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43182

Description

Phase II Consortium - Phase II Lung Cancer - NSCLC Stage I-III On-Study Form (for Adjuvant Studies and Inoperable Stage III) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF3F2FE3-D320-46AD-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF3F2FE3-D320-46AD-E034-0003BA3F9857

Keywords

Versions (6)
  1. 8/11/14 8/11/14 - Martin Dugas
  2. 8/11/14 8/11/14 - Martin Dugas
  3. 8/11/14 8/11/14 - Martin Dugas
  4. 8/11/14 8/11/14 - Martin Dugas
  5. 1/1/15 1/1/15 - Martin Dugas
  6. 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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    On-Study Form NSCLC Stage I-III

    English

    No Instruction available.

    1 forms  
    1. StudyEvent: Phase II Lung Cancer - NSCLC Stage I-III On-Study Form
      1. No Instruction available.
    CRF Header
    Description

    CRF Header

    Alias
    UMLS CUI-1
    C1320722
    Coordinating Group Protocol No.
    Description

    Protocol ID Coordinating Group

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1711341
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Coordinating Group Code
    Description

    Coordinating Group Code

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS CUI-1
    C1711341
    NCI Thesaurus ObjectClass
    C17005
    UMLS CUI-2
    C0805701
    NCI Thesaurus ObjectClass-2
    C25462
    NCI Thesaurus Property
    C25364
    Protocol Title
    Description

    Protocol Title

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986303
    NCI Thesaurus ObjectClass
    C25320
    NCI Thesaurus Property
    C42774
    Patient Study ID
    Description

    Patient Study ID

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Registering Group Code
    Description

    Registering Group Code

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS CUI-1
    C2347449
    NCI Thesaurus ObjectClass
    C17005
    UMLS CUI-2
    C0805701
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ObjectClass-2
    C25645
    Patient Medical Record Number
    Description

    Medical Record Number

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1301894
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25261
    NCI Thesaurus Property-2
    C25198
    Other Patient ID
    Description

    Trial subject ID Participating Group

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Institution/Affiliate
    Description

    Institution Name

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Registering Institution Code
    Description

    Registering Institution Code

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    UMLS CUI-2
    C0805701
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ObjectClass-2
    C25645
    Physician of Record
    Description

    Investigator Name

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2826892
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ObjectClass
    C17089
    NCI Thesaurus ObjectClass-2
    C25644
    Person Completing Form
    Description

    Person Completing Form

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1550483
    NCI Thesaurus ObjectClass
    C25657
    NCI Thesaurus Property
    C25364
    Date Form Completed (MM DD YYYY)
    Description

    Date Form Completed

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C1115437
    NCI Thesaurus ObjectClass
    C40988
    NCI Thesaurus Property
    C25250
    NCI Thesaurus ValueDomain-2
    C25367
    Are data amended (If data are amended, please circle in red when using paper form)
    Description

    Data amended

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Lung: Pre-treatment Characteristics
    Description

    Lung: Pre-treatment Characteristics

    Patient Weight
    Description

    Patient Weight

    Data type

    float

    Measurement units
    • kg
    Alias
    NCI Thesaurus ValueDomain
    C25209
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25208
    UMLS CUI-1
    C0005910
    kg
    Weight Loss in Previous Six Months (Approximate check one)
    Description

    Weight Loss past six months

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25664
    UMLS CUI-1
    C1262477
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C3828652
    NCI Thesaurus Property
    C3445
    NCI Thesaurus ValueDomain-2
    C25613
    Weight loss in previous 6 months (Approximate kg)
    Description

    Weight Loss past six months

    Data type

    integer

    Measurement units
    • %
    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-1
    C1262477
    NCI Thesaurus Property
    C3445
    UMLS CUI-2
    C3828652
    NCI Thesaurus ValueDomain
    C25613
    NCI Thesaurus ValueDomain-2
    C25712
    %
    Smoking History
    Description

    Smoking history

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C1519384
    NCI Thesaurus ObjectClass
    C17934
    NCI Thesaurus Property
    C18772
    Does the patient currently smoke
    Description

    Current Smoker

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C3241966
    NCI Thesaurus Property
    C25471
    NCI Thesaurus ObjectClass
    C17934
    NCI Metathesaurus Property
    C0449865
    Number of Cigarettes per day (If yes,)
    Description

    Smoker amount smoked

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C17934
    UMLS CUI-1
    C1608325
    NCI Thesaurus Property
    C25471
    NCI Metathesaurus Property
    C0449865
    NCI Thesaurus ValueDomain
    C25473
    NCI Thesaurus ValueDomain-2
    C25515
    Time since last cigarette (If no,)
    Description

    Smoking Discontinued Duration

    Data type

    text

    Alias
    NCI Thesaurus Property
    C25484
    UMLS CUI-1
    C0453997
    NCI Thesaurus ObjectClass
    C17934
    NCI Thesaurus ValueDomain
    C25330
    Lung: Disease Description Stage I-III
    Description

    Lung: Disease Description Stage I-III

    T Stage clinical, Clinical (leave blank if not done)
    Description

    T Stage clinical

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    NCI Thesaurus ObjectClass-2
    C12468
    NCI Thesaurus Property
    C25398
    NCI Thesaurus Property-2
    C25728
    NCI Thesaurus ValueDomain
    C16899
    UMLS CUI-1
    C0475455
    UMLS CUI-2
    C0205210
    N Stage, Clinical (leave blank if not done)
    Description

    N Stage clinical

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-1
    C0456532
    NCI Thesaurus ObjectClass-2
    C12468
    UMLS CUI-2
    C0205210
    NCI Thesaurus Property
    C25398
    NCI Thesaurus Property-2
    C25580
    NCI Thesaurus ValueDomain
    C16899
    M Stage, Clinical (leave blank if not done)
    Description

    M Stage clinical

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-1
    C0456533
    NCI Thesaurus ObjectClass-2
    C12468
    UMLS CUI-2
    C0205210
    NCI Thesaurus Property
    C25398
    NCI Thesaurus Property-2
    C25727
    NCI Thesaurus ValueDomain
    C16899
    T Stage, Pathologic (leave blank if not done)
    Description

    T Stage pathologic

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-1
    C0475455
    NCI Thesaurus ValueDomain
    C16899
    UMLS CUI-2
    C1521733
    NCI Thesaurus Property
    C25365
    N Stage, Pathologic (leave blank if not done)
    Description

    N Stage pathologic

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-1
    C0456532
    NCI Thesaurus ObjectClass-2
    C12468
    UMLS CUI-2
    C1521733
    NCI Thesaurus Property
    C25610
    NCI Thesaurus Property-2
    C25580
    NCI Thesaurus ValueDomain
    C16899
    M Stage, Pathologic (leave blank if not done)
    Description

    M Stage pathologic

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-1
    C0456533
    NCI Thesaurus ObjectClass-2
    C12468
    UMLS CUI-2
    C1521733
    NCI Thesaurus Property
    C25610
    NCI Thesaurus Property-2
    C25727
    NCI Thesaurus ValueDomain
    C16899
    MedDRA Code (for Primary Disease Site)
    Description

    Primary Site MedDRA Code

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C41331
    UMLS CUI-1
    C0449695
    NCI Thesaurus ObjectClass-2
    C71886
    UMLS CUI-2
    C1552878
    NCI Thesaurus Property
    C25162
    NCI Thesaurus Property-2
    C43820
    NCI Thesaurus ValueDomain
    C25162
    NCI Thesaurus ValueDomain-2
    C41331
    NCI Thesaurus ValueDomain-3
    C45255
    NCI Thesaurus ValueDomain-4
    C43820
    NCI Thesaurus ValueDomain-5
    C25714
    Lesion Site (Primary at diagnosis)
    Description

    Lesion Site, Primary

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS CUI-1
    C0449695
    NCI Thesaurus ObjectClass
    C3824
    NCI Thesaurus Property
    C25341
    Longest Diameter of Lesion(s)
    Description

    Longest Diameter of Lesion

    Data type

    float

    Measurement units
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS CUI-1
    C0221198
    NCI Thesaurus Property
    C25285
    UMLS CUI-2
    C1301886
    NCI Thesaurus Property-2
    C25558
    UMLS CUI-3
    C1522425
    NCI Thesaurus ValueDomain
    C25209
    NCI Thesaurus ValueDomain-2
    C25285
    cm
    Pathologic Stage based on Mediastinoscopy?
    Description

    Mediastinoscopy with biopsy

    Data type

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C19157
    UMLS CUI-1
    C0198422
    NCI Thesaurus ObjectClass-2
    C3200
    NCI Thesaurus Property
    C16829
    NCI Thesaurus Property-2
    C25452
    NCI Thesaurus ValueDomain
    C38147
    Pathologic Stage based on Bronchoscopy?
    Description

