ID

34954

Description

RTOG-0522 F1: Follow-up Form Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer NCT00265941 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F65D686D-87BE-6280-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F65D686D-87BE-6280-E034-0003BA3F9857

Keywords

Head and Neck Neoplasms

Clinical Trial

Follow-Up Studies

Copyright Holder

NCI

Uploaded on

February 5, 2019

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0

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.

Head and Neck Cancer NCT00265941 Follow-Up

model
Details

No Instruction available.

1 forms

StudyEvent: RTOG-0522 F1: Follow-up Form
1. No Instruction available.

Name

Type

Description | Question | Decode (Coded Value)

Data type

Alias

Header

Item Group

Header

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)

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Item

Case #

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)

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)

Research Comments

Item

COMMENTS

text

C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)

Person Completing Form

Item

Person completing form

text

C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)

Form Completion Date

Item

Form completion date, original

date

C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

CURRENT DISEASE STATUS AND METHOD OF DETERMINATION

Item Group

Current Disease Status And Method Of Determination

Patient Status

Item

PATIENT'S VITAL STATUS

text

C16960 (NCI Thesaurus ObjectClass)
C3846084 (UMLS CUI-1)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)

CL.2

Code List

PATIENT'S VITAL STATUS

CL Item

Alive (Alive)

CL Item

Dead (Dead)

Date last contact

Item

DATE OF LAST CONTACT OR DEATH

date

C16960 (NCI Thesaurus ObjectClass)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

Primary Cause of Death

Item

PRIMARY CAUSE OF DEATH

text

C25638 (NCI Thesaurus ValueDomain)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C28554 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ValueDomain-2)

CL.3

Code List

PRIMARY CAUSE OF DEATH

CL Item

Due To This Disease (Due to this disease)

CL Item

Due To Second Primary Or Other Malignancy (Due to second primary or other malignancy)

CL Item

Due To Protocol Treatment (Due to protocol treatment)

CL Item

Due To Other Cause (Due to other cause)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

DeathProtocolTreatmentRelatedSpecify

Item

Due to protocol treatment, specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus Property)
C1507394 (UMLS 2011AA Property)
C28554 (NCI Thesaurus ObjectClass)
C0011065 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property-2)

Documented clinical assessment for this cancer

Item

HAS THE PATIENT HAD A DOCUMENTED CLINICAL ASSESSMENT FOR THIS CANCER (SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

text

C38148 (NCI Thesaurus ValueDomain)
C1522577 (UMLS CUI-1)
C16033 (NCI Thesaurus Property)
C0006826 (UMLS CUI-2)
C9305 (NCI Thesaurus ObjectClass)
C25365 (NCI Thesaurus Property-2)

CL.4

Code List

HAS THE PATIENT HAD A DOCUMENTED CLINICAL ASSESSMENT FOR THIS CANCER (SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Follow-Up Date

Item

DATE OF LAST CLINICAL ASSESSMENT (Current Status)

date

C9305 (NCI Thesaurus ObjectClass)
C3694716 (UMLS CUI-1)
C16033 (NCI Thesaurus Property)
C25365 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

CurrentDiseasePrimaryMalignantNeoplasmAssessmentStatus

Item

Primary tumor (Original study site)

text

C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property-2)
C0205225 (UMLS 2011AA Property-2)
C9305 (NCI Thesaurus Property-3)
C0006826 (UMLS 2011AA Property-3)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)

CL.5

Code List

Primary tumor (Original study site)

CL Item

Disease Absent (Disease absent)

CL Item

Disease Present (Disease present)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CurrentDiseaseRightNodalStatus

Item

Nodal Disease Right

text

C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C25323 (NCI Thesaurus Property-2)
C0443268 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)

CL.6

Code List

Nodal Disease Right

CL Item

Disease Absent (Disease absent)

CL Item

Disease Present (Disease present)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CurrentDiseaseLeftNodalStatus

Item

Nodal Disease Left

text

C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
CL110875 (NCI Metathesaurus Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)

CL.7

Code List

Nodal Disease Left

CL Item

Disease Absent (Disease absent)

CL Item

Disease Present (Disease present)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Evaluation method

Item

Method of Evaluation (see Q5 codetable)

text

C25284 (NCI Thesaurus ValueDomain)
C2911685 (UMLS CUI-1)
C20989 (NCI Thesaurus ObjectClass)
C16847 (NCI Thesaurus Property)

CL.16

Code List

Method of Evaluation (see Q5 codetable)

CL Item

Clinical (Clinical examination)

C25398 (NCI Thesaurus)
C0205210 (UMLS 2011AA)

CL Item

Ct Scan (CT scan)

CL Item

Mri Scan (MRI scan)

CL Item

Pathologic (Pathologic)

C25610 (NCI Thesaurus)
C1521733 (UMLS 2011AA)

CL Item

Autopsy (Autopsy)

