Description:

RTOG-0522 AE: Adverse Event Evaluation Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F5E8260F-4A36-157F-E034-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F5E8260F-4A36-157F-E034-0003BA3F9857

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Versions (4) ▾
  1. 9/19/12
  2. 1/9/15
  3. 1/9/15
  4. 7/8/15
Uploaded on:

July 8, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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RTOG-0522 AE: Adverse Event Evaluation Form NCT00265941

Radiation Therapy Oncology Group Phase III Lung Pre-Op Chemotherapy vs. Pre-Op Concurrent Chemoradiation for NSCLC

RTOG clinical trial administrative data
AMENDED DATA
Report All Continuing Or New Adverse Events
Type of corresponding form (Score most severe grade observed during report period Grade 1-5.)
CTCAE ATTRIBUTION CODE (Attribution to Protocol Treatment See protocol sections 6 & 7 for definition of "protocol treatment")
Serious adverse event report submitted

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