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43120

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N107C Pre-Registration (Step 1) Form and Eligibility Checklist Stereotactic Radiosurgery or Whole-Brain Radiation Therapy in Treating Patients With Brain Metastases That Have Been Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A06D80B4-4143-B9BC-E040-BB89AD437EB8

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A06D80B4-4143-B9BC-E040-BB89AD437EB8

Keywords

Versions (2)
  1. 12/18/14 12/18/14 - Martin Dugas
  2. 9/20/21 9/20/21 -
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September 20, 2021

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Creative Commons BY-NC 3.0 Legacy
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    Cognitive/Functional Effects NCT01372774 Eligibility - N107C Pre-Registration (Step 1) Form and Eligibility Checklist - 3226376v1.0

    English

    No Instruction available.

    1 forms  
    1. StudyEvent: N107C Pre-Registration (Step 1) Form and Eligibility Checklist
      1. No Instruction available.
    Required Characteristics
    Description

    Required Characteristics

    Four or fewer brain metastases (as defined on the preoperative MRI brain scan) and status post resection of one of the lesions
    Description

    BrainMetastasisPresentInd-3

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus Property
    C25626
    UMLS 2011AA Property
    C0150312
    NCI Thesaurus ObjectClass
    C12439
    UMLS 2011AA ObjectClass
    C0006104
    NCI Thesaurus ObjectClass
    C19151
    UMLS 2011AA ObjectClass
    C0027627
    Pathology from the resected brain metastasis must be consistent with a non-central nervous system primary site (NOTE: Patients with or without active disease outside the nervous system are eligible including patients with unknown primaries, as long as the pathology from the brain is consistent with a non-central nervous system primary site.)
    Description

    PatientBrainMetastasisClinicalTrialEligibilityCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C12439
    UMLS 2011AA Property
    C0006104
    NCI Thesaurus Property
    C19151
    UMLS 2011AA Property
    C0027627
    NCI Thesaurus Property
    C16112
    UMLS 2011AA Property
    C1516637
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Any unresected lesions must measure <=3.0 cm in maximal extent on the contrasted preoperative treatment MRI brain scan obtained <=35 days prior to pre-registration (see Magnetic Resonance Imaging Guidelines, Section 11.2). The unresected lesions will be treated with SRS as outlined in the treatment section (Section 7.0) of the protocol. (NOTE: The metastases size restriction does not apply to the resected brain metastasis; with resected brain metastasis only surgical cavity size determines eligibility see 3.114)
    Description

    PatientBrainLesionClinicalTrialEligibilityCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C3824
    UMLS 2011AA Property
    C0221198
    NCI Thesaurus Property
    C12439
    UMLS 2011AA Property
    C0006104
    NCI Thesaurus Property
    C16112
    UMLS 2011AA Property
    C1516637
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Resection cavity must measure <5.0 cm in maximal extent on the postoperative MRI (or CT) brain scan obtained <=35 days prior to pre-registration (NOTE: It is permissible for the resection of a dominant brain metastasis to include a smaller "satellite" metastasis as long as the single resection cavity is less than the maximum size requirements.)
    Description

    PatientBrainLesionResectedClinicalTrialEligibilityCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C3824
    UMLS 2011AA Property
    C0221198
    NCI Thesaurus Property
    C12439
    UMLS 2011AA Property
    C0006104
    NCI Thesaurus Property
    C25654
    UMLS 2011AA Property
    C1521996
    NCI Thesaurus Property
    C16112
    UMLS 2011AA Property
    C1516637
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    All standard tumor-staging procedures necessary to define baseline extracranial disease status completed <=42 days prior to pre-registration
    Description

    PatientBrainMetastasisStagingClinicalTrialEligibilityCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C12439
    UMLS 2011AA Property
    C0006104
    NCI Thesaurus Property
    C19151
    UMLS 2011AA Property
    C0027627
    NCI Thesaurus Property
    C15608
    UMLS 2011AA Property
    C0332305
    NCI Thesaurus Property
    C16112
    UMLS 2011AA Property
    C1516637
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Ability to be treated with either a gamma knife or a linear accelerator-based radiosurgery system
    Description

    RadiationSurgeryLinearAcceleratorGammaKnifeDeviceUnitInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C15696
    UMLS 2011AA ObjectClass
    C0085203
    NCI Thesaurus Property
    C28169
    UMLS 2011AA Property
    C0023730
    NCI Thesaurus Property
    C15382
    UMLS 2011AA Property
    C0086330
    NCI Thesaurus Property
    C50329
    UMLS 2011AA Property
    C1509845
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Age >= 18 years
    Description

    PatientAgeInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25150
    UMLS 2011AA Property
    C0001779
    Age (=)
    Description

    PatientAgeValue

    Data type

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25150
    UMLS 2011AA Property
    C0001779
    Willing and able to complete neurocognitive examination without assistance
    Description

    NeurologicCognitiveAssessmentCompleteInd-3b

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus ObjectClass
    C25262
    UMLS 2011AA ObjectClass
    C0205494
    NCI Thesaurus ObjectClass
    C37926
    UMLS 2011AA ObjectClass
    C1516691
    NCI Thesaurus Property
    C25250
    UMLS 2011AA Property
    C0205197
    NCI Metathesaurus ValueDomain
    CL355214
    Willing and able to complete QOL by themselves or with assistance (see Section 4.0)
    Description