C25153 (NCI Thesaurus)
C0004398 (UMLS 2011AA)

CL Item

Other, Specify (Other, specify)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Evaluation method, specify

Item

Other, specify

text

C25685 (NCI Thesaurus ValueDomain)
C2911685 (UMLS CUI-1)
C20989 (NCI Thesaurus ObjectClass)
C1521902 (UMLS CUI-2)
C16847 (NCI Thesaurus Property)

DISEASE EVENTS

Item Group

Disease Events

EventDiseaseResponseStatus

Item

Event (Event Codes: Primary Tumor site under study 11,12; Regional Disease including Lymph Nodes from site under study 21,22,23,24)

text

C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C25499 (NCI Thesaurus ObjectClass)
C0441471 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)

CL.9

Code List

Event (Event Codes: Primary Tumor site under study 11,12; Regional Disease including Lymph Nodes from site under study 21,22,23,24)

CL Item

Disease Cleared (Disease cleared)

CL Item

Relapse (Relapse)

C18265 (NCI Thesaurus)

CL Item

Nodal Clearance-right (Nodal clearance-right)

CL Item

Nodal Relapse Or Progression-right (Nodal relapse or progression-right)

CL Item

Nodal Clearance-left (Nodal clearance-left)

CL Item

Nodal Relapse Or Progression-left (Nodal relapse or progression-left)

EventDiseaseResponseDate

Item

Date First Noted (mm-dd-yyyy)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C25499 (NCI Thesaurus ObjectClass)
C0441471 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)

Neoplasm recurrence, Distal

Item

Has the patient been diagnosed with first distant recurrence/progression? (SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

text

C19987 (NCI Thesaurus ObjectClass)
C0027627 (UMLS CUI-1)
C25321 (NCI Thesaurus Property)
C25509 (NCI Thesaurus Property-2)
C15220 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)

CL.11

Code List

Has the patient been diagnosed with first distant recurrence/progression? (SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Date of Neoplasm distal recurrence

Item

Date of First Distant Progression

date

C25164 (NCI Thesaurus ValueDomain)
C0027627 (UMLS CUI-1)
C25331 (NCI Thesaurus ObjectClass)
C25509 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS CUI-2)
C25275 (NCI Thesaurus Property)

HeadandNeckProgressionDistantSite

Item

Site(s) of distant progression (S use codetable below)

text

C25331 (NCI Thesaurus ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C25341 (NCI Thesaurus Property)
C25321 (NCI Thesaurus Property-2)
C13717 (NCI Thesaurus ValueDomain)
C0460004 (UMLS CUI-1)
C0450429 (UMLS CUI-2)
C0443203 (UMLS CUI-3)
C1515974 (UMLS CUI-4)

CL.12

Code List

Site(s) of distant progression (S use codetable below)

CL Item

None (None)

C41132 (NCI Thesaurus)
C0549184 (UMLS CUI-1)

CL Item

Oral Cavity (Oral cavity)

C12421 (NCI Thesaurus)
C0226896 (UMLS CUI-1)

CL Item

Oropharynx (Oropharynx)

C12762 (NCI Thesaurus)
C0521367 (UMLS CUI-1)

CL Item

Hypopharynx (Hypopharynx)

C12246 (NCI Thesaurus)
C0020629 (UMLS CUI-1)

CL Item

Larynx (Larynx)

C12420 (NCI Thesaurus)
C0023078 (UMLS CUI-1)

CL Item

Nasopharynx (Nasopharynx)

C12423 (NCI Thesaurus)
C0027442 (UMLS CUI-1)

CL Item

Other H + N (Other H + N)

CL Item

AML/MDS (AML/MDS)

C9441 (NCI Thesaurus)

CL Item

BCC (BCC)

CL Item

Bladder (Bladder)

C12414 (NCI Thesaurus)
C0005682 (UMLS CUI-1)

CL Item

Brain (Brain)

C0006104 (UMLS CUI-1)

CL Item

Colorectal (Colorectal)

C13363 (NCI Thesaurus)
C0555952 (UMLS CUI-1)

CL Item

Esophageal (Esophageal)

C37950 (NCI Thesaurus)
C1522619 (UMLS CUI-1)

CL Item

Gastric (Gastric)

C1704242 (UMLS CUI-1)

CL Item

Liver (Liver)

C12392 (NCI Thesaurus)
C0023884 (UMLS CUI-1)

CL Item

Lung (Lung)

C12468 (NCI Thesaurus)
C0024109 (UMLS CUI-1)

CL Item

Melanoma (Melanoma)

C3224 (NCI Thesaurus)
C0025202 (UMLS CUI-1)

CL Item

NHL (NHL)

C0024305 (UMLS CUI-1)

CL Item

Pancreatic (Pancreatic)

C25726 (NCI Thesaurus)
C0030274 (UMLS CUI-1)

CL Item

Renal (Renal)

