ID

11812

Description

Paclitaxel, Cisplatin, and Radiation Therapy With or Without Cetuximab in Treating Patients With Locally Advanced Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2A16F93C-C68B-2E25-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2A16F93C-C68B-2E25-E044-0003BA3F9857

Keywords

Versions (4)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 6/21/15 6/21/15 -
  4. 8/4/15 8/4/15 - Martin Dugas
Uploaded on

August 4, 2015

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Initial Evaluation Form Esophageal Cancer RTOG NCT00655876

English

No Instruction available.

1 forms  
  1. StudyEvent: I1: Radiation Therapy Oncology Group Phase III Esophagus Initial Evaluation Form
    1. No Instruction available.
Module 1
Description

Module 1

RTOG Study No.
Description

Protocol ID RTOG

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
RTOG Case #
Description

RTOG Case #

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus ObjectClass-2
C19778
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C49152
NCI Thesaurus ValueDomain
C25337
UMLS CUI [1,1]
C1514695
UMLS CUI [1,2]
C0600091
Institution Name
Description

Institution Name

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Institution No.
Description

Institution Number

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Patient Initials
Description

Patient Initials

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
RTOG Patient ID
Description

Trial subject ID RTOG

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
AMENDED DATA
Description

Data amended

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Patient status assessment
Description

Patient status assessment

Age
Description

Age

Data type

integer

Measurement units
  • years
Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus ValueDomain
C29848
NCI Thesaurus ValueDomain-2
C25463
NCI Thesaurus Property
C25150
UMLS CUI [1]
C0001779
years
Performance Status (Zubrod)
Description

ZubrodPerformanceStatusScore

Data type

text

Alias
NCI Thesaurus Property
C25367
NCI Thesaurus ObjectClass
C20641
UMLS 2011AA ObjectClass
C1518965
NCI Thesaurus ValueDomain
C25338
UMLS 2011AA ValueDomain
C0449820
History of Prior Malignancy (except non melanomatous skin cancer)
Description

PatientPriorMalignantNeoplasmHistoryInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C25629
UMLS 2011AA ObjectClass-2
C0332152
NCI Thesaurus Property
C9305
UMLS 2011AA Property
C0006826
NCI Thesaurus Property-2
C25629
UMLS 2011AA Property-2
C0332152
NCI Thesaurus Property-3
C18772
UMLS 2011AA Property-3
C0262926
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Site of Prior Cancer
Description

PriorCancerDiagnosisSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus ObjectClass-2
C25629
UMLS 2011AA ObjectClass-2
C0332152
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Prior cancer date eradicated
Description

CancerAblationDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C20985
UMLS 2011AA Property
C0547070
Weight
Description

Patient Weight

Data type

float

Measurement units
  • Kg
Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0005910
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25208
Kg
Extent of Dysphagia
Description

DysphagiaExtentStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C2980
UMLS 2011AA ObjectClass
C0011168
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Thesaurus Property
C25332
UMLS 2011AA Property
C0439792
Oral alimentation
Description

NutritionalSupportOralRouteofAdministrationAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C38288
UMLS 2011AA Property
C1527415
NCI Thesaurus Property-2
C25382
UMLS 2011AA Property-2
C1521801
NCI Thesaurus ObjectClass
C15433
UMLS 2011AA ObjectClass
C0242739
Nasogastric tube feeding
Description

NutritionalSupportNasogastricRouteofAdministrationTubeAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C15433
UMLS 2011AA ObjectClass
C0242739
NCI Thesaurus Property
C38285
UMLS 2011AA Property
C0694637
NCI Thesaurus Property-2
C41277
UMLS 2011AA Property-2
C1561954
NCI Thesaurus Property-3
C25382
UMLS 2011AA Property-3
C1521801
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Ostomy feeding
Description

NutritionalSupportOstomyTubeAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C15433
UMLS 2011AA ObjectClass
C0242739
NCI Thesaurus Property
C41277
UMLS 2011AA Property
C1561954
NCI Thesaurus Property-2
C15290
UMLS 2011AA Property-2
C0029473
NCI Thesaurus Property-3
C25382
UMLS 2011AA Property-3
C1521801
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Intravenous hyperalimentation
Description

NutritionalSupportIntravenousRouteofAdministrationAdministeredind-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C38276
UMLS 2011AA Property
C1522726
NCI Thesaurus Property-2
C25382
UMLS 2011AA Property-2
C1521801
NCI Thesaurus ObjectClass
C15433
UMLS 2011AA ObjectClass
C0242739
Other
Description

NutritionalSupportOtherAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C37902
UMLS 2011AA ObjectClass
C1521721
NCI Thesaurus ObjectClass-2
C25597
UMLS 2011AA ObjectClass-2
C1521739
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus Property-2
C25382
UMLS 2011AA Property-2
C1521801
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Other Specify
Description

NutritionalSupportAdministeredSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C37902
UMLS 2011AA ObjectClass
C1521721
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ObjectClass-2
C25597
UMLS 2011AA ObjectClass-2
C1521739
Estimate of daily caloric intake
Description

PersonEstimatedDailyCaloricIntakeAssessmentType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25473
UMLS 2011AA Property-2
C0332173
NCI Thesaurus Property-3
C25498
UMLS 2011AA Property-3
C0750572
NCI Thesaurus Property-4
C28135
UMLS 2011AA Property-4
C0006777
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Prior Treatment
Description

Prior Treatment

Prior Surgery (for esophageal cancer excludes diagnostic biopsy)
Description

PatientEsophagealCarcinomaSurgicalProcedurePersonalMedicalHistoryInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C15329
UMLS 2011AA Property
C0543467
NCI Thesaurus Property-2
C18772
UMLS 2011AA Property-2
C0262926
NCI Thesaurus Property-3
C3513
UMLS 2011AA Property-3
C0152018
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Prior chemotherapy (for study cancer)
Description

PatientEsophagealCarcinomaChemotherapyPersonalMedicalHistoryInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C15632
UMLS 2011AA Property
C0392920
NCI Thesaurus Property-2
C18772
UMLS 2011AA Property-2
C0262926
NCI Thesaurus Property-3
C3513
UMLS 2011AA Property-3
C0152018
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Prior chemotherapy (for other reasons)
Description

PatientChemotherapyPersonalMedicalHistoryInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C15632
UMLS 2011AA Property
C0392920
NCI Thesaurus Property-2
C18772
UMLS 2011AA Property-2
C0262926
Prior radiation therapy (to chest)
Description

PatientChestRadiationTherapyPersonalMedicalHistoryInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C15313
UMLS 2011AA Property
C1522449
NCI Thesaurus Property-2
C25389
UMLS 2011AA Property-2
C0817096
NCI Thesaurus Property-3
C18772
UMLS 2011AA Property-3
C0262926
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Prior therapy that targeted EGFR pathway
Description

PriorEpidermalGrowthFactorReceptorTherapyPerformedInd-3

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus ObjectClass-3
C17068
UMLS 2011AA ObjectClass-2
C0034802
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Prior platinum based and/or paclitaxel based therapy
Description

PatientChemotherapyPersonalMedicalHistoryPlatinum-BasedTaxaneCompoundTherapeuticProcedureInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C49236
NCI Thesaurus Property-2
C18772
NCI Thesaurus Property-3
C25620
NCI Thesaurus Property-4
C1490
NCI Thesaurus ValueDomain
C38147
UMLS CUI [1,1]
C1514463
UMLS CUI [1,2]
C1514162
UMLS CUI [1,3]
C0796419
Study Cancer
Description

Study Cancer

Site of study cancer
Description

ClinicalStudyMalignantNeoplasmAnatomicSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus ObjectClass-2
C15206
UMLS 2011AA ObjectClass-2
C0008972
Histologic Type
Description

UpperGITumorHistologicClassificationCategory

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C17639
UMLS 2011AA ObjectClass-2
C0203057
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property-2
C25161
UMLS 2011AA Property-2
C0008902
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ValueDomain-2
C25526
UMLS 2011AA ValueDomain-2
C0205462
Date of initial histologic diagnosis of malignancy
Description

MalignantNeoplasmInitialHistologicDiagnosisDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
NCI Thesaurus Property-2
C25526
UMLS 2011AA Property-2
C0205462
NCI Thesaurus Property-3
C15220
UMLS 2011AA Property-3
C0011900
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Cervical esophagus
Description

EsophagealCarcinomaCervicalEsophagusInvasionInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C12250
UMLS 2011AA Property
C0227186
NCI Thesaurus ObjectClass
C3513
UMLS 2011AA ObjectClass
C0152018
NCI Thesaurus Property-2
C20625
UMLS 2011AA Property-2
C1269955
Invasion into the trachea or major bronchi
Description