    PatientQuestionnaireCompleteEligibilityDeterminationInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25250
    UMLS 2011AA Property
    C0205197
    NCI Thesaurus Property
    C17048
    UMLS 2011AA Property
    C0034394
    NCI Thesaurus Property
    C25171
    UMLS 2011AA Property
    C0013893
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    ECOG performance status (PS) 0, 1, or 2
    Description

    EasternCooperativeOncologyGroupPerformanceStatusAssessmentInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ObjectClass
    C25491
    UMLS 2011AA ObjectClass
    C1512162
    NCI Metathesaurus ObjectClass
    CL092952
    ECOG Performance Status (=)
    Description

    PerformanceStatusAssessmentEasternCooperativeOncologyGroupScale

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25664
    UMLS 2011AA ValueDomain
    C0349674
    NCI Thesaurus Property
    C25367
    NCI Thesaurus ValueDomain
    C25491
    UMLS 2011AA ValueDomain
    C1512162
    NCI Thesaurus ObjectClass
    C20641
    UMLS 2011AA ObjectClass
    C1518965
    SRS facility is Radiological Physics Center (RPC) approved (see Section 6.24)
    Description

    RadiationTherapyCredentialStereotacticRadiosurgeryInstitutionInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus Property
    C15358
    UMLS 2011AA Property
    C0085203
    NCI Thesaurus Property
    C41206
    UMLS 2011AA Property
    C1272753
    NCI Thesaurus Property
    C73925
    UMLS 2011AA Property
    C2362313
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    The Neurocognitive Testing examiner must have credentialing confirming completion of the neurocognitive testing training (see Section 6.25)
    Description

    PersonCredentialNeurologicExaminationInstitutionInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C81313
    UMLS 2011AA Property
    C0027853
    NCI Thesaurus Property
    C41206
    UMLS 2011AA Property
    C1272753
    NCI Thesaurus Property
    C73925
    UMLS 2011AA Property
    C2362313
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Provide informed written consent
    Description

    PatientConsentAbilityInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus Property
    C78209
    UMLS 2011AA Property
    C0085732
    Willing to provide blood and urine samples for correlative research purposes (see Sections 6.0 and 14.0)
    Description

    PersonSpecimenUseConsentEligibilityDeterminationIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C19157
    UMLS 2011AA Property
    C0370003
    NCI Thesaurus Property
    C25171
    UMLS 2011AA Property
    C0013893
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus Property
    C25340
    UMLS 2011AA Property
    C0457083
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    Pre-registration Exclusion Criteria
    Description

    Pre-registration Exclusion Criteria

    Any of the following: Pregnant women Nursing women Men or women of childbearing potential who are unwilling to employ adequate contraception throughout the study and for men for up to 3 months after completing treatment
    Description

    PatientPhysicalExaminationPregnancyBreastFeedingContraindicatedInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus Property
    C25742
    UMLS 2011AA Property
    C0032961
    NCI Thesaurus Property
    C37933
    UMLS 2011AA Property
    C1444657
    NCI Thesaurus Property
    C25596
    UMLS 2011AA Property
    C0006147
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Prior cranial RT (radiation therapy)
    Description

    PriorCranialRadiationTherapyAdministeredInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus ObjectClass
    C25629
    UMLS 2011AA ObjectClass
    C0332152
    NCI Thesaurus ObjectClass
    C37936
    UMLS 2011AA ObjectClass
    C0205096
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Inability to complete an MRI with contrast of the head
    Description

    DiagnosticImagingNotPerformedInd-3

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C16502
    UMLS 2011AA ObjectClass
    C0011923
    NCI Thesaurus Property
    C25594
    UMLS 2011AA Property
    C1518422
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    Known allergy to gadolinium
    Description

    PatientClinicalStudyAgentHypersensitivityPersonalMedicalHistoryInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C3114
    UMLS 2011AA Property
    C0020517
    NCI Thesaurus Property
    C1708
    UMLS 2011AA Property
    C0450442
    NCI Thesaurus Property
    C15206
    UMLS 2011AA Property
    C0008972
    NCI Thesaurus Property
    C18772
    UMLS 2011AA Property
    C0262926
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Planned cytotoxic chemotherapy during the SRS and WBRT
    Description

    PatientInvestigationalClinicalTrialCurrentParticipationExclusionCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25608
    UMLS 2011AA Property
    C0679823
    NCI Thesaurus Property
    C25471
    UMLS 2011AA Property
    C0521116
    NCI Thesaurus Property
    C15207
    NCI Thesaurus Property
    C28041
    UMLS 2011AA Property
    C1517586
    NCI Thesaurus Property
    C25370
    UMLS 2011AA Property
    C0680251
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Primary germ cell tumor, small cell carcinoma, or lymphoma
    Description

    PatientConcurrentSystemicDiseaseorDisorderExclusionCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C13310
    UMLS 2011AA Property
    C0205373
    NCI Thesaurus Property
    C2991
    UMLS 2011AA Property
    C0012634
    NCI Thesaurus Property
    C25456
    UMLS 2011AA Property
    C0205420
    NCI Thesaurus Property
    C25370
    UMLS 2011AA Property
    C0680251
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Widespread definitive leptomeningeal metastasis
    Description