C25225 (NCI Thesaurus)
C0022646 (UMLS CUI-1)

CL Item

Squamous-skin (Squamous-Skin)

CL Item

Prostate (Prostate)

C12410 (NCI Thesaurus)
C0033572 (UMLS CUI-1)

CL Item

Other Hematologic (Other Hematologic)

CL Item

Other Solid (Other solid)

CL Item

Unknown Primary (Unknown primary)

Other hematologic

Item

Other hematologic

text

C25331 (NCI Thesaurus ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C25341 (NCI Thesaurus Property)
C25321 (NCI Thesaurus Property-2)
C25685 (NCI Thesaurus ValueDomain)
C16673 (NCI Thesaurus ValueDomain-2)

HeadandNeckProgressionDistantLocationSolidSpecify

Item

Other solid, specify

text

C25331 (NCI Thesaurus ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25321 (NCI Thesaurus Property-2)
C0443203 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C45300 (NCI Thesaurus ValueDomain-2)
C0205208 (UMLS 2011AA ValueDomain-2)

New primary cancer

Item Group

New primary cancer

Item

Has a new primary cancer or MDS been diagnosed that has not been previously reported? (MYELODYSPLASTIC SYNDROME SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

text

C25180 (NCI Thesaurus ValueDomain)
C0751623 (UMLS CUI-1)
C25586 (NCI Thesaurus ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C15220 (NCI Thesaurus Property)

CL.14

Code List

Has a new primary cancer or MDS been diagnosed that has not been previously reported? (MYELODYSPLASTIC SYNDROME SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

NewCancerDiagnosisDate

Item

Date of diagnosis

date

C25586 (NCI Thesaurus ObjectClass)
C0205314 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

HeadandNeckTumorNewPrimarySite

Item

Site(s) of new primary (S USE CODETABLE FROM Q7)

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property-2)
C0205225 (UMLS 2011AA Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)

CL.15

Code List

Site(s) of new primary (S USE CODETABLE FROM Q7)

CL Item

None (None)

C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)

CL Item

Oral Cavity (Oral cavity)

C12421 (NCI Thesaurus)
C0226896 (UMLS 2011AA)

CL Item

Oropharynx (Oropharynx)

C12762 (NCI Thesaurus)
C0521367 (UMLS 2011AA)

CL Item

Hypopharynx (Hypopharynx)

C12246 (NCI Thesaurus)
C0020629 (UMLS 2011AA)

CL Item

Larynx (Larynx)

C12420 (NCI Thesaurus)
C0023078 (UMLS 2011AA)

CL Item

Nasopharynx (Nasopharynx)

C12423 (NCI Thesaurus)
C0027442 (UMLS 2011AA)

CL Item

Other H + N (Other H + N)

CL Item

Aml/mds (AML/MDS)

C9441 (NCI Thesaurus)

CL Item

Bcc (BCC)

CL Item

Bladder (Bladder)

C12414 (NCI Thesaurus)
C0005682 (UMLS 2011AA)

CL Item

Brain (Brain)

CL Item

Colorectal (Colorectal)

C13363 (NCI Thesaurus)
C0555952 (UMLS 2011AA)

CL Item

Esophageal (Esophageal)

C37950 (NCI Thesaurus)
C1522619 (UMLS 2011AA)

CL Item

Gastric (Gastric)

CL Item

Liver (Liver)

C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)

CL Item

Lung (Lung)

C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)

CL Item

Melanoma (Melanoma)

C3224 (NCI Thesaurus)
C0025202 (UMLS 2011AA)

CL Item

Nhl (NHL)

CL Item

Pancreatic (Pancreatic)

C25726 (NCI Thesaurus)
C0030274 (UMLS 2011AA)

CL Item

Renal (Renal)

C25225 (NCI Thesaurus)
C0022646 (UMLS 2011AA)

CL Item

Squamous-skin (Squamous-Skin)

CL Item

Prostate (Prostate)

C12410 (NCI Thesaurus)
C0033572 (UMLS 2011AA)

CL Item

Other Hematologic (Other Hematologic)

CL Item

Other Solid (Other solid)

CL Item

Unknown Primary (Unknown primary)

HeadandNeckTumorNewPrimaryHematologicSpecify

Item

Other Hematologic, specify

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property-2)
C0205225 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16673 (NCI Thesaurus ValueDomain-2)
C0018943 (UMLS 2011AA ValueDomain-2)

HeadandNeckTumorNewPrimarySolidSpecify

Item

Other solid, specify

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property-2)
C0205225 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C45300 (NCI Thesaurus ValueDomain-2)
C0205208 (UMLS 2011AA ValueDomain-2)

Non-Protocol Therapy

Item Group

Non-Protocol Therapy

C1518384 (UMLS CUI-1)
C0087111 (UMLS CUI-2)

Non-protocolTherapyAdministeredInd-3duplicate

Item

Was any non-protocol therapy given (RELATED TO CANCER UNDER STUDY SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

