RTOG-1010 A2 Registration Worksheet Form Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer Source Form: NCI FormBuilder:

  1. 12/18/14 12/18/14 - Martin Dugas
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 9/17/21 9/17/21 -
Uploaded on:

September 17, 2021

To request one please log in.
License :
Creative Commons BY-NC 3.0 Legacy
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.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Adenocarcinoma of the Gastroesophageal Junction NCT01196390 Demographic - RTOG-1010 A2 Registration Worksheet Form - 3137821v1.0

No Instruction available.

  1. StudyEvent: RTOG-1010 A2 Registration Worksheet Form
    1. No Instruction available.
Module 1
Is the patient going to receive protocol treatment
If no, provide reason
Has the Step 2 eligibility checklist been completed
In the opinion of the investigator, is the patient eligible?
Patient has consented to take part in the Quality of Life Study
If no, provide reason
Presence of adenopathy
Is the patient HER2 positive

Similar models

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial