ID
10641
Beskrivning
SOUTHWEST ONCOLOGY GROUP S0221 AC+G TREATMENT FORM NCT00070564 Adjuvant Doxorubicin, Cyclophosphamide, and Paclitaxel in Treating Patients With Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E92C74F6-D5F3-6BB7-E034-0003BA3F9857
Länk
Nyckelord
Versioner (3)
- 2012-08-26 2012-08-26 -
- 2015-01-08 2015-01-08 - Martin Dugas
- 2015-06-03 2015-06-03 -
Uppladdad den
3 juni 2015
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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SOUTHWEST ONCOLOGY GROUP S0221 AC+G TREATMENT FORM NCT00070564
Instructions: Complete this form if the patient was assigned to Treatment Arm 1 or Arm 3. Submit this form only once, after the patient has completed AC+G chemotherapy and has recovered from acute toxicity. All dates are MONTH, DAY, YEAR. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: SOUTHWEST ONCOLOGY GROUP S0221 AC+G TREATMENT FORM
Beskrivning
Disease Status
Beskrivning
Follow-Up Date
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C9305
- UMLS CUI-1
- C3694716
- NCI Thesaurus Property
- C16033
- NCI Thesaurus Property-2
- C25365
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Beskrivning
Date last contact
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C0805839
- NCI Thesaurus Property
- C25461
- NCI Thesaurus Property-2
- C25551
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Beskrivning
Patient Status
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C3846084
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
Beskrivning
Treatment Status
Beskrivning
Protocol Treatment Arm
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C42651
- UMLS CUI-1
- C1522541
- NCI Thesaurus Property
- C32141
- NCI Thesaurus Property-2
- C25426
- NCI Thesaurus ValueDomain
- C25284
Beskrivning
StartTreatmentAssignmentArmInd
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Metathesaurus ObjectClass
- CL219258
- NCI Thesaurus Property
- C32141
- UMLS 2011AA Property
- C1140618
- NCI Thesaurus Property-2
- C25426
- UMLS 2011AA Property-2
- C1516050
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
Treatment Start Date
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25509
- UMLS CUI-1
- C3173309
- NCI Thesaurus Property
- C25431
- NCI Thesaurus Property-2
- C25275
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Beskrivning
Treatment End Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1531784
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25275
- NCI Thesaurus Property-2
- C25496
Beskrivning
Patient Weight
Datatyp
float
Måttenheter
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Beskrivning
Body Surface Area
Datatyp
float
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005902
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25157
Beskrivning
Agent
Datatyp
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
Beskrivning
AgentInitialDose
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property
- C25536
- UMLS 2011AA Property
- C1555582
- NCI Thesaurus Property-2
- C25256
- UMLS 2011AA Property-2
- C1265611
- NCI Thesaurus ValueDomain
- C25488
- UMLS 2011AA ValueDomain
- C0178602
- NCI Thesaurus ValueDomain-2
- C1708
- UMLS 2011AA ValueDomain-2
- C0450442
Beskrivning
Cumulative Dose Agent
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C2986497
- NCI Thesaurus ObjectClass-2
- C25470
- UMLS CUI-2
- C1521826
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25488
Beskrivning
Dose Modification
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25256
- NCI Thesaurus Property
- C25572
- NCI Thesaurus ValueDomain-2
- C25572
Beskrivning
Adverse event assessment
Beskrivning
NeutropeniaAdverseEventObservedInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass-2
- C3277
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
Beskrivning
NeutropeniaAdverseEventObservedCycleText
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass-2
- C3277
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain-2
- C25472
- UMLS 2011AA ValueDomain-2
- C1511572
Beskrivning
FebrileNeutropeniaAdverseEventObservedInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Metathesaurus ObjectClass
- C0746883
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
Beskrivning
FebrileNeutropeniaAdverseEventObservedCycleText
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Metathesaurus ObjectClass
- C0746883
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain-2
- C25472
- UMLS 2011AA ValueDomain-2
- C1511572
Beskrivning
AnemiaAdverseEventObservedInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass-2
- C2869
- UMLS 2011AA ObjectClass-2
- C0002871
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
Beskrivning
AnemiaAdverseEventObservedCycleText
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass-2
- C2869
- UMLS 2011AA ObjectClass-2
- C0002871
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain-2
- C25472
- UMLS 2011AA ValueDomain-2
- C1511572
Beskrivning
Comments
Similar models
Instructions: Complete this form if the patient was assigned to Treatment Arm 1 or Arm 3. Submit this form only once, after the patient has completed AC+G chemotherapy and has recovered from acute toxicity. All dates are MONTH, DAY, YEAR. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: SOUTHWEST ONCOLOGY GROUP S0221 AC+G TREATMENT FORM
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C3694716 (UMLS CUI-1)
C16033 (NCI Thesaurus Property)
C25365 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C3846084 (UMLS CUI-1)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)
C42651 (NCI Thesaurus ObjectClass-2)
C1522541 (UMLS CUI-1)
C32141 (NCI Thesaurus Property)
C25426 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
CL219258 (NCI Metathesaurus ObjectClass)
C32141 (NCI Thesaurus Property)
C1140618 (UMLS 2011AA Property)
C25426 (NCI Thesaurus Property-2)
C1516050 (UMLS 2011AA Property-2)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C25509 (NCI Thesaurus ObjectClass-2)
C3173309 (UMLS CUI-1)
C25431 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C1531784 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C25496 (NCI Thesaurus Property-2)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
C0005902 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25157 (NCI Thesaurus Property)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C0450442 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property-2)
C1265611 (UMLS 2011AA Property-2)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ValueDomain-2)
C0450442 (UMLS 2011AA ValueDomain-2)
C2986497 (UMLS CUI-1)
C25470 (NCI Thesaurus ObjectClass-2)
C1521826 (UMLS CUI-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25304 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1707811 (UMLS CUI-1)
C25256 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C25572 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C1512698 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C3277 (NCI Thesaurus ObjectClass-2)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C0877248 (UMLS 2011AA ObjectClass)
C3277 (NCI Thesaurus ObjectClass-2)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25472 (NCI Thesaurus ValueDomain-2)
C1511572 (UMLS 2011AA ValueDomain-2)
C1512698 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C0746883 (NCI Metathesaurus ObjectClass)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C0877248 (UMLS 2011AA ObjectClass)
C0746883 (NCI Metathesaurus ObjectClass)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25472 (NCI Thesaurus ValueDomain-2)
C1511572 (UMLS 2011AA ValueDomain-2)
C1512698 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C2869 (NCI Thesaurus ObjectClass-2)
C0002871 (UMLS 2011AA ObjectClass-2)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C0877248 (UMLS 2011AA ObjectClass)
C2869 (NCI Thesaurus ObjectClass-2)
C0002871 (UMLS 2011AA ObjectClass-2)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25472 (NCI Thesaurus ValueDomain-2)
C1511572 (UMLS 2011AA ValueDomain-2)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)