CL.17

Code List

Was any non-protocol therapy given (RELATED TO CANCER UNDER STUDY SINCE SUBMISSION OF THE PREVIOUS FOLLOW-UP FORM)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Non-protocolSurgeryPerformedInd-3

Item

Non-Protocol Surgery

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C1518384 (UMLS 2011AA ObjectClass-2)

CL.18

Code List

Non-Protocol Surgery

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Non-protocolTherapyAdministeredBeginDate

Item

Non-protocol Therapy Start Date

date

C15368 (NCI Thesaurus ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C1518384 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)

Non-ProtocolTherapyDetailsText

Item

Details

text

C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C1518384 (UMLS 2011AA ObjectClass)
C25480 (NCI Thesaurus Property)
C1522508 (UMLS 2011AA Property)

Non-protocolChemotherapyAdministeredInd-3

Item

Non-Protocol Chemotherapy

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C1518384 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

CL.19

Code List

Non-Protocol Chemotherapy

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Non-protocolBiologicalTherapyAdministeredInd-3

Item

Non-Protocol Biologic Response Modifier

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS 2011AA ObjectClass)
C0005527 (NCI Metathesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

CL.20

Code List

Non-Protocol Biologic Response Modifier

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Non-protocol radiation therapy to primary

Item

Non-protocol radiation therapy to primary

text

C15313 (NCI Thesaurus ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C8509 (NCI Thesaurus Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C1518384 (UMLS CUI-2)
C0677930 (UMLS CUI-3)

CL.21

Code List

Non-protocol radiation therapy to primary

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Non-protocol radiation therapy to nodes (right)

Item

Non-protocol radiation therapy to nodes (right)

text

C15313 (NCI Thesaurus ObjectClass)
C25323 (NCI Thesaurus ObjectClass-2)
C25590 (NCI Thesaurus ObjectClass-3)
C25228 (NCI Thesaurus Property)
C25382 (NCI Thesaurus Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C0443268 (UMLS CUI-2)
C1518384 (UMLS CUI-3)
C0205090 (UMLS CUI-4)

CL.22

Code List

Non-protocol radiation therapy to nodes (right)

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)

Non-protocolNodalRadiationTherapyLeftAdministeredInd-3

Item

Non-protocol radiation therapy to nodes (left)

text

C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25323 (NCI Thesaurus ObjectClass-2)
C0443268 (UMLS 2011AA ObjectClass-2)
C25590 (NCI Thesaurus ObjectClass-3)
C1518384 (UMLS 2011AA ObjectClass-3)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

CL.23

Code List

Non-protocol radiation therapy to nodes (left)

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)

Non-protocol radiation therapy to other sites

Item

Non-protocol radiation therapy to other sites

text

C15313 (NCI Thesaurus ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C13717 (NCI Thesaurus Property)
C17649 (NCI Thesaurus Property-2)
C25382 (NCI Thesaurus Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C1518384 (UMLS CUI-2)
C1515974 (UMLS CUI-3)

CL.24

Code List

Non-protocol radiation therapy to other sites

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Non-protocolTherapyOtherAdministeredInd-3

Item

Other Non-Protocol Therapy

text

C15368 (NCI Thesaurus ObjectClass)
C25590 (NCI Thesaurus ObjectClass-2)
C1518384 (UMLS 2011AA ObjectClass)
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.25

Code List

Other Non-Protocol Therapy

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Supportive Care non-Protocol

Item

Was any non-protocol supportive therapy given (Was any non-protocol supportive therapy given since submission of the previous follow-up form)

text

C38148 (NCI Thesaurus ValueDomain)
C0344211 (UMLS CUI-1)
C15368 (NCI Thesaurus Property)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS CUI-2)
C37902 (NCI Thesaurus ObjectClass-2)

CL.26

Code List

Was any non-protocol supportive therapy given (Was any non-protocol supportive therapy given since submission of the previous follow-up form)

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)

SupportTherapyAdministeredType

Item

Type of Supportive Care Given

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C37902 (NCI Thesaurus ObjectClass-2)
C1521721 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

CL.27

Code List

Type of Supportive Care Given

CL Item

Other (Other)

C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)

CL Item

Pilocarpine (Pilocarpine)

Swallowing and Tube Feeding

Item Group

Swallowing and Tube Feeding

SwallowingFunctionCurrentDeficitInd-3

Item

Does the patient currently have swallowing problems

text

C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass-2)
C0011167 (UMLS 2011AA ObjectClass-2)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

CL.28

Code List

Does the patient currently have swallowing problems

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

SwallowingFunctionCurrentDeficitDuration

Item

How long have swallowing problems been present (IF YES,)

text

C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass-2)
C0011167 (UMLS 2011AA ObjectClass-2)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)

CL.29

Code List

How long have swallowing problems been present (IF YES,)

