Description:

NCT00980954 RTOG 0724 F1: Radiation Therapy Oncology Group Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy Follow-up Form Chemotherapy and Pelvic Radiation Therapy With or Without Additional Chemotherapy in Treating Patients With High-Risk Early-Stage Cervical Cancer After Radical Hysterectomy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5C78147E-D46C-4734-E044-0003BA3F9857

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5C78147E-D46C-4734-E044-0003BA3F9857
Keywords:
  1. 8/27/12 8/27/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 7/8/15 7/8/15 -
  5. 7/8/15 7/8/15 -
  6. 9/20/21 9/20/21 -
Uploaded on:

September 20, 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.

NCT00980954 RTOG 0724 F1: Radiation Therapy Oncology Group Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy Follow-up Form

INSTRUCTIONS: Submit this form at the appropriate followup interval and whenever there is a change in the patient's status. Dates are mm-dd-yyyy unless otherwise specified.

  1. StudyEvent: RTOG 0724 F1: Radiation Therapy Oncology Group Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy Follow-up Form
    1. INSTRUCTIONS: Submit this form at the appropriate followup interval and whenever there is a change in the patient's status. Dates are mm-dd-yyyy unless otherwise specified.
RTOG clinical trial administrative data
Amended Data
Death Assessment
Vital Status
Primary Cause of Death
Has Patient Been Diagnosed With A New Progression?
Has the patient had a documented clinical assessment for this cancer?
Local tumor
Pelvic lymph nodes
Para-aortic nodes
Distant metastasis
Second primary
Method of Evaluation
Event
If there was recurrence of disease, was the recurrence
Did the disease recurrence extend out to the bony landmarks
Has a new primary cancer or MDS been diagnosed that has not been previously reported?
New Primary Site (s)
Non-Protocol Therapy
Non-Protocol Therapy Type
Protocol Specific Adverse Event Evaluation
Any adverse events
CTCAE Term
Attribution
SAE report submitted

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