EsophagealCarcinomaTracheaBronchusInvasionInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C3513
UMLS 2011AA ObjectClass
C0152018
NCI Thesaurus Property
C12683
UMLS 2011AA Property
C0006255
NCI Thesaurus Property-2
C12428
UMLS 2011AA Property-2
C0040578
NCI Thesaurus Property-3
C20625
UMLS 2011AA Property-3
C1269955
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Evidence of tracheoesophageal fistule
Description

EsophagealCarcinomaTracheoesophagealFistulaInvasionInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C3513
UMLS 2011AA ObjectClass
C0152018
NCI Thesaurus Property
C20625
UMLS 2011AA Property
C1269955
NCI Thesaurus Property-2
C35080
UMLS 2011AA Property-2
C0040588
Esophageal Tumor Clinical T Stage
Description

Esophageal Tumor Clinical T Stage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus ObjectClass-2
C37950
NCI Thesaurus Property
C25398
NCI Thesaurus Property-2
C25728
NCI Thesaurus ValueDomain
C16899
UMLS CUI [1,1]
C0014859
UMLS CUI [1,2]
C0475455
Is the tumor proximal thoracic
Description

MalignantNeoplasmProximalChestAnatomicSiteInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C13717
UMLS 2011AA Property
C1515974
NCI Thesaurus Property-2
C25389
UMLS 2011AA Property-2
C0817096
NCI Thesaurus Property-3
C25236
UMLS 2011AA Property-3
C0205107
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Clinical N Stage
Description

EsophagealTumorClinicalNStage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C37950
UMLS 2011AA ObjectClass-2
C1522619
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
Clinical M Stage
Description

EsophagealTumorClinicalMStage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C37950
UMLS 2011AA ObjectClass-2
C1522619
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25727
UMLS 2011AA Property-2
C0456533
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
Celiac lymph nodes
Description

EsophagealCarcinomaCeliacLymphNodeMetastasisInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C19151
UMLS 2011AA Property
C0027627
NCI Thesaurus ObjectClass
C3513
UMLS 2011AA ObjectClass
C0152018
NCI Thesaurus Property-2
C65166
UMLS 2011AA Property-2
C0229766
Cervical lymph nodes
Description

EsophagealCarcinomaCervicalLymphNodeMetastasisInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C19151
UMLS 2011AA Property
C0027627
NCI Thesaurus ObjectClass
C3513
UMLS 2011AA ObjectClass
C0152018
NCI Thesaurus Property-2
C32298
UMLS 2011AA Property-2
C0588054
Supraclavicular lymph nodes
Description

EsophagealCarcinomaSupraclavicularLymphNodeMetastasisInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C19151
UMLS 2011AA Property
C0027627
NCI Thesaurus Property-2
C12903
UMLS 2011AA Property-2
C0229730
NCI Thesaurus ObjectClass
C3513
UMLS 2011AA ObjectClass
C0152018
Laboratory Tests
Description

Laboratory Tests

Hemoglobin
Description

Hemoglobin

Data type

float

Measurement units
  • g/dL
Alias
NCI Thesaurus Property
C16676
NCI Thesaurus Property-2
C20200
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus ValueDomain
C25712
UMLS CUI [1]
C0019046
g/dL
ANC
Description

ANC

Data type

float

Measurement units
  • 1000/ul
Alias
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C63321
NCI Thesaurus ValueDomain
C38046
NCI Thesaurus ValueDomain-2
C25712
UMLS CUI [1]
C0200633
1000/ul
Peripheral Platelet Count
Description

Peripheral Platelet Count

Data type

float

Measurement units
  • 1000/uL
Alias
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C12520
NCI Thesaurus ValueDomain
C38046
NCI Thesaurus ValueDomain-2
C25712
UMLS CUI [1]
C0005821
1000/uL
Serum creatinine
Description

Serum creatinine

Data type

float

Measurement units
  • mg/dL
Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C13325
NCI Thesaurus Property-2
C399
UMLS CUI [1]
C0201976
mg/dL
AST (SGOT)
Description

AST (SGOT)

Data type

float

Measurement units
  • U/L
Alias
NCI Thesaurus ObjectClass
C13308
NCI Thesaurus Property
C25202
NCI Thesaurus Property-2
C37984
NCI Thesaurus ValueDomain
C38046
NCI Thesaurus ValueDomain-2
C25712
UMLS CUI [1]
C0201899
U/L
AST (SGOT) ULN
Description