CL Item

Less Than 1 Month (Less than 1 month)

CL Item

1 To <7 Months (1 to <7 months)

CL Item

7 To <13 Months (7 to <13 months)

CL Item

13 To <19 Months (13 to <19 months)

CL Item

19 To <24 Months (19 to <24 months)

CL Item

2 Years Or Longer (2 years or longer)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

GavageCurrentAdministrationInd-3

Item

Does the patient currently require tube feeding (12)

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)

CL.30

Code List

Does the patient currently require tube feeding (12)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

GavagePrimaryAdministrationInd-3

Item

Is patient dependent on tube feeding for >50% of nutritional support (If yes,)

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25251 (NCI Thesaurus Property)
C0205225 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)

CL.31

Code List

Is patient dependent on tube feeding for >50% of nutritional support (If yes,)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

GavageAdministeredInd-3

Item

Was a feeding tube inserted during this reporting period (13)

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

CL.32

Code List

Was a feeding tube inserted during this reporting period (13)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

GavageAdministeredDate

Item

Date feeding tube placed (13a)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

GavageDiscontinuedAdministrationInd-3

Item

Was a feeding tube discontinued during this reporting period (14)

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25484 (NCI Thesaurus Property)
C1444662 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)

CL.33

Code List

Was a feeding tube discontinued during this reporting period (14)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

GavageEndDate

Item

Date Feeding Tube Discontinued (IF YES,)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25496 (NCI Thesaurus Property-2)
C2746065 (UMLS 2011AA Property-2)

TracheostomyPerformedInd-3

Item

Was a tracheostomy performed during this reporting period (15)

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15341 (NCI Thesaurus ObjectClass)
C0040590 (UMLS 2011AA ObjectClass)

CL.34

Code List

Was a tracheostomy performed during this reporting period (15)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

TracheostomyPerformedDate

Item

Date trach placed (IF YES,)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15341 (NCI Thesaurus ObjectClass)
C0040590 (UMLS 2011AA ObjectClass)

TracheostomyDiscontinuedInd

Item

Was use of a tracheostomy discontinued during this reporting period

text

C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C25484 (NCI Thesaurus Property)
C1444662 (UMLS 2011AA Property)
C15341 (NCI Thesaurus ObjectClass)
C0040590 (UMLS 2011AA ObjectClass)

CL.35

Code List

Was use of a tracheostomy discontinued during this reporting period

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

TracheostomyDiscontinuedDate

Item

Date Tracheostomy was Closed (IF YES,)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C25484 (NCI Thesaurus Property)
C1444662 (UMLS 2011AA Property)
C15341 (NCI Thesaurus ObjectClass)
C0040590 (UMLS 2011AA ObjectClass)

Protocol Specific Adverse Event Evaluation

Item Group

Protocol Specific Adverse Event Evaluation

CTC Adverse Event Term

Item

CTC Adverse Event Term

text

C25284 (NCI Thesaurus ValueDomain)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C45559 (NCI Thesaurus Property)

CL.41

Code List

CTC Adverse Event Term

CL Item

Acidosis Nos (Acidosis (metabolic or respiratory))

C0001122 (NCI Metathesaurus)

CL Item

Capillary Leak Syndrome (Acute vascular leak syndrome)

C0343084 (NCI Metathesaurus)

CL Item

Adrenal Insufficiency (Adrenal insufficiency)

CL Item

Adult Respiratory Distress Syndrome (Adult respiratory distress syndrome (ARDS))

C3353 (NCI Thesaurus)
C0035222 (UMLS 2011AA)

CL Item

Blood Albumin Decreased (Albumin, serum-low (hypoalbuminemia))

CL039392 (NCI Metathesaurus)

CL Item

Alcohol Intolerance Syndrome (antabuse-like Syndrome) (Alcohol intolerance syndrome (antabuse-like syndrome))

CL Item

Blood Alkaline Phosphatase Nos Increased (Alkaline phosphatase)

CL Item

Alkalosis Nos (Alkalosis (metabolic or respiratory))

C0002063 (NCI Metathesaurus)

CL Item

Hypersensitivity Nos (Allergic reaction/hypersensitivity (including drug fever))

CL Item

Rhinitis Allergic Nos (Allergic rhinitis (including sneezing, nasal stuffiness, postnasal drip))

C0002103 (NCI Metathesaurus)

CL Item

Allergy/immunology Other (Allergy/Immunology-Other (Specify))

CL Item

Alanine Aminotransferase Increased (ALT, SGPT (serum glutamic pyruvic transaminase))

C26948 (NCI Thesaurus)
C0151905 (UMLS 2011AA)

CL Item

Blood Amylase Increased (Amylase)

CL038581 (NCI Metathesaurus)

CL Item

Anorexia (Anorexia)

C2875 (NCI Thesaurus)
C0003123 (UMLS 2011AA)

CL Item

Apnoea (Apnea)

