ID
2287
Beschrijving
T1 Radiation Therapy Oncology Group Phase III Randomized Study of Intermediate Risk Prostate Cancer Radiotherapy Form Interstitial Brachytherapy With or Without External-Beam Radiation Therapy in Treating Patients With Prostate Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AA89543F-5C0D-58C5-E034-0003BA12F5E7
Link
Trefwoorden
Versies (3)
- 19-09-12 19-09-12 -
- 28-05-15 28-05-15 -
- 03-06-15 03-06-15 -
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19 september 2012
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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NCT00063882 Treatment - T1 Radiation Therapy Oncology Group Phase III Randomized Study of Intermediate Risk Prostate Cancer Radiotherapy Form - 2058472v3.0
INSTRUCTIONS: Submit this form at the completion of protocol therapy. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated. A copy must be submitted to the RTOG
- StudyEvent: T1 Radiation Therapy Oncology Group Phase III Randomized Study of Intermediate Risk Prostate Cancer Radiotherapy Form
Beschrijving
Unnamed2
Beschrijving
RTOGStudy
Datatype
text
Beschrijving
Case#
Datatype
text
Beschrijving
InstitutionName
Datatype
text
Beschrijving
NCIInstitutionNumber
Datatype
text
Beschrijving
PatientName,First
Datatype
text
Beschrijving
PatientStudyID,RegisteringGroup
Datatype
text
Beschrijving
Unnamed3
Beschrijving
Unnamed4
Beschrijving
RTBeginDate
Datatype
date
Beschrijving
RTEndDate
Datatype
date
Beschrijving
RTTotalDose
Datatype
double
Beschrijving
RTInterruptionsInd
Datatype
text
Beschrijving
RadiationTherapyUnscheduledInterruptionSpecify
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property
- C25211
- UMLS 2011AA Property
- C0086960
- NCI Thesaurus Property
- C25542
- UMLS 2011AA Property
- C1512900
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beschrijving
OffTreatmentReason
Datatype
text
Beschrijving
Alternativetherapy,specify(reasonradiationtherapyended)
Datatype
text
Beschrijving
OffTreatmentReason,ComplicatingDisease
Datatype
text
Beschrijving
Intensity-ModulatedRadiationTherapyAdministrationInd-3
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C16135
- UMLS 2011AA ObjectClass
- C1512814
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
Beschrijving
BrachytherapyOff-TreatmentReason
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus Property
- C25601
- UMLS 2011AA Property
- C1518544
- NCI Thesaurus ObjectClass
- C15195
- UMLS 2011AA ObjectClass
- C0006098
Beschrijving
specifyRx(alternativeRxgiven)
Datatype
text
Beschrijving
Other,specify(reasontreatmentended)
Datatype
text
Beschrijving
ISOTOPETYPE
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beschrijving
Other,specify
Datatype
text
Beschrijving
Other,specify
Datatype
text
Beschrijving
DATEOFPRE-IMPLANTTRUSSTUDY
Datatype
text
Beschrijving
DATEOFIMPLANT
Datatype
text
Beschrijving
CTPostBrachytherapyDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C17204
- UMLS 2011AA ObjectClass
- C0040405
- NCI Thesaurus Property
- C38008
- UMLS 2011AA Property
- C0687676
- NCI Metathesaurus Property
- CL054378
Beschrijving
AVERAGEACTIVITYPERSEEDASMEASUREDBYINSTITUTION
Datatype
text
Beschrijving
MIDPOINTAPPARENTACTIVITYSTATEDBYTHEVENDOR
Datatype
text
Beschrijving
AssessmentDate
Datatype
date
Beschrijving
AssessmentDate
Datatype
date
Beschrijving
NUMBEROFSEEDSUSED
Datatype
text
Beschrijving
NUMBEROFNEEDLESUSED
Datatype
text
Beschrijving
BrachytherapyRadioactiveSeedImplantDosingUnitLostInd-3
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25560
- UMLS 2011AA Property
- C0745777
- NCI Thesaurus Property
- C67446
- UMLS 2011AA Property
- C1882540
- NCI Thesaurus ObjectClass
- C15195
- UMLS 2011AA ObjectClass
- C0006098
Beschrijving
WEREDOSEVOLUMEHISTOGRAMSDONE
Datatype
text
Beschrijving
SurgicalProcedureCatheterUrethraPostBrachytherapyPerformedTherapyInd-3
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15329
- UMLS 2011AA ObjectClass
- C0543467
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus Property
- C38008
- UMLS 2011AA Property
- C0687676
- NCI Thesaurus Property
- C15195
- UMLS 2011AA Property
- C0006098
- NCI Thesaurus Property
- C17446
- UMLS 2011AA Property
- C0085590
- NCI Thesaurus Property
- C12417
- UMLS 2011AA Property
- C0041967
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Beschrijving
DATEINSERTED
Datatype
text
Beschrijving
DATEREMOVED
Datatype
text
Beschrijving
Comments
Datatype
text
Beschrijving
Signature
Datatype
text
Beschrijving
FormCompletionDate,Original
Datatype
date
Beschrijving
Ccrr Module For T1 Radiation Therapy Oncology Group Phase Iii Randomized Study Of Intermediate Risk Prostate Cancer Radiotherapy Form
Similar models
INSTRUCTIONS: Submit this form at the completion of protocol therapy. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated. A copy must be submitted to the RTOG
- StudyEvent: T1 Radiation Therapy Oncology Group Phase III Randomized Study of Intermediate Risk Prostate Cancer Radiotherapy Form
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1522449 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C25211 (NCI Thesaurus Property)
C0086960 (UMLS 2011AA Property)
C25542 (NCI Thesaurus Property)
C1512900 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0205394 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C16135 (NCI Thesaurus ObjectClass)
C1512814 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0392360 (UMLS 2011AA ValueDomain)
C25601 (NCI Thesaurus Property)
C1518544 (UMLS 2011AA Property)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C0011065 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C38008 (NCI Thesaurus Property)
C0687676 (UMLS 2011AA Property)
CL054378 (NCI Metathesaurus Property)
C1512699 (UMLS 2011AA ValueDomain)
C25560 (NCI Thesaurus Property)
C0745777 (UMLS 2011AA Property)
C67446 (NCI Thesaurus Property)
C1882540 (UMLS 2011AA Property)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0543467 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C38008 (NCI Thesaurus Property)
C0687676 (UMLS 2011AA Property)
C15195 (NCI Thesaurus Property)
C0006098 (UMLS 2011AA Property)
C17446 (NCI Thesaurus Property)
C0085590 (UMLS 2011AA Property)
C12417 (NCI Thesaurus Property)
C0041967 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)