Description:

A0 HQ Confirmation - PHASE III ESOPHAGEAL: RT/PACLITAXEL/CISPLATIN +/ Paclitaxel, Cisplatin, and Radiation Therapy With or Without Cetuximab in Treating Patients With Locally Advanced Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6D4170C3-6E1D-4980-E040-BB89AD435BA5

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6D4170C3-6E1D-4980-E040-BB89AD435BA5
Keywords:
  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

DOI:
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.

Esophageal Cancer NCT00655876 Demographic - A0 HQ Confirmation - 2904861v1.0

No Instruction available.

  1. StudyEvent: A0 HQ Confirmation
    1. No Instruction available.
Module 1
Has the eligibility checklist been completed
In the opinion of the investigator, is the patient eligible?
Race
Ethnicity
Gender
Country of Residence (if not USA)
Method of Payment
Any care at VA or military hospital
Did this patient provide written consent to give tissue specimen(s) for research
Patient's Initial Consent given for specimen use for research unrelated to the patient's cancer?
Did patient consent to future contact about more research?
Histology
Cancer lesion size
Celiac node status
Patient has consented to take part in the Quality of Life Study
If no, provide reason

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