AST (SGOT) ULN

Data type

float

Measurement units
  • U/L
Alias
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus Property
C25202
NCI Thesaurus Property-2
C20200
NCI Thesaurus ValueDomain
C25712
NCI Thesaurus ValueDomain-2
C25706
UMLS CUI [1,1]
C0242192
UMLS CUI [1,2]
C1519815
U/L
Bilirubin, total
Description

Bilirubin, total

Data type

float

Measurement units
  • mg/dL
Alias
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C38037
NCI Thesaurus ValueDomain
C25712
NCI Thesaurus ValueDomain-2
C38024
UMLS CUI [1]
C0201913
mg/dL
Total bilirubin ULN
Description

Bilirubin, Total ULN

Data type

float

Measurement units
  • mg/dL
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
C38024
NCI Thesaurus ValueDomain-3
C25706
mg/dL
Date
Description

Laboratory Procedure Date

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C0022885
NCI Thesaurus Property
C25214
UMLS CUI-2
C0011008
NCI Thesaurus Property-2
C38000
NCI Thesaurus ObjectClass
C25294
Diagnosis Work-up
Description

Diagnosis Work-up

History and Physical
Description

PersonalMedicalHistoryPhysicalExaminationPerformedInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass-2
C18772
UMLS 2011AA ObjectClass-2
C0262926
CT scan or MRI of the chest or abdomen
Description

MagneticResonanceImagingComputedTomographyDiagnosticImagingChestAbdominalCavityAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16502
NCI Thesaurus ObjectClass-2
C17204
NCI Thesaurus ObjectClass-3
C16809
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C25389
NCI Thesaurus Property-3
C12664
NCI Thesaurus ValueDomain
C38147
UMLS CUI [1,1]
C0040405
UMLS CUI [1,2]
C0024485
UMLS CUI [1,3]
C0817096
UMLS CUI [1,4]
C0230168
Endoscopic biopsy of esophageal tumor
Description

EndoscopicBiopsyDiagnosticProcedureEsophagealCarcinomaAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C18020
UMLS 2011AA ObjectClass
C0430022
NCI Thesaurus ObjectClass-2
C15389
UMLS 2011AA ObjectClass-2
C0184980
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C3513
UMLS 2011AA Property-2
C0152018
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
EKG
Description

ElectrocardiographyDiagnosticProcedureAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
NCI Thesaurus ObjectClass-2
C18020
UMLS 2011AA ObjectClass-2
C0430022
Bronchoscopy
Description

BronchoscopyPerformedInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus ObjectClass
C16366
NCI Thesaurus Property
C38000
UMLS CUI [1]
C0006290
PET/CT
Description

PositronEmissionTomographyComputedTomographyDiagnosticProcedureAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C17007
NCI Thesaurus ObjectClass-2
C17204
NCI Thesaurus ObjectClass-3
C18020
NCI Thesaurus Property
C20989
NCI Thesaurus ValueDomain
C38147
UMLS CUI [1,1]
C0032743
UMLS CUI [1,2]
C0040405
Date
Description

Assessment Date

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2985720
NCI Thesaurus ObjectClass
C25367
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus Property
C38000
Co-morbidties
Description

Co-morbidties

Hospitalized for unstable angina and/or CHF in last 6 months
Description

UnstableAnginaHospitalizationInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25179
UMLS 2011AA Property
C0019993
NCI Metathesaurus ObjectClass
C0002965
Transmural MI in last 6 months
Description

TransmuralMyocardialInfarctionConfirmedInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25458
UMLS 2011AA Property
C0750484
NCI Thesaurus ObjectClass
C27996
UMLS 2011AA ObjectClass
C0027051
NCI Metathesaurus ObjectClass
CL233186
IV antibiotics at time of registration
Description

IntravenousAntibioticAtRegistrationInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C13346
UMLS 2011AA ObjectClass
C0348016
NCI Thesaurus ObjectClass-2
C258
UMLS 2011AA ObjectClass-2
C0003232
NCI Thesaurus Property
C25646
UMLS 2011AA Property
C1514821
NCI Thesaurus Property-2
C25427
UMLS 2011AA Property-2
C1516077
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration
Description

ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25179
UMLS 2011AA Property
C0019993
NCI Thesaurus ObjectClass
C3199
UMLS 2011AA ObjectClass
C0024117
NCI Metathesaurus ObjectClass
CL316903
Prior allergic reaction to cisplatin
Description

CisplatinPriorAllergicReactionInd-2

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C376
UMLS 2011AA ObjectClass
C0008838
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Metathesaurus Property
CL240612
Prior allergic reaction to C225
Description