CL Item

Arachnoiditis (Arachnoiditis/meningismus/radiculitis)

C37913 (NCI Thesaurus)
C0003708 (UMLS 2011AA)

CL Item

Arthritis Nos (Arthritis (non-septic))

CL Item

Ascites (Ascites (non-malignant))

C2885 (NCI Thesaurus)
C0003962 (UMLS 2011AA)

CL Item

Aspiration (Aspiration)

C15631 (NCI Thesaurus)
C0349707 (UMLS 2011AA)

CL Item

Aspartate Aminotransferase Increased (AST, SGOT (serum glutamic oxaloacetic transaminase))

C26947 (NCI Thesaurus)
C0151904 (UMLS 2011AA)

CL Item

Ataxia Nec (Ataxia (incoordination))

CL Item

Atelectasis (Atelectasis)

C2888 (NCI Thesaurus)
C0004144 (UMLS 2011AA)

CL Item

Atrophy, Skin (Atrophy, skin)

CL Item

Atrophy, Subcutaneous Fat (Atrophy, subcutaneous fat)

CL Item

Auditory/ear Other (Auditory/Ear-Other (Specify))

CL Item

Autoimmune Disorder Nos (Autoimmune reaction)

CL Item

Blood Bicarbonate Decreased (Bicarbonate, serum-low)

CL038577 (NCI Metathesaurus)

CL Item

Blood Bilirubin Increased (Bilirubin (hyperbilirubinemia))

CL039714 (NCI Metathesaurus)

CL Item

Bladder Disorder Nos (Bladder spasms)

CL Item

Blood/bone Marrow Other (Blood/Bone Marrow-Other (Specify))

CL Item

Bone Age (alteration In Bone Age) (Bone age (alteration in bone age))

CL Item

Bone Growth: Femoral Head; Slipped Capital Femoral Epiphysis (Bone growth: femoral head; slipped capital femoral epiphysis)

CL Item

Bone Growth: Limb Length Discrepancy (Bone growth: limb length discrepancy)

CL Item

Bone Growth: Spine Kyphosis/lordosis (Bone growth: spine kyphosis/lordosis)

CL Item

Bone Marrow Depression Nos (Bone marrow cellularity)

CL Item

Bone: Spine-scoliosis (Bone: spine-scoliosis)

CL Item

Brachial Plexopathy (Brachial plexopathy)

C27194 (NCI Thesaurus)
C0700251 (UMLS 2011AA)

CL Item

Breast Function/lactation (Breast function/lactation)

CL Item

Breast Nipple/areolar Deformity (Breast nipple/areolar deformity)

CL Item

Breast Volume/hypoplasia (Breast volume/hypoplasia)

CL Item

Bronchospasm, Wheezing (Bronchospasm, wheezing)

CL Item

Ecchymosis (Bruising (in absence of grade 3 or 4 thrombocytopenia))

C26758 (NCI Thesaurus)
C0013491 (UMLS 2011AA)

CL Item

Burn (Burn)

C34441 (NCI Thesaurus)
C0006434 (UMLS 2011AA)

CL Item

Hypercalcaemia (Calcium, serum-high (hypercalcemia))

CL Item

Hypocalcaemia (Calcium, serum-low (hypocalcemia))

CL Item

Pulmonary Function Test Nos Decreased (Carbon monoxide diffusion capacity (DL(co)))

CL040958 (NCI Metathesaurus)

CL Item

Arrhythmia Nos (Cardiac Arrhythmia-Other (Specify))

CL Item

Cardiac General Other (Cardiac General-Other (Specify))

CL Item

Myocardial Ischaemia (Cardiac ischemia/infarction)

C0151744 (NCI Metathesaurus)

CL Item

Cardiac Troponin I Increased (Cardiac troponin I (cTnI))

CL038402 (NCI Metathesaurus)

CL Item

Cardiac Troponin T Increased (Cardiac troponin T (cTnT))

CL038393 (NCI Metathesaurus)

CL Item

Cardiopulmonary Arrest, Cause Unknown (non-fatal) (Cardiopulmonary arrest, cause unknown (non-fatal))

CL Item

Cataract Nec (Cataract)

CL Item

Cd4 Lymphocytes Decreased (CD4 count)

CL038783 (NCI Metathesaurus)

CL Item

Cervical Spine-range Of Motion (Cervical spine-range of motion)

CL Item

Chelitis (Cheilitis)

CL Item

Cholecystitis (Cholecystitis)

C34465 (NCI Thesaurus)
C0008325 (UMLS 2011AA)

CL Item

Hypercholesteraemia (Cholesterol, serum-high (hypercholesteremia))

CL Item

Chyle Or Lymph Leakage (Chyle or lymph leakage)

CL Item

Chylothorax (Chylothorax)

C0008733 (NCI Metathesaurus)

CL Item

Cerebral Ischaemia (CNS cerebrovascular ischemia)