    Bronchoscopy with biopsy

    Data type

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C19157
    UMLS CUI-1
    C0189396
    NCI Thesaurus ObjectClass-2
    C3200
    NCI Thesaurus Property
    C16366
    NCI Thesaurus Property-2
    C25452
    NCI Thesaurus ValueDomain
    C38147
    Pathologic Stage based on Thoracotomy/Sternotomy?
    Description

    Open biopsy of pleura

    Data type

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C19157
    UMLS CUI-1
    C0189517
    NCI Thesaurus ObjectClass-2
    C3200
    NCI Thesaurus Property
    C15537
    NCI Thesaurus Property-2
    C25452
    NCI Thesaurus ValueDomain
    C38147
    Histologic Type
    Description

    Histologic Type

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-1
    C0449574
    NCI Thesaurus ObjectClass-2
    C12468
    NCI Thesaurus Property
    C25526
    NCI Thesaurus Property-2
    C25161
    NCI Thesaurus ValueDomain
    C25372
    NCI Thesaurus ValueDomain-2
    C25526
    Specify Other Histologic Type
    Description

    Histologic Type, other

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS CUI-1
    C1299220
    NCI Thesaurus ObjectClass
    C3262
    NCI Thesaurus Property
    C25526
    NCI Thesaurus Property-2
    C25161
    Was resection attempted?
    Description

    Surgical resection attempted

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS CUI-1
    C0015252
    NCI Thesaurus ObjectClass
    C25698
    NCI Thesaurus ObjectClass-2
    C15232
    UMLS CUI-2
    C1516084
    NCI Thesaurus Property
    C39769
    Status of Primary Tumor (If resected,)
    Description

    Resection type primary tumor

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C0449522
    NCI Thesaurus ObjectClass
    C3262
    UMLS CUI-2
    C0677930
    NCI Thesaurus ObjectClass-2
    C25251
    NCI Thesaurus Property
    C15232
    Has the patient been diagnosed with first local-regional recurrence
    Description

    Neoplasm Recurrence, locoregional

    Data type

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C19987
    UMLS CUI-1
    C0027643
    NCI Thesaurus Property
    C25388
    NCI Thesaurus Property-2
    C25509
    NCI Thesaurus Property-3
    C15220
    NCI Thesaurus ValueDomain
    C38148
    Does the tumor involve the surgical margin
    Description

    Surgical margin involved by tumor

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0332649
    NCI Thesaurus ObjectClass
    C25698
    NCI Thesaurus Property
    C25547
    NCI Thesaurus ObjectClass-2
    C41227
    Was all gross tumor removed
    Description

    Residual tumor stage R0

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0475288
    NCI Thesaurus ObjectClass
    C3262
    NCI Thesaurus Property
    C25326
    NCI Thesaurus Property-2
    C25650
    Is measurable disease present? (only applicable in studies where there is disease at baseline)
    Description

    Measurable Disease

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C1513041
    NCI Thesaurus Property
    C25626
    NCI Thesaurus ObjectClass
    C2991
    NCI Thesaurus ObjectClass-2
    C37894
    Is non-measurable disease present? (only applicable in studies where there is disease at baseline)
    Description

    Non-Measurable Disease

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C1334988
    NCI Thesaurus Property
    C25626
    NCI Thesaurus ObjectClass
    C2991
    NCI Thesaurus ObjectClass-2
    C25589
    Lung: Prior Treatment (CDUS Module) NSCLC Stage I-III
    Description

    Lung: Prior Treatment (CDUS Module) NSCLC Stage I-III

    Prior therapy type (per CDUS reporting guidelines check all that apply)
    Description

    Prior therapy type

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C1514463
    NCI Thesaurus ObjectClass
    C25629
    NCI Thesaurus ObjectClass-2
    C15368
    NCI Thesaurus Property
    C25365
    Number of prior therapy regimens (For example, planned treatment of chemotherapy + RT = 1 regimen)
    Description

    Number of prior therapy regimens

    Data type

    integer

    Alias
    NCI Thesaurus ObjectClass
    C25629
    UMLS CUI-1
    C0750480
    NCI Thesaurus ObjectClass-2
    C15368
    NCI Thesaurus ValueDomain
    C25463
    UMLS CUI-2
    C0040808
    NCI Thesaurus Property
    C15697
    UMLS CUI-3
    C0332152
    MedDRA Code (for Primary Disease Site)
    Description