CetuximabPriorAllergicReactionInd-3

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C1723
UMLS 2011AA ObjectClass
C0879636
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Metathesaurus Property
CL240612
Prior allergic reaction to taxol
Description

PatientPaclitaxelHypersensitivityPersonalMedicalHistoryInd-3

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C1411
UMLS 2011AA Property
C0144576
NCI Thesaurus Property-2
C3114
UMLS 2011AA Property-2
C0020517
NCI Thesaurus Property-3
C18772
UMLS 2011AA Property-3
C0262926
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Prior severe infusion reaction to a monocolonal antibody
Description

PatientMonoclonalAntibodyInfusionHypersensitivityPersonalMedicalHistoryInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C3114
UMLS 2011AA Property
C0020517
NCI Thesaurus Property-2
C15388
UMLS 2011AA Property-2
C0574032
NCI Thesaurus Property-3
C20401
UMLS 2011AA Property-3
C0003250
NCI Thesaurus Property-4
C18772
UMLS 2011AA Property-4
C0262926
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Footer
Description

Footer

Comments
Description

Research Comments

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Investigator Signature (The reported case report information has been reviewed and confirmed by the principal investigator)
Description

Investigator Signature

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C2346576
NCI Thesaurus Property
C25678
NCI Thesaurus ObjectClass
C17089
Date
Description

Investigator Signature Date

Data type

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
Back to the top of the page

Similar models

No Instruction available.

