ID
11023
Beskrivning
E1208 Treatment Form NCT01004978 Chemoembolization With or Without Sorafenib Tosylate in Treating Patients With Liver Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6FCB9730-7048-93EE-E040-BB89AD434904
Länk
Nyckelord
Versioner (4)
- 2012-09-19 2012-09-19 -
- 2015-01-08 2015-01-08 - Martin Dugas
- 2015-01-09 2015-01-09 - Martin Dugas
- 2015-06-16 2015-06-16 -
Uppladdad den
16 juni 2015
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0 Legacy
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E1208 Treatment Form NCT01004978
INSTRUCTIONS: Complete this form at the end of each cycle. Submit original to the ECOG Coordinating Center. Keep a copy for your files
Beskrivning
Patient demographics
Beskrivning
Patient Initials
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Beskrivning
Protocol Number ECOG
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Beskrivning
Study Number Participating Group
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Beskrivning
Institution Name
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25454
- UMLS CUI-1
- C1301943
- NCI Thesaurus ObjectClass-2
- C21541
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ValueDomain
- C25191
- NCI Thesaurus ValueDomain-2
- C21541
Beskrivning
Patient ID ECOG
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Beskrivning
Trial subject ID Participating Group
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Beskrivning
Vital Status
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
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
Primary Cause of Death
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C28554
- NCI Thesaurus ValueDomain-2
- C25251
Beskrivning
Cause of Death, specify
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1521902
- NCI Thesaurus Property
- C28554
Beskrivning
Patient Characteristics
Beskrivning
Reporting Period Start Date
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25616
- UMLS CUI-1
- C2361257
- NCI Thesaurus Property-2
- C25651
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Beskrivning
Reporting Period End Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2361259
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25651
Beskrivning
ECOG Performance Status
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
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
Måttenheter
- m2
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS CUI-1
- C0005902
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property
- C25157
Beskrivning
Bilirubin, Total ULN
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201913
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C38037
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Beskrivning
LaboratoryProcedureTotalBilirubinResultValue
Datatyp
float
Måttenheter
- mg/dL
Alias
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property-2
- C38037
- UMLS 2011AA Property-2
- C0201913
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beskrivning
Therapy Administered - Section I
Beskrivning
Concomitant Medication Start Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2826734
- NCI Thesaurus ValueDomain-2
- C25431
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25275
Beskrivning
Concomitant Medication End Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2826744
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25275
Beskrivning
Patient Diary complete
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C3259162
- NCI Thesaurus Property
- C25250
- NCI Metathesaurus ObjectClass
- C0030705
Beskrivning
AgentDailyQuantityPrescriptionDose
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property-2
- C28180
- UMLS 2011AA Property-2
- C1521941
- NCI Thesaurus Property-3
- C25256
- UMLS 2011AA Property-3
- C1265611
- NCI Thesaurus ValueDomain
- C25488
- UMLS 2011AA ValueDomain
- C0178602
Beskrivning
DoseModificationDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25488
- UMLS 2011AA ObjectClass
- C0178602
- NCI Thesaurus Property
- C25572
Beskrivning
DoseModificationDailyDose
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25473
- UMLS 2011AA ValueDomain
- C0332173
- NCI Thesaurus ObjectClass
- C25488
- UMLS 2011AA ObjectClass
- C0178602
- NCI Thesaurus ValueDomain-2
- C25488
- UMLS 2011AA ValueDomain-2
- C0178602
- NCI Thesaurus Property
- C25572
Beskrivning
Dose Modification Reason
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C0392360
- NCI Thesaurus Property
- C25572
Beskrivning
Dose Modification Reason, other
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C3840932
- NCI Thesaurus Property
- C25572
Beskrivning
Tace Administration
Beskrivning
Agent administered during reporting period
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C0450442
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property
- C25382
Beskrivning
Agent Administered Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0450442
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property
- C25382
- UMLS CUI-3
- C0011008
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
Medication Dose
Datatyp
float
Alias
- NCI Thesaurus ValueDomain
- C25488
- UMLS CUI-1
- C3174092
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain-2
- C1708
- NCI Thesaurus Property
- C25382
Beskrivning
AgentNotAdministeredText
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property-2
- C25409
- UMLS 2011AA Property-2
- C1533734
Beskrivning
TherapyArteryChemoembolizationAdministrationType
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C12372
- UMLS 2011AA Property
- C0003842
- NCI Thesaurus Property-2
- C25409
- UMLS 2011AA Property-2
- C1533734
- NCI Thesaurus Property-3
- C15752
- UMLS 2011AA Property-3
- C0796679
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beskrivning
Section E: Non-protocol Therapy
Beskrivning
Non-protocol therapy
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-1
- C1518384
- NCI Thesaurus ObjectClass-2
- C16212
- UMLS CUI-2
- C0087111
- NCI Thesaurus Property
- C25320
- NCI Thesaurus Property-2
- C49236
- NCI Thesaurus Property-3
- C25456
- NCI Thesaurus Property-4
- C25382
- NCI Thesaurus ValueDomain
- C38148
Beskrivning
Comments
Beskrivning
Investigator Signature
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Beskrivning
Investigator Signature Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
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C25367 (NCI Thesaurus ValueDomain-2)
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C16960 (NCI Thesaurus ObjectClass)
C28554 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ValueDomain-2)
C0439673 (UMLS 2011AA)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1521902 (UMLS CUI-2)
C28554 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property)
C2361257 (UMLS CUI-1)
C25651 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
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C25208 (NCI Thesaurus Property)
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C25157 (NCI Thesaurus Property)
C0201913 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C38037 (NCI Thesaurus Property-2)
C0201913 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C2826734 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C2826744 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C3259162 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
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C1707811 (UMLS CUI-1)
C25488 (NCI Thesaurus ObjectClass)
C3840932 (UMLS CUI-2)
C25572 (NCI Thesaurus Property)
C0450442 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1521801 (UMLS CUI-2)
C25382 (NCI Thesaurus Property)
C0450442 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
C1521801 (UMLS CUI-2)
C25382 (NCI Thesaurus Property)
C0011008 (UMLS CUI-3)
C1521826 (UMLS CUI-1)
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C42614 (NCI Thesaurus ValueDomain-2)
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