C0917798 (NCI Metathesaurus)

CL Item

Cns Necrosis/cystic Progression (CNS necrosis/cystic progression)

CL Item

Coagulation Disorder Nos (Coagulation-Other (Specify))

CL Item

Learning Disorder Nos (Cognitive disturbance)

C0023186 (NCI Metathesaurus)

CL Item

Colitis Nos (Colitis)

CL Item

Colitis, Infectious (e.g., Clostridium Difficile) (Colitis, infectious (e.g., Clostridium difficile))

CL Item

Ventricular Asystole (Conduction abnormality/Atrioventricular heart block - Asystole)

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - AV block-first degree)

CL Item

Conduction Abnormality/atrioventricular Heart Block - Av Block-second Degree Mobitz Type I (wenckebach) (Conduction abnormality/Atrioventricular heart block - AV block-Second degree Mobitz Type I (Wenckebach))

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - AV block-second degree Mobitz Type II)

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - AV block-third degree (complete AV block))

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - Conduction abnormality NOS)

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - Sick sinus syndrome)

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - Stokes-Adams syndrome)

CL Item

Conduction Abnormality/atrioventricular Heart Block (Conduction abnormality/Atrioventricular heart block - Wolff-Parkinson-White syndrome)

CL Item

Confusion (Confusion)

C37928 (NCI Thesaurus)
C0009676 (UMLS 2011AA)

CL Item

Constipation (Constipation)

C37930 (NCI Thesaurus)
C0009806 (UMLS 2011AA)

CL Item

Constitutional Symptoms Other (Constitutional Symptoms-Other (Specify))

CL Item

Cough (Cough)

C37935 (NCI Thesaurus)
C0010200 (UMLS 2011AA)

CL Item

Blood Creatine Phosphokinase Increased (CPK (creatine phosphokinase))

CL038686 (NCI Metathesaurus)

CL Item

Blood Creatinine Increased (Creatinine)

C0235431 (NCI Metathesaurus)

CL Item

Cushingoid (Cushingoid appearance (e.g., moon face, buffalo hump, centripetal obesity, cutaneous striae))

C37938 (NCI Thesaurus)
C0878661 (UMLS 2011AA)

CL Item

Cystitis (Cystitis)

C26738 (NCI Thesaurus)
C0010692 (UMLS 2011AA)

CL Item

Cytokine Release Syndrome/acute Infusion Reaction (Cytokine release syndrome/acute infusion reaction)

CL Item

Death Not Associated With Ctcae Term (Death not associated with CTCAE term - Death NOS)

CL Item

Death Not Associated With Ctcae Term (Death not associated with CTCAE term - Disease progression NOS)

CL Item

Death Not Associated With Ctcae Term (Death not associated with CTCAE term - Multi-organ failure)

CL Item

Death Not Associated With Ctcae Term (Death not associated with CTCAE term - Sudden death)

CL Item

Dehydration (Dehydration)

C26740 (NCI Thesaurus)
C0011175 (UMLS 2011AA)

CL Item

Dental: Dentures Or Prosthesis (Dental: dentures or prosthesis)

CL Item

Dental: Periodontal Disease (Dental: periodontal disease)

CL Item

Dental: Teeth (Dental: teeth)

CL Item

Dental: Teeth Development (Dental: teeth development)

CL Item

Dermal Change Lymphedema, Phlebolymphedema (Dermal change lymphedema, phlebolymphedema)

CL Item

Dermatology/skin Other (Dermatology/Skin-Other (Specify))

CL Item

Diarrhoea Nos (Diarrhea)

CL Item

Disseminated Intravascular Coagulation (DIC (disseminated intravascular coagulation))

C2992 (NCI Thesaurus)
C0012739 (UMLS 2011AA)

CL Item

Distention/bloating, Abdominal (Distention/bloating, abdominal)

CL Item

Dizziness (exc Vertigo) (Dizziness)

CL Item

Dry Eye Nec (Dry eye syndrome)

CL Item

Dry Mouth (Dry mouth/salivary gland (xerostomia))

C26917 (NCI Thesaurus)
C0043352 (UMLS 2011AA)

CL Item

Dry Skin (Dry skin)

C0151908 (NCI Metathesaurus)

CL Item

Dysphagia (Dysphagia (difficulty swallowing))

C2980 (NCI Thesaurus)
C0011168 (UMLS 2011AA)

CL Item

Dyspnoea Nos (Dyspnea (shortness of breath))

CL Item

Edema, Larynx (Edema, larynx)

CL Item

Edema: Head And Neck (Edema: head and neck)

CL Item

Oedema Nos (Edema: limb)

CL Item

Edema: Trunk/genital (Edema: trunk/genital)

CL Item

Edema: Viscera (Edema: viscera)

CL Item

Ejaculatory Dysfunction (Ejaculatory dysfunction)

CL Item

Encephalopathy (Encephalopathy)