1 forms
  1. StudyEvent: I1: Radiation Therapy Oncology Group Phase III Esophagus Initial Evaluation Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Module 1
Protocol ID RTOG
Item
RTOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
RTOG Case number
Item
RTOG Case #
text
C16960 (NCI Thesaurus ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C49152 (NCI Thesaurus Property-2)
C25337 (NCI Thesaurus ValueDomain)
C1514695 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Trial subject ID RTOG
Item
RTOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Data amended
Item
AMENDED DATA
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Patient status assessment
Age
Item
Age
integer
C16960 (NCI Thesaurus ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS CUI [1])
Item
Performance Status (Zubrod)
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL.2
Code List
Performance Status (Zubrod)
CL Item
Normal Activity (0)
CL Item
Symptoms, But Nearly Fully Ambulatory (1)
CL Item
Some Bed Time, But Needs To Be In Bed <50% Of Normal Daytime (2)
CL Item
Needs To Be In Bed > 50% Of Normal Daytime (3)
CL Item
Unable To Get Out Of Bed (4)
PatientPriorMalignantNeoplasmHistoryInd-2
Item
History of Prior Malignancy (except non melanomatous skin cancer)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C9305 (NCI Thesaurus Property)
C0006826 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PriorCancerDiagnosisSite
Item
Site of Prior Cancer
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
CancerAblationDate
Item
Prior cancer date eradicated
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C20985 (NCI Thesaurus Property)
C0547070 (UMLS 2011AA Property)
Patient Weight
Item
Weight
float
C25209 (NCI Thesaurus ValueDomain)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
Item
Extent of Dysphagia
text
C2980 (NCI Thesaurus ObjectClass)
C0011168 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C25332 (NCI Thesaurus Property)
C0439792 (UMLS 2011AA Property)
CL.4
Code List
Extent of Dysphagia
CL Item
Asymptomatic (Asymptomatic)
C3833 (NCI Thesaurus)
C0231221 (UMLS 2011AA)
CL Item
Cannot Swallow (Cannot swallow)
CL Item
Symptomatic, Liquids Only (Symptomatic, liquids only)
CL Item
Symptomatic, Soft Foods Only (Symptomatic, soft foods only)
CL Item
Symptomatic, Unrestricted Diet (Symptomatic, unrestricted diet)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Oral alimentation
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38288 (NCI Thesaurus Property)
C1527415 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)
CL.5
Code List
Oral alimentation
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Nasogastric tube feeding
text
C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)
C38285 (NCI Thesaurus Property)
C0694637 (UMLS 2011AA Property)
C41277 (NCI Thesaurus Property-2)
C1561954 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.6
Code List
Nasogastric tube feeding
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Ostomy feeding
text
C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)
C41277 (NCI Thesaurus Property)
C1561954 (UMLS 2011AA Property)
C15290 (NCI Thesaurus Property-2)
C0029473 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.7
Code List
Ostomy feeding
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Intravenous hyperalimentation
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38276 (NCI Thesaurus Property)
C1522726 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)
CL.8
Code List
Intravenous hyperalimentation
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Other
text
C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25597 (NCI Thesaurus ObjectClass-2)
C1521739 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.9
Code List
Other
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
NutritionalSupportAdministeredSpecify
Item
Other Specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25597 (NCI Thesaurus ObjectClass-2)
C1521739 (UMLS 2011AA ObjectClass-2)
Item
Estimate of daily caloric intake
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25473 (NCI Thesaurus Property-2)
C0332173 (UMLS 2011AA Property-2)
C25498 (NCI Thesaurus Property-3)
C0750572 (UMLS 2011AA Property-3)
C28135 (NCI Thesaurus Property-4)
C0006777 (UMLS 2011AA Property-4)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.10
Code List
Estimate of daily caloric intake
CL Item
< 1500 Cal/day (< 1500 cal/day)
CL Item
>= 1500 Cal/day (>= 1500 cal/day)
Item Group
Prior Treatment
PatientEsophagealCarcinomaSurgicalProcedurePersonalMedicalHistoryInd-2
Item
Prior Surgery (for esophageal cancer excludes diagnostic biopsy)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15329 (NCI Thesaurus Property)
C0543467 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C3513 (NCI Thesaurus Property-3)
C0152018 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientEsophagealCarcinomaChemotherapyPersonalMedicalHistoryInd-2
Item
Prior chemotherapy (for study cancer)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15632 (NCI Thesaurus Property)
C0392920 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C3513 (NCI Thesaurus Property-3)
C0152018 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientChemotherapyPersonalMedicalHistoryInd-2
Item
Prior chemotherapy (for other reasons)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15632 (NCI Thesaurus Property)
C0392920 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
PatientChestRadiationTherapyPersonalMedicalHistoryInd-2
Item
Prior radiation therapy (to chest)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15313 (NCI Thesaurus Property)
