ID
2781
Description
Upper Gastrointestinal Cancers - Treatment Form (for Periodic Reporting) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A9B2-3FA4-E034-080020C9C0E0
Link
Keywords
Versions (2)
- 9/19/12 9/19/12 -
- 1/8/15 1/8/15 - Martin Dugas
Uploaded on
September 19, 2012
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Treatment - Upper Gastrointestinal Cancers - Treatment Form (for Periodic Reporting) - 2020209v2.31
No Instruction available.
- StudyEvent: Upper Gastrointestinal Cancers - Treatment Form (for Periodic Reporting)
Description
Gi: Treatment Reporting Interval
Description
Gi: Treatment Schedule - Radiation Therapy
Description
ProtocolTreatment,RTInd
Data type
text
Description
RTBeginDate
Data type
date
Description
RTEndDate
Data type
date
Description
RTType
Data type
text
Description
RTType,Other
Data type
text
Description
RTSite
Data type
text
Description
RTTotalDose
Data type
double
Description
RTInterruptionsInd
Data type
text
Description
RTInterruptionsReason
Data type
text
Description
Gi: Treatment Cycle Information - Systemic Therapy
Description
ProtocolTreatment,SystemicTherapyInd
Data type
text
Description
TotalCourseNumber
Data type
double
Description
FirstTreatmentStartDate
Data type
date
Description
LastTreatmentDate
Data type
date
Description
SystemicTherapyType
Data type
text
Description
SystemicTherapyType,Other
Data type
text
Description
AgentName
Data type
text
Description
AgentTotalDose(percourse)
Data type
double
Description
AgentDoseUnits
Data type
text
Description
DoseModification(Change)
Data type
text
Description
TherapyModificationName
Data type
text
Description
TherapyModificationReason
Data type
text
Description
Allows Documentation Of Any Additional Cooments
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No Instruction available.
- StudyEvent: Upper Gastrointestinal Cancers - Treatment Form (for Periodic Reporting)
C0805701 (UMLS 2011AA ValueDomain)
C1507394 (UMLS 2011AA ObjectClass)
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C1705823 (UMLS 2011AA Property)
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C0021083 (UMLS 2011AA)
C0439148 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0439473 (UMLS 2011AA)
C0475210 (UMLS 2011AA)
C0439209 (UMLS 2011AA)
C0439242 (UMLS 2011AA)
C0439210 (UMLS 2011AA)
C0439200 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)