Description:

CALGB: ADJUVANT RADIOTHERAPY REPORT FORM 2 NCT00041119 Four Versus Six Cycles of Cyclophosphamide/Doxorubicin or Paclitaxel in Adjuvant Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E03851EE-EEDC-5498-E034-0003BA12F5E7

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E03851EE-EEDC-5498-E034-0003BA12F5E7

Keywords:
Versions (3) ▾
  1. 8/26/12
  2. 1/9/15
  3. 6/21/15
Uploaded on:

June 21, 2015

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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CALGB: ADJUVANT RADIOTHERAPY REPORT FORM 2 NCT00041119

INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted.

Header
Are data amended
Patient demographics
Radiation Treatment
Has the patient received adjuvant radiation therapy (prior to diagnosis of recurrence or second primary cancer)
Nature of radiotherapy (mark one box with an X)