C1522449 (UMLS 2011AA Property)
C25389 (NCI Thesaurus Property-2)
C0817096 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PriorEpidermalGrowthFactorReceptorTherapyPerformedInd-3
Item
Prior therapy that targeted EGFR pathway
boolean
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C17068 (NCI Thesaurus ObjectClass-3)
C0034802 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Prior platinum based and/or paclitaxel based therapy
Item
Prior platinum based and/or paclitaxel based therapy
boolean
C16960 (NCI Thesaurus ObjectClass)
C49236 (NCI Thesaurus Property)
C18772 (NCI Thesaurus Property-2)
C25620 (NCI Thesaurus Property-3)
C1490 (NCI Thesaurus Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1514463 (UMLS CUI [1,1])
C1514162 (UMLS CUI [1,2])
C0796419 (UMLS CUI [1,3])
Item Group
Study Cancer
Item
Site of study cancer
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C15206 (NCI Thesaurus ObjectClass-2)
C0008972 (UMLS 2011AA ObjectClass-2)
CL.17
Code List
Site of study cancer
CL Item
Upper Thoracic Esophagus (Upper thoracic esophagus)
C25355 (NCI Thesaurus)
C1282910 (UMLS 2011AA)
C12251 (NCI Thesaurus-3)
C0227188 (UMLS 2011AA-4)
CL Item
Mid Thoracic Esophagus (Mid thoracic esophagus)
CL Item
Lower Thoracic Excludes Ge Junction (Lower thoracic excludes GE junction)
CL Item
Cervical Esophagus (Cervical Esophagus)
C12250 (NCI Thesaurus)
C0227186 (UMLS 2011AA)
CL Item
Gastroesophageal Junction, Siewert Type I (Gastroesophageal junction, Siewert Type I)
CL Item
Gastroesophageal Junction, Siewert Type Ii (Gastroesophageal junction, Siewert Type II)
Item
Histologic Type
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C17639 (NCI Thesaurus ObjectClass-2)
C0203057 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0205462 (UMLS 2011AA ValueDomain-2)
CL.18
Code List
Histologic Type
CL Item
Squamous Cell Carcinoma (Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
CL Item
Adenocarcinoma (Adenocarcinoma)
C2852 (NCI Thesaurus)
C0001418 (UMLS 2011AA)
MalignantNeoplasmInitialHistologicDiagnosisDate
Item
Date of initial histologic diagnosis of malignancy
date
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C25526 (NCI Thesaurus Property-2)
C0205462 (UMLS 2011AA Property-2)
C15220 (NCI Thesaurus Property-3)
C0011900 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
EsophagealCarcinomaCervicalEsophagusInvasionInd-2
Item
Cervical esophagus
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C12250 (NCI Thesaurus Property)
C0227186 (UMLS 2011AA Property)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C20625 (NCI Thesaurus Property-2)
C1269955 (UMLS 2011AA Property-2)
EsophagealCarcinomaTracheaBronchusInvasionInd-2
Item
Invasion into the trachea or major bronchi
boolean
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C12683 (NCI Thesaurus Property)
C0006255 (UMLS 2011AA Property)
C12428 (NCI Thesaurus Property-2)
C0040578 (UMLS 2011AA Property-2)
C20625 (NCI Thesaurus Property-3)
C1269955 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
EsophagealCarcinomaTracheoesophagealFistulaInvasionInd-2
Item
Evidence of tracheoesophageal fistule
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C20625 (NCI Thesaurus Property)
C1269955 (UMLS 2011AA Property)
C35080 (NCI Thesaurus Property-2)
C0040588 (UMLS 2011AA Property-2)
Item
Esophageal Tumor Clinical T Stage
text
C3262 (NCI Thesaurus ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C25398 (NCI Thesaurus Property)
C25728 (NCI Thesaurus Property-2)
C16899 (NCI Thesaurus ValueDomain)
C0014859 (UMLS CUI [1,1])
C0475455 (UMLS CUI [1,2])
CL.22
Code List
Esophageal Tumor Clinical T Stage
CL Item
Tumor Invades Lamina Propria Or Submucosa (T1)
CL Item
Tumor Invades Muscularis Propria (T2)
CL Item
Tumor Invades Adventitia (T3)
CL Item
Tumor Invades Adjacent Structures (T4)
MalignantNeoplasmProximalChestAnatomicSiteInd-2
Item
Is the tumor proximal thoracic
boolean
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C13717 (NCI Thesaurus Property)
C1515974 (UMLS 2011AA Property)
C25389 (NCI Thesaurus Property-2)
C0817096 (UMLS 2011AA Property-2)
C25236 (NCI Thesaurus Property-3)
C0205107 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Clinical N Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
CL.24
Code List
Clinical N Stage
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Regional Lymph Node Metastasis (N1)
Item
Clinical M Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
CL.25
Code List
Clinical M Stage
CL Item
No Distant Metastasis (M0)
CL Item
Metastases Present - See Figo And Ajcc Staging For Complete Details (M1a)
EsophagealCarcinomaCeliacLymphNodeMetastasisInd-2
Item
Celiac lymph nodes
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C65166 (NCI Thesaurus Property-2)
C0229766 (UMLS 2011AA Property-2)
EsophagealCarcinomaCervicalLymphNodeMetastasisInd-2
Item
Cervical lymph nodes
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C32298 (NCI Thesaurus Property-2)
C0588054 (UMLS 2011AA Property-2)
EsophagealCarcinomaSupraclavicularLymphNodeMetastasisInd-2
Item
Supraclavicular lymph nodes
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C12903 (NCI Thesaurus Property-2)
C0229730 (UMLS 2011AA Property-2)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
Item Group
Laboratory Tests
Hemoglobin
Item
Hemoglobin
float
C16676 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0019046 (UMLS CUI [1])
Neutrophil count
Item
ANC
float
C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C63321 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0200633 (UMLS CUI [1])
Platelets
Item
Peripheral Platelet Count
float
C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C12520 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0005821 (UMLS CUI [1])
