Description:

NCT00057928 SOUTHWEST ONCOLOGY GROUP S0227 FOLLOW UP FORM (S0227) S0227 Comparison of Cisplatin Combined With Either Paclitaxel or Gemcitabine in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C447B6-E4F0-3A7F-E034-0003BA12F5E7

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C447B6-E4F0-3A7F-E034-0003BA12F5E7
Keywords:
Versions (3)
  1. 8/27/12 8/27/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 7/3/15 7/3/15 -
Uploaded on:

July 3, 2015

DOI:
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Creative Commons BY-NC 3.0 Legacy
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NCT00057928 SOUTHWEST ONCOLOGY GROUP S0227 FOLLOW UP FORM (S0227)

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1 forms  
  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP S0227 FOLLOW UP FORM (S0227)
    1. No Instruction available.
Header
Vital Status
Vital Status
Disease Follow Up Status
Has the patient had a documented clinical assessment for this cancer since submission of the previous follow-up form?
Notice Of First Relapse Or Progression
Has the patient developed a first protocol defined relapse or progression that has not been previously reported
Notice Of New Primary
Has a new primary cancer or myelodysplastic syndrome (MDS) been diagnosed that has not been previously reported?
Comments
Non-protocol Treatment
Has the patient received any (non-protocol) cancer treatment in this reporting period
Non-Protocol Surgery (If Yes, complete the following)
Non-Protocol Chemotherapy (if yes, Treatment Start Date)
Non-Protocol Hormonal Therapy (if yes, Treatment Start Date)
Non-Protocol Immunotherapy (if yes, Treatment Start Date)
Non-Protocol Radiation Therapy (if yes, Treatment Start Date)
Other Non-Protocol Therapy (if yes, Treatment Start Date)
Long Term Toxicity
Has the patient experienced (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment) any severe (grade >= 3) long term toxicity that has not been previously reported?
Neuropathy-motor
Neuropathy-sensory
Comments
Ccrr Module For Southwest Oncology Group S0227 Follow Up Form (s0227)
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