    Description

    Enclosed

    Type de données

    boolean

    Notes
    Description

    Notes

    Type de données

    text

    Notes
    Description

    Notes

    Similar models

    No Instruction available.

    1. StudyEvent: RADIOTHERAPY SUBMISSION FORM - LUNG
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Type de données
    Alias
    Item Group
    SWOG clinical trial administrative data
    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)
    SWOGPatientID
    Item
    SWOG Patient ID
    text
    PatientInitials
    Item
    Patient Initials (L, F M)
    text
    Institution/Affiliate
    Item
    Institution / Affiliate
    text
    Investigator
    Item
    Investigator
    text
    Item Group
    RADIOTHERAPY documentation
    RTFacility
    Item
    RT Facility
    text
    RTPhysician
    Item
    RT Physician
    text
    RTEndDate
    Item
    Radiation Therapy End Date (month, day, year )
    date
    Item
    Required Materials (if not enclosed, explain in Notes)
    text
    Code List
    Required Materials (if not enclosed, explain in Notes)
    CL Item
    Treatment Prescription Sheet (Treatment Prescription Sheet)
    CL Item
    Simulator Films or digital reconstruction rendering (Simulator Films or digital reconstruction rendering)
    CL Item
    CT Scan (CT Scan)
    CL Item
    Polaroid of Treatment Set-Up (Polaroid of Treatment Set-Up)
    CL Item
    Lung Carcinoma Radiation Therapy Form (Lung Carcinoma Radiation Therapy Form)
    Item
    Dose Volume Histogram
    text
    Code List
    Dose Volume Histogram
    CL Item
    Tumor (Tumor)
    CL Item
    Left Lung (Left Lung)
    CL Item
    Right Lung (Right Lung)
    CL Item
    Right + Left Lung (Right + Left Lung)
    Enclosed
    Item
    Enclosed
    boolean
    Notes
    Item
    Notes
    text
    Item Group
    Notes

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