    Primary Site MedDRA Code

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C41331
    UMLS CUI-1
    C0449695
    NCI Thesaurus ObjectClass-2
    C71886
    UMLS CUI-2
    C1552878
    NCI Thesaurus Property
    C25162
    NCI Thesaurus Property-2
    C43820
    NCI Thesaurus ValueDomain
    C25162
    NCI Thesaurus ValueDomain-2
    C41331
    NCI Thesaurus ValueDomain-3
    C45255
    NCI Thesaurus ValueDomain-4
    C43820
    NCI Thesaurus ValueDomain-5
    C25714
    Lung: Prior Systemic Therapy NSCLC Advanced
    Description

    Lung: Prior Systemic Therapy NSCLC Advanced

    Prior systemic therapy
    Description

    Prior systemic therapy

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS CUI-1
    C1515119
    NCI Thesaurus ObjectClass
    C15698
    UMLS CUI-2
    C0332152
    NCI Thesaurus ObjectClass-2
    C25629
    NCI Thesaurus Property
    C25382
    Number of prior therapy regimens (For example, planned treatment of chemotherapy + RT = 1 regimen)
    Description

    Number of prior therapy regimens

    Data type

    integer

    Alias
    NCI Thesaurus ObjectClass
    C25629
    UMLS CUI-1
    C0750480
    NCI Thesaurus ObjectClass-2
    C15368
    NCI Thesaurus ValueDomain
    C25463
    UMLS CUI-2
    C0040808
    NCI Thesaurus Property
    C15697
    UMLS CUI-3
    C0332152
    Agent Name
    Description

    Agent

    Data type

    text

    Alias
    NCI Thesaurus Property
    C25364
    UMLS CUI-1
    C1521826
    NCI Thesaurus ObjectClass
    C1708
    NCI Thesaurus ValueDomain
    C1708
    NCI Thesaurus ValueDomain-2
    C42614
    Agent Start Date (MM DD YYYY)
    Description

    Concomitant Medication Start Date

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2826734
    NCI Thesaurus ValueDomain-2
    C25431
    NCI Thesaurus ObjectClass
    C1708
    NCI Thesaurus Property
    C25275
    Agent End Date (MM DD YYYY)
    Description

    Concomitant Medication End Date

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2826744
    NCI Thesaurus ObjectClass
    C1708
    NCI Thesaurus Property
    C25275
    Agent Total Cumulative Dose
    Description

    Cumulative Dose Agent

    Data type

    float

    Alias
    NCI Thesaurus ObjectClass
    C1708
    UMLS CUI-1
    C2986497
    NCI Thesaurus ObjectClass-2
    C25470
    UMLS CUI-2
    C1521826
    NCI Thesaurus Property
    C25304
    NCI Thesaurus Property-2
    C25256
    NCI Thesaurus ValueDomain
    C25304
    NCI Thesaurus ValueDomain-2
    C25488
    Units
    Description

    Units

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C1519795
    NCI Thesaurus ValueDomain-2
    C44278
    NCI Thesaurus ObjectClass
    C1708
    NCI Thesaurus Property
    C25256
    Overall Response Duration (weeks)
    Description

    Overall Response Duration

    Data type

    float

    Alias
    NCI Thesaurus ObjectClass
    C25755
    UMLS CUI-1
    C0237585
    NCI Thesaurus Property
    C25605
    NCI Thesaurus Property-2
    C25275
    NCI Thesaurus ValueDomain
    C25605
    NCI Thesaurus ValueDomain-2
    C25330
    Procedure Description
    Description

    Procedure Description

    Prior Surgery
    Description

    Prior Surgery

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0744961
    NCI Thesaurus Property
    C38000
    NCI Thesaurus ObjectClass
    C15329
    NCI Thesaurus ObjectClass-2
    C25629
    Surgical Approach
    Description

    Surgical Approach

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C0449446
    NCI Thesaurus ObjectClass
    C12468
    NCI Thesaurus ObjectClass-2
    C15329
    NCI Thesaurus Property
    C25382
    Primary Surgery Type
    Description

    Primary Surgery Type

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25251
    UMLS CUI-1
    C0944781
    NCI Thesaurus ObjectClass-2
    C12468
    NCI Thesaurus ObjectClass-3
    C15329
    NCI Thesaurus Property
    C38000
    NCI Thesaurus ValueDomain
    C25284
    Surgery Details
    Description

    Operative Surgical Procedures

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C0543467
    NCI Thesaurus ObjectClass
    C15329
    NCI Thesaurus Property
    C25480
    Other, specify
    Description