    PatientMetastaticMalignantNeoplasmtotheBrainExclusionCriteriaInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C3813
    UMLS 2011AA Property
    C0220650
    NCI Thesaurus Property
    C25370
    UMLS 2011AA Property
    C0680251
    A brain metastasis that is located <=5 mm of the optic chiasm or within the brainstem
    Description

    PatientCentralNervousSystemDiseaseorDisorderEligibilityDeterminationInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C12438
    UMLS 2011AA Property
    C3714787
    NCI Thesaurus Property
    C2991
    UMLS 2011AA Property
    C0012634
    NCI Thesaurus Property
    C25171
    UMLS 2011AA Property
    C0013893
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Pre-registration Check
    Description

    Pre-registration Check

    Consent form signed and dated
    Description

    InformedConsentFormSignedInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16468
    UMLS 2011AA ObjectClass
    C0009797
    NCI Thesaurus Property
    C25679
    Date Informed Consent Signed (mm/dd/yyyy)
    Description

    InformedConsentFormSignedDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain
    C25367
    NCI Thesaurus ObjectClass
    C16468
    UMLS 2011AA ObjectClass
    C0009797
    NCI Thesaurus Property
    C25679
    Authorization for use and disclosure of protected health information signed and dated (Non-USA institution only check NA)
    Description

    PatientHealthRecordIndicator

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25178
    UMLS 2011AA Property
    C0018684
    Date of authorization (mm/dd/yyyy)
    Description

    HealthInsurancePortabilityandAccountabilityActTissueDonorAuthorizationDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C25168
    UMLS 2011AA Property
    C0040288
    NCI Thesaurus ObjectClass
    C62504
    UMLS 2011AA ObjectClass
    C0600593
    NCI Thesaurus Property
    C41192
    UMLS 2011AA Property
    C1524004
    A mandatory correlative research component for blood and urine is part of this study; the patient will be automatically registered onto this component (see Sections 3.119f and 14.0)
    Description

    PatientRegisteredInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25644
    Pre-registration tests/procedures must be completed <=14 days prior to pre-registration (see Section 4.0)
    Description

    PatientPriorRegistrationLaboratoryProcedureVerificationInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25646
    UMLS 2011AA Property
    C1514821
    NCI Thesaurus Property
    C25629
    UMLS 2011AA Property
    C0332152
    NCI Thesaurus Property
    C25294
    UMLS 2011AA Property
    C0022885
    NCI Thesaurus Property
    C45513
    UMLS 2011AA Property
    C1711411
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Earliest pre-registration test date (mm/dd/yyyy NOTE: The earliest pre-registration test date must be less than or equal to the latest pre-registration test date. The above dates DO NOT include footnote 9 of the test schedule that reads "All standard tumor-staging procedures necessary to define baseline extracranial status as deemed appropriate by the treating oncology physician completed <=42 days prior to pre-registration.")
    Description

    PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationBeginDate

    Data type

    date

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25646
    UMLS 2011AA Property
    C1514821
    NCI Thesaurus Property
    C25629
    UMLS 2011AA Property
    C0332152
    NCI Thesaurus Property
    C25294
    UMLS 2011AA Property
    C0022885
    NCI Thesaurus Property
    C25171
    UMLS 2011AA Property
    C0013893
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain
    C25431
    UMLS 2011AA ValueDomain
    C0439659
    Latest pre-registration test date (mm/dd/yyyy)
    Description

    PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationEndDate

    Data type

    date

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25646
    UMLS 2011AA Property
    C1514821
    NCI Thesaurus Property
    C25629
    UMLS 2011AA Property
    C0332152
    NCI Thesaurus Property
    C25294
    UMLS 2011AA Property
    C0022885
    NCI Thesaurus Property
    C25171
    UMLS 2011AA Property
    C0013893
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    All required baseline symptoms (see Section 10.3) must be documented and graded
    Description

    ClinicalTrialBaselineDiseaseDocumentedChecklistInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C15207
    NCI Thesaurus Property
    C25213
    UMLS 2011AA Property
    C1442488
    NCI Thesaurus Property
    C2991
    UMLS 2011AA Property
    C0012634
    NCI Thesaurus Property
    C25356
    UMLS 2011AA Property
    C1301725
    NCI Thesaurus Property
    C49073
    UMLS 2011AA Property
    C1707357
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    A radiation oncologist has seen the patient and confirms the patient is a suitable candidate for this study
    Description

    RadiationOncologistConsultationPerformedInd-3

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass
    C17833
    UMLS 2011AA ObjectClass
    C1514693
    NCI Thesaurus Property
    C41188
    UMLS 2011AA Property
    C0009818
    Blood/urine kits available on site
    Description

    ClinicalTrialBloodSpecimenCollectionAvailabilityChecklistInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C15207
    NCI Thesaurus Property
    C12434
    UMLS 2011AA Property
    C0229664
    NCI Thesaurus Property
    C25453
    UMLS 2011AA Property
    C1516698
    NCI Thesaurus Property
    C19157
    UMLS 2011AA Property
    C0370003
    NCI Thesaurus Property
    C25429
    UMLS 2011AA Property
    C0470187
    NCI Thesaurus Property
    C49073
    UMLS 2011AA Property
    C1707357
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Patient Questionnaire Booklet-Quality of Life (QOL) and Patient and Examiner Questionnaire Booklet-Neurocognitive Evaluations are available on site; copies are not acceptable for this submission
    Description

    ProtocolQuestionnaireAvailableInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C25320
    UMLS 2011AA ObjectClass
    C1507394
    NCI Thesaurus ObjectClass
    C17048
    UMLS 2011AA ObjectClass
    C0034394
    NCI Thesaurus Property
    C25429
    UMLS 2011AA Property
    C0470187
    Ran
    Description

    Ran

    Patient has given permission to store and use his/her blood samples for use in future research to learn about, prevent, or treat cancer
    Description

    BloodSpecimenMalignantNeoplasmRelatedResearchConsentIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C12434
    UMLS 2011AA ObjectClass
    C0229664
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C15319
    NCI Thesaurus Property
    C25648
    UMLS 2011AA Property
    C0439849
    NCI Thesaurus Property
    C9305
    UMLS 2011AA Property
    C0006826
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    Patient has given permission to store and use his/her blood samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    Description

    BloodSpecimenOtherDiseasesandDisordersResearchConsentInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C12434
    UMLS 2011AA ObjectClass
    C0229664
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus Property
    C15319
    NCI Thesaurus Property
    C2991
    UMLS 2011AA Property
    C0012634
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Patient has given permission for NCCTG to give his/her stored blood samples for use in future research to outside researchers
    Description

    PatientOptionalConsentInd-2

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25603
    UMLS 2011AA Property
    C1518600
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    Patient has given permission to store and use his/her urine samples for use in future research to learn about, prevent, or treat cancer
    Description

    UrineSpecimenMalignantNeoplasmRelatedResearchConsentInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C13283
    UMLS 2011AA ObjectClass
    C0042036
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C15319
    NCI Thesaurus Property
    C25648
    UMLS 2011AA Property
    C0439849
    NCI Thesaurus Property
    C9305
    UMLS 2011AA Property
    C0006826
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Patient has given permission to store and use his/her urine samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    Description

    UrineSpecimenOtherDiseaseorDisorderConsentInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C13283
    UMLS 2011AA ObjectClass
    C0042036
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus Property
    C2991
    UMLS 2011AA Property
    C0012634
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Patient has given permission for NCCTG to give his/her stored urine samples for use in future research to outside researchers
    Description

    PersonSpecimenExternalInvestigatorConsentInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C44280
    UMLS 2011AA Property
    C0205101
    NCI Thesaurus Property
    C19157
    UMLS 2011AA Property
    C0370003
    NCI Thesaurus Property
    C25936
    UMLS 2011AA Property
    C0035173
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Patient has given permission to store and use his/her tissue samples for use in future research to learn about, prevent, or treat cancer
    Description

    PersonSpecimenMalignantNeoplasmResearchConsentInd-2

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C15319
    NCI Thesaurus Property
    C9305
    UMLS 2011AA Property
    C0006826
    NCI Thesaurus Property
    C19157
    UMLS 2011AA Property
    C0370003
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Patient has given permission to store and use his/her tissue samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    Description

    BloodTissueSpecimenOtherDiseasesandDisordersResearchConsentInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C12801
    UMLS 2011AA ObjectClass
    C0040300
    NCI Thesaurus ObjectClass
    C12434
    UMLS 2011AA ObjectClass
    C0229664
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus Property
    C15319
    NCI Thesaurus Property
    C2991
    UMLS 2011AA Property
    C0012634
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Patient has given permission for NCCTG to give his/her stored tissue samples for use in future research to outside researchers
    Description

    TissueSpecimenMalignantNeoplasmRelatedResearchConsentInd-3

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C12801
    UMLS 2011AA ObjectClass
    C0040300
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C15319
    NCI Thesaurus Property
    C25648
    UMLS 2011AA Property
    C0439849
    NCI Thesaurus Property
    C9305
    UMLS 2011AA Property
    C0006826
    NCI Thesaurus Property
    C25460
    UMLS 2011AA Property
    C1511481
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
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    Similar models

