Description:

PACCT1 Registration Worksheet (step 2) Hormone Therapy With or Without Combination Chemotherapy in Treating Women Who Have Undergone Surgery for Node-Negative Breast Cancer (The TAILORx Trial) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=519E7791-5762-1478-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=519E7791-5762-1478-E044-0003BA3F9857

Keywords:
Versions (3) ▾
  1. 8/26/12
  2. 1/9/15
  3. 9/17/21
Uploaded on:

September 17, 2021

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00310180 Eligibility - PACCT1 Registration Worksheet (step 2) - 2764685v1.0

No Instruction available.

  1. StudyEvent: PACCT1 Registration Worksheet (step 2)
    1. No Instruction available.
Eligibility
Has the eligibility checklist been completed
In the opinion of the investigator, is the patient eligible?
Have you contacted Zemotak International to request kits to collect and ship the samples
Is the reported lab value/assessment correct on the webpage
Tumor size
Menopausal status
Planned Chemotherapy regimen
Planned radiation therapy
The ECOG Randomization will use the RS score to stratify patients into the following ranges
Did the consent form signed by the patient contain the mandatory Quality of Life study
Race
Patient's Race
Patient Demographics / Pre-treatment Characteristics
Patient's Sex
Patient Ethnicity
Method of payment (check one)
Country of residence

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