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:
Versions (6) ▾
  1. 8/27/12
  2. 1/9/15
  3. 1/9/15
  4. 7/8/15
  5. 7/8/15
  6. 9/20/21
Uploaded on:

September 20, 2021

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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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

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