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    1 forms
    1. StudyEvent: N107C Pre-Registration (Step 1) Form and Eligibility Checklist
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item
    Four or fewer brain metastases (as defined on the preoperative MRI brain scan) and status post resection of one of the lesions
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    C12439 (NCI Thesaurus ObjectClass)
    C0006104 (UMLS 2011AA ObjectClass)
    C19151 (NCI Thesaurus ObjectClass)
    C0027627 (UMLS 2011AA ObjectClass)
    CL.1
    Code List
    Four or fewer brain metastases (as defined on the preoperative MRI brain scan) and status post resection of one of the lesions
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Pathology from the resected brain metastasis must be consistent with a non-central nervous system primary site (NOTE: Patients with or without active disease outside the nervous system are eligible including patients with unknown primaries, as long as the pathology from the brain is consistent with a non-central nervous system primary site.)
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C12439 (NCI Thesaurus Property)
    C0006104 (UMLS 2011AA Property)
    C19151 (NCI Thesaurus Property)
    C0027627 (UMLS 2011AA Property)
    C16112 (NCI Thesaurus Property)
    C1516637 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.2
    Code List
    Pathology from the resected brain metastasis must be consistent with a non-central nervous system primary site (NOTE: Patients with or without active disease outside the nervous system are eligible including patients with unknown primaries, as long as the pathology from the brain is consistent with a non-central nervous system primary site.)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Any unresected lesions must measure <=3.0 cm in maximal extent on the contrasted preoperative treatment MRI brain scan obtained <=35 days prior to pre-registration (see Magnetic Resonance Imaging Guidelines, Section 11.2). The unresected lesions will be treated with SRS as outlined in the treatment section (Section 7.0) of the protocol. (NOTE: The metastases size restriction does not apply to the resected brain metastasis; with resected brain metastasis only surgical cavity size determines eligibility see 3.114)
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C3824 (NCI Thesaurus Property)
    C0221198 (UMLS 2011AA Property)
    C12439 (NCI Thesaurus Property)
    C0006104 (UMLS 2011AA Property)
    C16112 (NCI Thesaurus Property)
    C1516637 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.3
    Code List
    Any unresected lesions must measure <=3.0 cm in maximal extent on the contrasted preoperative treatment MRI brain scan obtained <=35 days prior to pre-registration (see Magnetic Resonance Imaging Guidelines, Section 11.2). The unresected lesions will be treated with SRS as outlined in the treatment section (Section 7.0) of the protocol. (NOTE: The metastases size restriction does not apply to the resected brain metastasis; with resected brain metastasis only surgical cavity size determines eligibility see 3.114)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Resection cavity must measure <5.0 cm in maximal extent on the postoperative MRI (or CT) brain scan obtained <=35 days prior to pre-registration (NOTE: It is permissible for the resection of a dominant brain metastasis to include a smaller "satellite" metastasis as long as the single resection cavity is less than the maximum size requirements.)
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C3824 (NCI Thesaurus Property)
    C0221198 (UMLS 2011AA Property)
    C12439 (NCI Thesaurus Property)
    C0006104 (UMLS 2011AA Property)
    C25654 (NCI Thesaurus Property)
    C1521996 (UMLS 2011AA Property)
    C16112 (NCI Thesaurus Property)
    C1516637 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.4
    Code List
    Resection cavity must measure <5.0 cm in maximal extent on the postoperative MRI (or CT) brain scan obtained <=35 days prior to pre-registration (NOTE: It is permissible for the resection of a dominant brain metastasis to include a smaller "satellite" metastasis as long as the single resection cavity is less than the maximum size requirements.)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    All standard tumor-staging procedures necessary to define baseline extracranial disease status completed <=42 days prior to pre-registration
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C12439 (NCI Thesaurus Property)
    C0006104 (UMLS 2011AA Property)
    C19151 (NCI Thesaurus Property)
    C0027627 (UMLS 2011AA Property)
    C15608 (NCI Thesaurus Property)
    C0332305 (UMLS 2011AA Property)
    C16112 (NCI Thesaurus Property)
    C1516637 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.5
    Code List
    All standard tumor-staging procedures necessary to define baseline extracranial disease status completed <=42 days prior to pre-registration
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Ability to be treated with either a gamma knife or a linear accelerator-based radiosurgery system
    text
    C15696 (NCI Thesaurus ObjectClass)
    C0085203 (UMLS 2011AA ObjectClass)
    C28169 (NCI Thesaurus Property)
    C0023730 (UMLS 2011AA Property)
    C15382 (NCI Thesaurus Property)
    C0086330 (UMLS 2011AA Property)
    C50329 (NCI Thesaurus Property)
    C1509845 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.6
    Code List
    Ability to be treated with either a gamma knife or a linear accelerator-based radiosurgery system
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Age >= 18 years
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25150 (NCI Thesaurus Property)
    C0001779 (UMLS 2011AA Property)
    CL.7
    Code List
    Age >= 18 years
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    PatientAgeValue
    Item
    Age (=)
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25150 (NCI Thesaurus Property)
    C0001779 (UMLS 2011AA Property)
    Item
    Willing and able to complete neurocognitive examination without assistance
    text
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C25262 (NCI Thesaurus ObjectClass)
    C0205494 (UMLS 2011AA ObjectClass)
    C37926 (NCI Thesaurus ObjectClass)
    C1516691 (UMLS 2011AA ObjectClass)
    C25250 (NCI Thesaurus Property)
    C0205197 (UMLS 2011AA Property)
    CL355214 (NCI Metathesaurus ValueDomain)
    CL.8
    Code List
    Willing and able to complete neurocognitive examination without assistance
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Willing and able to complete QOL by themselves or with assistance (see Section 4.0)
