ID

1777

Description

RTOG-0421 I7: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Dosimetry Nodal Planning Diagram 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=EC502BE7-41DA-14BE-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EC502BE7-41DA-14BE-E034-0003BA3F9857

Keywords

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

September 19, 2012

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Creative Commons BY-NC 3.0 Legacy
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Head and Neck Cancer NCT00113399 On-Study - RTOG-0421 I7: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Dosimetry Nodal Planning Diagram - 2299952v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: RTOG-0421 I7: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Dosimetry Nodal Planning Diagram
    1. No Instruction available.
Unnamed Module 1
Description

Unnamed Module 1

RTOG Study No.
Description

ProtocolRTOGIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C19778
UMLS 2011AA Property
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Case #
Description

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C19778
UMLS 2011AA ObjectClass
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C49152
UMLS 2011AA Property
C1706256
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Institution Name
Description

InstitutionName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution No.
Description

InstitutionIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Initials
Description

PatientInitialsName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Patient Study No.
Description

PatientRadiationTherapyOncologyGroupIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C19778
UMLS 2011AA Property
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
If this is a revised or corrected form, indicate by checking box.
Description

CaseReportFormModifiedInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property
C25573
Unnamed Module 2
Description

Unnamed Module 2

NODAL SITES (*)
Description

HeadandNeckLymphNodeInvolvedSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus Property
C25547
Other
Description

LymphNodeTypeSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
<= 3 CM
Description

SmallTumorNodalHeadandNeckSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C25376
UMLS 2011AA ObjectClass
C0700321
NCI Thesaurus Property
C12418
UMLS 2011AA Property
C0460004
NCI Thesaurus Property
C25323
UMLS 2011AA Property
C0443268
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
>3-6 CM
Description

MediumTumorNodalHeadandNeckSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C49507
UMLS 2011AA ObjectClass
C0439536
NCI Thesaurus Property
C12418
UMLS 2011AA Property
C0460004
NCI Thesaurus Property
C25323
UMLS 2011AA Property
C0443268
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
>6CM
Description

LargeTumorNodalHeadandNeckSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C49508
UMLS 2011AA ObjectClass
C0549177
NCI Thesaurus Property
C12418
UMLS 2011AA Property
C0460004
NCI Thesaurus Property
C25323
UMLS 2011AA Property
C0443268
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NODES FIXED
Description

FixedLymphNodeHeadandNeckSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus Property
C12418
UMLS 2011AA Property
C0460004
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Metathesaurus ObjectClass
C0443218
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No Instruction available.

1 forms
  1. StudyEvent: RTOG-0421 I7: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Dosimetry Nodal Planning Diagram
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Unnamed Module 1
ProtocolRTOGIdentifierNumber
Item
RTOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus Property)
C1514695 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
RadiationTherapyOncologyGroupPatientCaseIdentifierNumber
Item
Case #
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass)
C1514695 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property)
C1706256 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
InstitutionIdentifierNumber
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
PatientRadiationTherapyOncologyGroupIdentifierNumber
Item
Patient Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus Property)
C1514695 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
If this is a revised or corrected form, indicate by checking box.
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25573 (NCI Thesaurus Property)
CL.1
Code List
If this is a revised or corrected form, indicate by checking box.
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item Group
Unnamed Module 2
Item
NODAL SITES (*)
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25547 (NCI Thesaurus Property)
CL.2
Code List
NODAL SITES (*)
CL Item
Occipital (Occipital)
CL Item
Postauricular (Postauricular)
CL Item
Upper (Upper)
C25355 (NCI Thesaurus)
C1282910 (UMLS 2011AA)
CL Item
Middle (Middle)
C25569 (NCI Thesaurus)
C0444598 (UMLS 2011AA)
CL Item
Lower (Lower)
C25309 (NCI Thesaurus)
C0441994 (UMLS 2011AA)
CL Item
Preauricular (Preauricular)
CL Item
Infra-auricular (Infra-auricular)
CL Item
Buccinator (Buccinator)
CL Item
Submandibular (Submandibular)
CL Item
Submental (Submental)
CL Item
Jugulodigastric (Jugulodigastric)
CL Item
Midjugular (Midjugular)
CL Item
Lower Jugular (Lower jugular)
CL Item
Prelaryngeal (Prelaryngeal)
CL Item
Pretracheal (Pretracheal)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
LymphNodeTypeSpecify
Item
Other
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
Item
<= 3 CM
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25376 (NCI Thesaurus ObjectClass)
C0700321 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus Property)
C0460004 (UMLS 2011AA Property)
C25323 (NCI Thesaurus Property)
C0443268 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.3
Code List
<= 3 CM
CL Item
Rt (RT)
CL Item
Lt (LT)
Item
>3-6 CM
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C49507 (NCI Thesaurus ObjectClass)
C0439536 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus Property)
C0460004 (UMLS 2011AA Property)
C25323 (NCI Thesaurus Property)
C0443268 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.4
Code List
>3-6 CM
CL Item
Rt (RT)
CL Item
Lt (LT)
Item
>6CM
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C49508 (NCI Thesaurus ObjectClass)
C0549177 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus Property)
C0460004 (UMLS 2011AA Property)
C25323 (NCI Thesaurus Property)
C0443268 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.5
Code List
>6CM
CL Item
Rt (RT)
CL Item
Lt (LT)
Item
NODES FIXED
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C12418 (NCI Thesaurus Property)
C0460004 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C0443218 (NCI Metathesaurus ObjectClass)
CL.6
Code List
NODES FIXED
CL Item
Rt (RT)
CL Item
Lt (LT)
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