    Operative Surgical Procedures, specify

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS CUI-1
    C0543467
    NCI Thesaurus ObjectClass
    C15329
    UMLS CUI-2
    C1521902
    NCI Thesaurus Property
    C25480
    Surgery Date (MM DD YYYY)
    Description

    Surgery Date

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C1628561
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus ObjectClass
    C15329
    NCI Thesaurus Property
    C25275
    Duration of Surgery (enter hours and minutes elapsed)
    Description

    Duration of Surgery

    Data type

    durationDatetime

    Alias
    NCI Thesaurus ObjectClass
    C15329
    UMLS CUI-1
    C0488629
    NCI Thesaurus Property
    C25275
    NCI Thesaurus ValueDomain
    C25330
    Lung: Prior Radiation Therapy NSCLC Advanced
    Description

    Lung: Prior Radiation Therapy NSCLC Advanced

    Prior Radiation Therapy
    Description

    Prior Radiation Therapy

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C0332152
    NCI Thesaurus ObjectClass-2
    C25629
    NCI Thesaurus Property
    C25382
    Total Dose to Lung (cGy)
    Description

    Total Dose to Lung

    Data type

    float

    Alias
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-1
    C2169193
    NCI Thesaurus Property
    C12468
    UMLS CUI-2
    C0024109
    NCI Thesaurus Property-2
    C25382
    NCI Thesaurus ValueDomain
    C25304
    NCI Thesaurus ValueDomain-2
    C25488
    Radiation Therapy End Date (MM DD YYYY)
    Description

    Radiation Therapy End Date

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C0806020
    NCI Thesaurus Property
    C25275
    NCI Thesaurus Property-2
    C25496
    Were there any unscheduled interruptions in radiation therapy?
    Description

    Unscheduled Interruptions in Radiation Therapy

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C1512900
    NCI Thesaurus Property
    C25542
    RT Interruptions Reason (Specify)
    Description

    Radiation Therapy Interruptions Reason

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C1512900
    NCI Thesaurus Property
    C25542
    UMLS CUI-3
    C0566251
    Comments
    Description