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25250 (NCI Thesaurus Property)
    C0205197 (UMLS 2011AA Property)
    C17048 (NCI Thesaurus Property)
    C0034394 (UMLS 2011AA Property)
    C25171 (NCI Thesaurus Property)
    C0013893 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.9
    Code List
    Willing and able to complete QOL by themselves or with assistance (see Section 4.0)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    ECOG performance status (PS) 0, 1, or 2
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25491 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS 2011AA ObjectClass)
    CL092952 (NCI Metathesaurus ObjectClass)
    CL.10
    Code List
    ECOG performance status (PS) 0, 1, or 2
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    ECOG Performance Status (=)
    text
    C25664 (NCI Thesaurus ValueDomain)
    C0349674 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus ValueDomain)
    C1512162 (UMLS 2011AA ValueDomain)
    C20641 (NCI Thesaurus ObjectClass)
    C1518965 (UMLS 2011AA ObjectClass)
    CL.11
    Code List
    ECOG Performance Status (=)
    CL Item
    Fully Active, Able To Carry On All Pre-disease Performance Without Restriction. (0)
    CL Item
    Restricted In Physically Strenuous Activity But Ambulatory And Able To Carry Out Work Of A Light Or Sedentary Nature, E.g., Light Housework, Office Work. (1)
    CL Item
    Ambulatory And Capable Of All Selfcare But Unable To Carry Out Any Work Activities. Up And About More Than 50% Of Waking Hours. (2)
    Item
    SRS facility is Radiological Physics Center (RPC) approved (see Section 6.24)
    text
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C15358 (NCI Thesaurus Property)
    C0085203 (UMLS 2011AA Property)
    C41206 (NCI Thesaurus Property)
    C1272753 (UMLS 2011AA Property)
    C73925 (NCI Thesaurus Property)
    C2362313 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.12
    Code List
    SRS facility is Radiological Physics Center (RPC) approved (see Section 6.24)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    The Neurocognitive Testing examiner must have credentialing confirming completion of the neurocognitive testing training (see Section 6.25)
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C81313 (NCI Thesaurus Property)
    C0027853 (UMLS 2011AA Property)
    C41206 (NCI Thesaurus Property)
    C1272753 (UMLS 2011AA Property)
    C73925 (NCI Thesaurus Property)
    C2362313 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.13
    Code List
    The Neurocognitive Testing examiner must have credentialing confirming completion of the neurocognitive testing training (see Section 6.25)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Provide informed written consent
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C78209 (NCI Thesaurus Property)
    C0085732 (UMLS 2011AA Property)
    CL.14
    Code List
    Provide informed written consent
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Willing to provide blood and urine samples for correlative research purposes (see Sections 6.0 and 14.0)
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus Property)
    C0370003 (UMLS 2011AA Property)
    C25171 (NCI Thesaurus Property)
    C0013893 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C25340 (NCI Thesaurus Property)
    C0457083 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    CL.15
    Code List
    Willing to provide blood and urine samples for correlative research purposes (see Sections 6.0 and 14.0)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item Group
    Pre-registration Exclusion Criteria
    Item
    Any of the following: Pregnant women Nursing women Men or women of childbearing potential who are unwilling to employ adequate contraception throughout the study and for men for up to 3 months after completing treatment
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C25742 (NCI Thesaurus Property)
    C0032961 (UMLS 2011AA Property)
    C37933 (NCI Thesaurus Property)
    C1444657 (UMLS 2011AA Property)
    C25596 (NCI Thesaurus Property)
    C0006147 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.16
    Code List
    Any of the following: Pregnant women Nursing women Men or women of childbearing potential who are unwilling to employ adequate contraception throughout the study and for men for up to 3 months after completing treatment
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Prior cranial RT (radiation therapy)
    text
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25629 (NCI Thesaurus ObjectClass)
    C0332152 (UMLS 2011AA ObjectClass)
    C37936 (NCI Thesaurus ObjectClass)
    C0205096 (UMLS 2011AA ObjectClass)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.17
    Code List
    Prior cranial RT (radiation therapy)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Inability to complete an MRI with contrast of the head
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C16502 (NCI Thesaurus ObjectClass)
    C0011923 (UMLS 2011AA ObjectClass)
    C25594 (NCI Thesaurus Property)
    C1518422 (UMLS 2011AA Property)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    CL.18
    Code List
    Inability to complete an MRI with contrast of the head
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Known allergy to gadolinium
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C3114 (NCI Thesaurus Property)
    C0020517 (UMLS 2011AA Property)
    C1708 (NCI Thesaurus Property)
    C0450442 (UMLS 2011AA Property)
    C15206 (NCI Thesaurus Property)
    C0008972 (UMLS 2011AA Property)
    C18772 (NCI Thesaurus Property)
    C0262926 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.19
    Code List
    Known allergy to gadolinium
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Planned cytotoxic chemotherapy during the SRS and WBRT
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25608 (NCI Thesaurus Property)
    C0679823 (UMLS 2011AA Property)
    C25471 (NCI Thesaurus Property)
    C0521116 (UMLS 2011AA Property)
    C15207 (NCI Thesaurus Property)
    C28041 (NCI Thesaurus Property)
    C1517586 (UMLS 2011AA Property)
    C25370 (NCI Thesaurus Property)
    C0680251 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.20
    Code List
    Planned cytotoxic chemotherapy during the SRS and WBRT
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Primary germ cell tumor, small cell carcinoma, or lymphoma
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C13310 (NCI Thesaurus Property)
    C0205373 (UMLS 2011AA Property)
