Description:

RTOG-0421 AE: Adverse Event Evaluation Form NCT00113399 Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB6FBB34-B48C-4885-E034-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB6FBB34-B48C-4885-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-0421 AE: Adverse Event Evaluation Form NCT00113399

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 (INSTRUCTIONS: the CTC AE Version 3.0 is used to score all adverse events)
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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