C26920 (NCI Thesaurus)
C0085584 (UMLS 2011AA)

CL Item

Endocrine Other (Endocrine-Other (Specify))

CL Item

Enteritis (inflammation Of The Small Bowel) (Enteritis (inflammation of the small bowel))

CL Item

Impotence (Erectile dysfunction)

C3133 (NCI Thesaurus)
C0242350 (UMLS 2011AA)

CL Item

Oesophagitis Nos (Esophagitis)

CL Item

Exostosis (Exostosis)

C3029 (NCI Thesaurus)
C1442903 (UMLS 2011AA)

CL Item

Extrapyramidal Disorder Nec (Extrapyramidal/involuntary movement/restlessness)

CL Item

Extremity-lower (gait/walking) (Extremity-lower (gait/walking))

CL Item

Extremity-upper (function) (Extremity-upper (function))

CL Item

Eyelid Dysfunction (Eyelid dysfunction)

CL Item

Fatigue (Fatigue (asthenia, lethargy, malaise))

C3036 (NCI Thesaurus)
C0015672 (UMLS 2011AA)

CL Item

Febrile Neutropenia (fever Of Unknown Origin Without Clinically Or Microbiologically Documented Infection) (anc <1.0 X 10^9/l, Fever >=38.5 Degrees C) (Febrile neutropenia)

CL Item

Feminization (Feminization of male)

C26773 (NCI Thesaurus)
C0015799 (UMLS 2011AA)

CL Item

Forced Expiratory Volume Decreased (FEV(1))

CL036765 (NCI Metathesaurus)

CL Item

Pyrexia (Fever (in the absence of neutropenia, where neutropenia is defined as ANC <1.0 x 10^9/L))

CL Item

Blood Fibrinogen Decreased (Fibrinogen)

CL039651 (NCI Metathesaurus)

CL Item

Fibrosis-cosmesis (Fibrosis-cosmesis)

CL Item

Fibrosis-deep Connective Tissue (Fibrosis-deep connective tissue)

CL Item

Fistula, Gi (Fistula, GI - Abdomen NOS)

CL Item

Anal Fistula (Fistula, GI - Anus)

C0205929 (NCI Metathesaurus)

CL Item

Fistula, Gi (Fistula, GI - Biliary tree)

CL Item

Fistula, Gi (Fistula, GI - Colon/cecum/appendix)

CL Item

Intestinal Fistula (Fistula, GI - Duodenum)

C34732 (NCI Thesaurus)
C0021833 (UMLS 2011AA)

CL Item

Tracheo-oesophageal Fistula Nos (Fistula, GI - Esophagus)

CL Item

Fistula, Gi (Fistula, GI - Gallbladder)

CL Item

Fistula, Gi (Fistula, GI - Ileum)

CL Item

Fistula, Gi (Fistula, GI - Jejunum)

CL Item

Fistula, Gi (Fistula, GI - Oral cavity)

CL Item

Fistula, Gi (Fistula, GI - Pancreas)

CL Item

Fistula, Gi (Fistula, GI - Pharynx)

CL Item

Fistula, Gi (Fistula, GI - Rectum)

CL Item

Fistula, Gi (Fistula, GI - Salivary gland)

CL Item

Fistula, Gi (Fistula, GI - Small bowel NOS)

CL Item

Fistula, Gi (Fistula, GI - Stomach)

CL Item

Fistula, Gu (Fistula, GU - Bladder)

CL Item

Fistula, Gu (Fistula, GU - Genital tract-female)

CL Item

Fistula, Gu (Fistula, GU - Kidney)

CL Item

Fistula, Gu (Fistula, GU - Ureter)

CL Item

Fistula, Gu (Fistula, GU - Urethra)

CL Item

Fistula, Gu (Fistula, GU - Uterus)

CL Item

Urogenital Fistula (Fistula, GU - Vagina)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Bronchus)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Larynx)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Lung)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Oral cavity)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Pharynx)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Pleura)

CL Item

Fistula, Pulmonary/upper Respiratory (Fistula, pulmonary/upper respiratory - Trachea)

CL Item

Flatulence (Flatulence)

C37954 (NCI Thesaurus)
C0016204 (UMLS 2011AA)

CL Item

Flu-like Syndrome (Flu-like syndrome)

CL Item

Flushing (Flushing)

C26775 (NCI Thesaurus)
C0016382 (UMLS 2011AA)

CL Item

Fracture (Fracture)

C3046 (NCI Thesaurus)
C0016658 (UMLS 2011AA)

CL Item

Gastritis Nos (Gastritis (including bile reflux gastritis))

CL Item

ID

Description

Link

Keywords

Versions (5)

Copyright Holder

Uploaded on

DOI

License

Model comments :

Itemgroup comments for :

Item comments for :

Head and Neck Cancer NCT00265941 Follow-Up

No Instruction available.

Description

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description