    C2991 (NCI Thesaurus Property)
    C0012634 (UMLS 2011AA Property)
    C25456 (NCI Thesaurus Property)
    C0205420 (UMLS 2011AA Property)
    C25370 (NCI Thesaurus Property)
    C0680251 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.21
    Code List
    Primary germ cell tumor, small cell carcinoma, or lymphoma
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Widespread definitive leptomeningeal metastasis
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C3813 (NCI Thesaurus Property)
    C0220650 (UMLS 2011AA Property)
    C25370 (NCI Thesaurus Property)
    C0680251 (UMLS 2011AA Property)
    CL.22
    Code List
    Widespread definitive leptomeningeal metastasis
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    A brain metastasis that is located <=5 mm of the optic chiasm or within the brainstem
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C12438 (NCI Thesaurus Property)
    C3714787 (UMLS 2011AA Property)
    C2991 (NCI Thesaurus Property)
    C0012634 (UMLS 2011AA Property)
    C25171 (NCI Thesaurus Property)
    C0013893 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.23
    Code List
    A brain metastasis that is located <=5 mm of the optic chiasm or within the brainstem
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item Group
    Pre-registration Check
    Item
    Consent form signed and dated
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16468 (NCI Thesaurus ObjectClass)
    C0009797 (UMLS 2011AA ObjectClass)
    C25679 (NCI Thesaurus Property)
    CL.24
    Code List
    Consent form signed and dated
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    InformedConsentFormSignedDate
    Item
    Date Informed Consent Signed (mm/dd/yyyy)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain)
    C16468 (NCI Thesaurus ObjectClass)
    C0009797 (UMLS 2011AA ObjectClass)
    C25679 (NCI Thesaurus Property)
    Item
    Authorization for use and disclosure of protected health information signed and dated (Non-USA institution only check NA)
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25178 (NCI Thesaurus Property)
    C0018684 (UMLS 2011AA Property)
    CL.25
    Code List
    Authorization for use and disclosure of protected health information signed and dated (Non-USA institution only check NA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Not Applicable (NA)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    HealthInsurancePortabilityandAccountabilityActTissueDonorAuthorizationDate
    Item
    Date of authorization (mm/dd/yyyy)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25168 (NCI Thesaurus Property)
    C0040288 (UMLS 2011AA Property)
    C62504 (NCI Thesaurus ObjectClass)
    C0600593 (UMLS 2011AA ObjectClass)
    C41192 (NCI Thesaurus Property)
    C1524004 (UMLS 2011AA Property)
    Item
    A mandatory correlative research component for blood and urine is part of this study; the patient will be automatically registered onto this component (see Sections 3.119f and 14.0)
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25644 (NCI Thesaurus Property)
    CL.26
    Code List
    A mandatory correlative research component for blood and urine is part of this study; the patient will be automatically registered onto this component (see Sections 3.119f and 14.0)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Pre-registration tests/procedures must be completed <=14 days prior to pre-registration (see Section 4.0)
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25646 (NCI Thesaurus Property)
    C1514821 (UMLS 2011AA Property)
    C25629 (NCI Thesaurus Property)
    C0332152 (UMLS 2011AA Property)
    C25294 (NCI Thesaurus Property)
    C0022885 (UMLS 2011AA Property)
    C45513 (NCI Thesaurus Property)
    C1711411 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.27
    Code List
    Pre-registration tests/procedures must be completed <=14 days prior to pre-registration (see Section 4.0)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationBeginDate
    Item
    Earliest pre-registration test date (mm/dd/yyyy NOTE: The earliest pre-registration test date must be less than or equal to the latest pre-registration test date. The above dates DO NOT include footnote 9 of the test schedule that reads "All standard tumor-staging procedures necessary to define baseline extracranial status as deemed appropriate by the treating oncology physician completed <=42 days prior to pre-registration.")
    date
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25646 (NCI Thesaurus Property)
    C1514821 (UMLS 2011AA Property)
    C25629 (NCI Thesaurus Property)
    C0332152 (UMLS 2011AA Property)
    C25294 (NCI Thesaurus Property)
    C0022885 (UMLS 2011AA Property)
    C25171 (NCI Thesaurus Property)
    C0013893 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25431 (NCI Thesaurus ValueDomain)
    C0439659 (UMLS 2011AA ValueDomain)
    PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationEndDate
    Item
    Latest pre-registration test date (mm/dd/yyyy)
    date
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25646 (NCI Thesaurus Property)
    C1514821 (UMLS 2011AA Property)
    C25629 (NCI Thesaurus Property)
    C0332152 (UMLS 2011AA Property)
    C25294 (NCI Thesaurus Property)
    C0022885 (UMLS 2011AA Property)
    C25171 (NCI Thesaurus Property)
    C0013893 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    Item
    All required baseline symptoms (see Section 10.3) must be documented and graded
    text
    C15207 (NCI Thesaurus ObjectClass)
    C25213 (NCI Thesaurus Property)
    C1442488 (UMLS 2011AA Property)
    C2991 (NCI Thesaurus Property)
    C0012634 (UMLS 2011AA Property)
    C25356 (NCI Thesaurus Property)
    C1301725 (UMLS 2011AA Property)
    C49073 (NCI Thesaurus Property)
    C1707357 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.28
    Code List
    All required baseline symptoms (see Section 10.3) must be documented and graded
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    A radiation oncologist has seen the patient and confirms the patient is a suitable candidate for this study
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C17833 (NCI Thesaurus ObjectClass)
    C1514693 (UMLS 2011AA ObjectClass)
    C41188 (NCI Thesaurus Property)
    C0009818 (UMLS 2011AA Property)
    CL.29
    Code List
    A radiation oncologist has seen the patient and confirms the patient is a suitable candidate for this study
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Blood/urine kits available on site
    text
    C15207 (NCI Thesaurus ObjectClass)
    C12434 (NCI Thesaurus Property)