Creatinine, Serum
Item
Serum creatinine
float
C16960 (NCI Thesaurus ObjectClass)
C13325 (NCI Thesaurus Property)
C399 (NCI Thesaurus Property-2)
C0201976 (UMLS CUI [1])
AST
Item
AST (SGOT)
float
C13308 (NCI Thesaurus ObjectClass)
C25202 (NCI Thesaurus Property)
C37984 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0201899 (UMLS CUI [1])
AST ULN
Item
AST (SGOT) ULN
float
C25294 (NCI Thesaurus ObjectClass)
C25202 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0242192 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Bilirubin, total
Item
Bilirubin, total
float
C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0201913 (UMLS CUI [1])
Bilirubin, Total ULN
Item
Total bilirubin ULN
float
C25294 (NCI Thesaurus ObjectClass)
C0201913 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C25706 (NCI Thesaurus ValueDomain-3)
Laboratory Procedure Date
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0022885 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C38000 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
Item Group
Diagnosis Work-up
PersonalMedicalHistoryPhysicalExaminationPerformedInd-2
Item
History and Physical
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C18772 (NCI Thesaurus ObjectClass-2)
C0262926 (UMLS 2011AA ObjectClass-2)
CT scan or MRI of the chest or abdomen
Item
CT scan or MRI of the chest or abdomen
boolean
C16502 (NCI Thesaurus ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C16809 (NCI Thesaurus ObjectClass-3)
C20989 (NCI Thesaurus Property)
C25389 (NCI Thesaurus Property-2)
C12664 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0040405 (UMLS CUI [1,1])
C0024485 (UMLS CUI [1,2])
C0817096 (UMLS CUI [1,3])
C0230168 (UMLS CUI [1,4])
EndoscopicBiopsyDiagnosticProcedureEsophagealCarcinomaAssessmentInd-2
Item
Endoscopic biopsy of esophageal tumor
boolean
C18020 (NCI Thesaurus ObjectClass)
C0430022 (UMLS 2011AA ObjectClass)
C15389 (NCI Thesaurus ObjectClass-2)
C0184980 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3513 (NCI Thesaurus Property-2)
C0152018 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ElectrocardiographyDiagnosticProcedureAssessmentInd-2
Item
EKG
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C18020 (NCI Thesaurus ObjectClass-2)
C0430022 (UMLS 2011AA ObjectClass-2)
Bronchoscopy
Item
Bronchoscopy
boolean
C38147 (NCI Thesaurus ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C38000 (NCI Thesaurus Property)
C0006290 (UMLS CUI [1])
PET/CT
Item
PET/CT
boolean
C17007 (NCI Thesaurus ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C18020 (NCI Thesaurus ObjectClass-3)
C20989 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C0032743 (UMLS CUI [1,1])
C0040405 (UMLS CUI [1,2])
Assessment Date
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C2985720 (UMLS CUI-1)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C38000 (NCI Thesaurus Property)
Item Group
Co-morbidties
UnstableAnginaHospitalizationInd-2
Item
Hospitalized for unstable angina and/or CHF in last 6 months
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C0002965 (NCI Metathesaurus ObjectClass)
TransmuralMyocardialInfarctionConfirmedInd-2
Item
Transmural MI in last 6 months
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C27996 (NCI Thesaurus ObjectClass)
C0027051 (UMLS 2011AA ObjectClass)
CL233186 (NCI Metathesaurus ObjectClass)
IntravenousAntibioticAtRegistrationInd-2
Item
IV antibiotics at time of registration
boolean
C13346 (NCI Thesaurus ObjectClass)
C0348016 (UMLS 2011AA ObjectClass)
C258 (NCI Thesaurus ObjectClass-2)
C0003232 (UMLS 2011AA ObjectClass-2)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25427 (NCI Thesaurus Property-2)
C1516077 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2
Item
COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C3199 (NCI Thesaurus ObjectClass)
C0024117 (UMLS 2011AA ObjectClass)
CL316903 (NCI Metathesaurus ObjectClass)
CisplatinPriorAllergicReactionInd-2
Item
Prior allergic reaction to cisplatin
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C376 (NCI Thesaurus ObjectClass)
C0008838 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
CL240612 (NCI Metathesaurus Property)
CetuximabPriorAllergicReactionInd-3
Item
Prior allergic reaction to C225
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1723 (NCI Thesaurus ObjectClass)
C0879636 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
CL240612 (NCI Metathesaurus Property)
PatientPaclitaxelHypersensitivityPersonalMedicalHistoryInd-3
Item
Prior allergic reaction to taxol
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C1411 (NCI Thesaurus Property)
C0144576 (UMLS 2011AA Property)
C3114 (NCI Thesaurus Property-2)
C0020517 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
PatientMonoclonalAntibodyInfusionHypersensitivityPersonalMedicalHistoryInd-2
Item
Prior severe infusion reaction to a monocolonal antibody
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3114 (NCI Thesaurus Property)
C0020517 (UMLS 2011AA Property)
C15388 (NCI Thesaurus Property-2)
C0574032 (UMLS 2011AA Property-2)
C20401 (NCI Thesaurus Property-3)
C0003250 (UMLS 2011AA Property-3)
C18772 (NCI Thesaurus Property-4)
C0262926 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item Group
Footer
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Investigator Signature
Item
Investigator Signature (The reported case report information has been reviewed and confirmed by the principal investigator)
text
C25704 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
Investigator Signature Date
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial