ID

1849

Descrição

RTOG-0421 I6: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Staging Diagrams / Larynx 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=EB4905D5-B71C-6C3A-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB4905D5-B71C-6C3A-E034-0003BA3F9857

Palavras-chave

Versões (3)
  1. 19/09/2012 19/09/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
  3. 21/06/2015 21/06/2015 -
Transferido a

19 de setembro de 2012

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy
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Head and Neck Cancer NCT00113399 On-Study - RTOG-0421 I6: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Staging Diagrams / Larynx - 2299343v3.0

Inglês

No Instruction available.

1 Formulários  
  1. StudyEvent: RTOG-0421 I6: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Staging Diagrams / Larynx
    1. No Instruction available.
Unnamed Module 1
Descrição

Unnamed Module 1

RTOG Study
Descrição

ProtocolRTOGIdentifierNumber

Tipo de dados

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 #
Descrição

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Tipo de dados

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
Descrição

InstitutionName

Tipo de dados

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.
Descrição

InstitutionIdentifierNumber

Tipo de dados

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
Descrição

PatientInitialsName

Tipo de dados

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.
Descrição

PatientRadiationTherapyOncologyGroupIdentifierNumber

Tipo de dados

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.
Descrição

CaseReportFormModifiedInd-2

Tipo de dados

text

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

Unamed Module 2

SITE CHARACTERISTICS ( all that apply)
Descrição

LarynxTumorCharacteristicsSite

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12420
UMLS 2011AA ObjectClass
C0023078
NCI Thesaurus Property
C25447
UMLS 2011AA Property
C1521970
Supraglottis
Descrição

LarynxTumorCharacteristicsSupraglottisSite

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12420
UMLS 2011AA ObjectClass
C0023078
NCI Thesaurus Property
C25447
UMLS 2011AA Property
C1521970
Glottis
Descrição

LarynxTumorCharacteristicsGlottisSite

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12420
UMLS 2011AA ObjectClass
C0023078
NCI Thesaurus Property
C25447
UMLS 2011AA Property
C1521970
Subglottis
Descrição

LarynxTumorCharacteristicsSubglottisSite

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12420
UMLS 2011AA ObjectClass
C0023078
NCI Thesaurus Property
C25447
UMLS 2011AA Property
C1521970
GENERAL CHARACTERISTICS ( all that apply)
Descrição

LarynxTumorGeneralizedCharacteristicsSite

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12420
UMLS 2011AA ObjectClass
C0023078
NCI Thesaurus Property
C63764
UMLS 2011AA Property
C0205246
NCI Thesaurus Property
C25447
UMLS 2011AA Property
C1521970
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
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Similar models

No Instruction available.

1 Formulários
  1. StudyEvent: RTOG-0421 I6: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Staging Diagrams / Larynx
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Unnamed Module 1
ProtocolRTOGIdentifierNumber
Item
RTOG Study
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
Unamed Module 2
Item
SITE CHARACTERISTICS ( all that apply)
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12420 (NCI Thesaurus ObjectClass)
C0023078 (UMLS 2011AA ObjectClass)
C25447 (NCI Thesaurus Property)
C1521970 (UMLS 2011AA Property)
CL.2
Code List
SITE CHARACTERISTICS ( all that apply)
CL Item
Supraglottis (Supraglottis)
CL Item
Glottis (Glottis)
C12724 (NCI Thesaurus)
C0017681 (UMLS 2011AA)
CL Item
Subglottis (Subglottis)
Item
Supraglottis
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12420 (NCI Thesaurus ObjectClass)
C0023078 (UMLS 2011AA ObjectClass)
C25447 (NCI Thesaurus Property)
C1521970 (UMLS 2011AA Property)
CL.3
Code List
Supraglottis
CL Item
Limited To One Subsite (Limited to one subsite)
CL Item
Involves >1 Subsite (Involves >1 subsite)
Item
Glottis
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12420 (NCI Thesaurus ObjectClass)
C0023078 (UMLS 2011AA ObjectClass)
C25447 (NCI Thesaurus Property)
C1521970 (UMLS 2011AA Property)
CL.4
Code List
Glottis
CL Item
Extends To Supraglottis And/or Subglottis (Extends to Supraglottis and/or Subglottis)
Item
Subglottis
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12420 (NCI Thesaurus ObjectClass)
C0023078 (UMLS 2011AA ObjectClass)
C25447 (NCI Thesaurus Property)
C1521970 (UMLS 2011AA Property)
CL.5
Code List
Subglottis
CL Item
Extends To Vocal Cord(s) (Extends to vocal cord(s))
Item
GENERAL CHARACTERISTICS ( all that apply)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12420 (NCI Thesaurus ObjectClass)
C0023078 (UMLS 2011AA ObjectClass)
C63764 (NCI Thesaurus Property)
C0205246 (UMLS 2011AA Property)
C25447 (NCI Thesaurus Property)
C1521970 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.6
Code List
GENERAL CHARACTERISTICS ( all that apply)
CL Item
Exophytic Only (Exophytic only)
CL Item
Deeply Infiltrating (Deeply infiltrating)
CL Item
Normal Mobility Of Vocal Cords (Normal mobility of vocal cords)
CL Item
Impaired Mobility Of Vocal Cord (Impaired mobility of vocal cord)
CL Item
Fixed Vocal Cord (Fixed vocal cord)
CL Item
No Cartilage Involvement (No cartilage involvement)
CL Item
Gross Cartilage Involvement (Gross cartilage involvement)
CL Item
Invasion Beyond Larynx (Invasion beyond larynx)
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