    C0229664 (UMLS 2011AA Property)
    C25453 (NCI Thesaurus Property)
    C1516698 (UMLS 2011AA Property)
    C19157 (NCI Thesaurus Property)
    C0370003 (UMLS 2011AA Property)
    C25429 (NCI Thesaurus Property)
    C0470187 (UMLS 2011AA Property)
    C49073 (NCI Thesaurus Property)
    C1707357 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.30
    Code List
    Blood/urine kits available on site
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient Questionnaire Booklet-Quality of Life (QOL) and Patient and Examiner Questionnaire Booklet-Neurocognitive Evaluations are available on site; copies are not acceptable for this submission
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C25320 (NCI Thesaurus ObjectClass)
    C1507394 (UMLS 2011AA ObjectClass)
    C17048 (NCI Thesaurus ObjectClass)
    C0034394 (UMLS 2011AA ObjectClass)
    C25429 (NCI Thesaurus Property)
    C0470187 (UMLS 2011AA Property)
    CL.31
    Code List
    Patient Questionnaire Booklet-Quality of Life (QOL) and Patient and Examiner Questionnaire Booklet-Neurocognitive Evaluations are available on site; copies are not acceptable for this submission
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission to store and use his/her blood samples for use in future research to learn about, prevent, or treat cancer
    text
    C12434 (NCI Thesaurus ObjectClass)
    C0229664 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C15319 (NCI Thesaurus Property)
    C25648 (NCI Thesaurus Property)
    C0439849 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus Property)
    C0006826 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    CL.32
    Code List
    Patient has given permission to store and use his/her blood samples for use in future research to learn about, prevent, or treat cancer
    CL Item
    Yes: C49488 (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No: C49487 (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission to store and use his/her blood samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    text
    C12434 (NCI Thesaurus ObjectClass)
    C0229664 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C15319 (NCI Thesaurus Property)
    C2991 (NCI Thesaurus Property)
    C0012634 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.33
    Code List
    Patient has given permission to store and use his/her blood samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission for NCCTG to give his/her stored blood samples for use in future research to outside researchers
    text
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25603 (NCI Thesaurus Property)
    C1518600 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    CL.34
    Code List
    Patient has given permission for NCCTG to give his/her stored blood samples for use in future research to outside researchers
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission to store and use his/her urine samples for use in future research to learn about, prevent, or treat cancer
    text
    C13283 (NCI Thesaurus ObjectClass)
    C0042036 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C15319 (NCI Thesaurus Property)
    C25648 (NCI Thesaurus Property)
    C0439849 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus Property)
    C0006826 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.35
    Code List
    Patient has given permission to store and use his/her urine samples for use in future research to learn about, prevent, or treat cancer
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission to store and use his/her urine samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    text
    C13283 (NCI Thesaurus ObjectClass)
    C0042036 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C2991 (NCI Thesaurus Property)
    C0012634 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.36
    Code List
    Patient has given permission to store and use his/her urine samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission for NCCTG to give his/her stored urine samples for use in future research to outside researchers
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C44280 (NCI Thesaurus Property)
    C0205101 (UMLS 2011AA Property)
    C19157 (NCI Thesaurus Property)
    C0370003 (UMLS 2011AA Property)
    C25936 (NCI Thesaurus Property)
    C0035173 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.37
    Code List
    Patient has given permission for NCCTG to give his/her stored urine samples for use in future research to outside researchers
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission to store and use his/her tissue samples for use in future research to learn about, prevent, or treat cancer
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C15319 (NCI Thesaurus Property)
    C9305 (NCI Thesaurus Property)
    C0006826 (UMLS 2011AA Property)
    C19157 (NCI Thesaurus Property)
    C0370003 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    CL.38
    Code List
    Patient has given permission to store and use his/her tissue samples for use in future research to learn about, prevent, or treat cancer
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission to store and use his/her tissue samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    text
    C12801 (NCI Thesaurus ObjectClass)
    C0040300 (UMLS 2011AA ObjectClass)
    C12434 (NCI Thesaurus ObjectClass)
    C0229664 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C15319 (NCI Thesaurus Property)
    C2991 (NCI Thesaurus Property)
    C0012634 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.39
    Code List
    Patient has given permission to store and use his/her tissue samples for use in future research to learn about, prevent, or treat other health problems (for example: diabetes, Alzheimer's disease, or heart disease.)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Patient has given permission for NCCTG to give his/her stored tissue samples for use in future research to outside researchers
    text
    C12801 (NCI Thesaurus ObjectClass)
    C0040300 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C15319 (NCI Thesaurus Property)
    C25648 (NCI Thesaurus Property)
    C0439849 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus Property)
    C0006826 (UMLS 2011AA Property)
    C25460 (NCI Thesaurus Property)
    C1511481 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.40
    Code List
    Patient has given permission for NCCTG to give his/her stored tissue samples for use in future research to outside researchers
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
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