    Comments

    Comments
    Description

    Research Comments

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
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    1 forms
    1. StudyEvent: Phase II Lung Cancer - NSCLC Stage I-III On-Study Form
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    CRF Header
    C1320722 (UMLS CUI-1)
    Protocol ID Coordinating Group
    Item
    Coordinating Group Protocol No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1711341 (UMLS CUI-2)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Coordinating Group Code
    Item
    Coordinating Group Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C1711341 (UMLS CUI-1)
    C17005 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25462 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    Protocol Title
    Item
    Protocol Title
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986303 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C42774 (NCI Thesaurus Property)
    Patient Study ID
    Item
    Patient Study ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Registering Group Code
    Item
    Registering Group Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C2347449 (UMLS CUI-1)
    C17005 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25645 (NCI Thesaurus ObjectClass-2)
    Medical Record Number
    Item
    Patient Medical Record Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1301894 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25261 (NCI Thesaurus Property)
    C25198 (NCI Thesaurus Property-2)
    Trial subject ID Participating Group
    Item
    Other Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Institution Name
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Registering Institution Code
    Item
    Registering Institution Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25645 (NCI Thesaurus ObjectClass-2)
    Investigator Name
    Item
    Physician of Record
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2826892 (UMLS CUI-1)
    C25364 (NCI Thesaurus Property)
    C17089 (NCI Thesaurus ObjectClass)
    C25644 (NCI Thesaurus ObjectClass-2)
    Person Completing Form
    Item
    Person Completing Form
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25657 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Date Form Completed
    Item
    Date Form Completed (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1115437 (UMLS CUI-1)
    C40988 (NCI Thesaurus ObjectClass)
    C25250 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Data amended
    Item
    Are data amended (If data are amended, please circle in red when using paper form)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Item Group
    Lung: Pre-treatment Characteristics
    Patient Weight
    Item
    Patient Weight
    float
    C25209 (NCI Thesaurus ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C25208 (NCI Thesaurus Property)
    C0005910 (UMLS CUI-1)
    Item
    Weight Loss in Previous Six Months (Approximate check one)
    text
    C25664 (NCI Thesaurus ValueDomain)
    C1262477 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C3828652 (UMLS CUI-2)
    C3445 (NCI Thesaurus Property)
    C25613 (NCI Thesaurus ValueDomain-2)
    CL.2
    Code List
    Weight Loss in Previous Six Months (Approximate check one)
    CL Item
    <5% Of Body Weight (< 5% of body weight)
    CL Item
    5 To <10% Of Body Weight (5 to < 10% of body weight)
    CL Item
    10 To <20% Of Body Weight (10 to <20% of body weight)
    CL Item
    > Or = 20% Of Body Weight (> or = 20% of body weight)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Weight Loss past six months
    Item
    Weight loss in previous 6 months (Approximate kg)
    integer
    C16960 (NCI Thesaurus ObjectClass)
    C1262477 (UMLS CUI-1)
    C3445 (NCI Thesaurus Property)
    C3828652 (UMLS CUI-2)
    C25613 (NCI Thesaurus ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    Item
    Smoking History
    text
    C25284 (NCI Thesaurus ValueDomain)
    C1519384 (UMLS CUI-1)
    C17934 (NCI Thesaurus ObjectClass)
    C18772 (NCI Thesaurus Property)
    CL.3
    Code List
    Smoking History
    CL Item
    Never Smoked (Never smoked)
    CL Item
    Pipe Or Cigar Smoker Only (Pipe or cigar smoker only)
    CL Item
    Cigarette Smoker <20 Pack-years (Cigarette smoker, <20 pack-years)
    CL Item
    Cigarette Smoker 20-40 Pack-years (Cigarette smoker, 20-40 pack-years)
    CL Item
    Cigarette Smoker >40 Pack-years (Cigarette smoker, >40 pack-years)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Current Smoker
    Item
    Does the patient currently smoke
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C3241966 (UMLS CUI-1)
    C25471 (NCI Thesaurus Property)
    C17934 (NCI Thesaurus ObjectClass)
    C0449865 (NCI Metathesaurus Property)
    Item
    Number of Cigarettes per day (If yes,)
    text
    C17934 (NCI Thesaurus ObjectClass)
    C1608325 (UMLS CUI-1)
    C25471 (NCI Thesaurus Property)
    C0449865 (NCI Metathesaurus Property)
    C25473 (NCI Thesaurus ValueDomain)
    C25515 (NCI Thesaurus ValueDomain-2)
    CL.5
    Code List
    Number of Cigarettes per day (If yes,)
    CL Item
    Fewer Than 10 Cigarettes (Fewer than 10 cigarettes)
    CL Item
    10 To 20 Cigarettes (10 to 20 cigarettes)
    CL Item
    More Than 20 Cigarettes (More than 20 cigarettes)
    CL Item
    Not Applicable (Not applicable)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    Item
    Time since last cigarette (If no,)
    text
    C25484 (NCI Thesaurus Property)
    C0453997 (UMLS CUI-1)
    C17934 (NCI Thesaurus ObjectClass)
    C25330 (NCI Thesaurus ValueDomain)
    CL.6
    Code List
    Time since last cigarette (If no,)
    CL Item
    Less Than 1 Month (Less than 1 month)
    CL Item
    1 Month To <6 Months (1 month to <6 months)
    CL Item
    6 Months To <1 Year (6 months to <1 year)
    CL Item
    1 Year To <5 Years (1 year to <5 years)
    CL Item
    5 Years To <10 Years (5 years to <10 years)
    CL Item
    More Than 10 Years (More than 10 years)
    CL Item
    Not Applicable (Not applicable)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    Item Group
    Lung: Disease Description Stage I-III
    T Stage clinical
    Item
    T Stage clinical, Clinical (leave blank if not done)
    text
    C3262 (NCI Thesaurus ObjectClass)
    C12468 (NCI Thesaurus ObjectClass-2)
    C25398 (NCI Thesaurus Property)
    C25728 (NCI Thesaurus Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    C0475455 (UMLS CUI-1)
    C0205210 (UMLS CUI-2)
    N Stage clinical
    Item
    N Stage, Clinical (leave blank if not done)
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0456532 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass-2)
    C0205210 (UMLS CUI-2)
    C25398 (NCI Thesaurus Property)
    C25580 (NCI Thesaurus Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    M Stage clinical
    Item
    M Stage, Clinical (leave blank if not done)
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0456533 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass-2)
    C0205210 (UMLS CUI-2)
    C25398 (NCI Thesaurus Property)
    C25727 (NCI Thesaurus Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    T Stage pathologic
    Item
    T Stage, Pathologic (leave blank if not done)
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0475455 (UMLS CUI-1)
    C16899 (NCI Thesaurus ValueDomain)
    C1521733 (UMLS CUI-2)
    C25365 (NCI Thesaurus Property)
    N Stage pathologic
    Item
    N Stage, Pathologic (leave blank if not done)
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0456532 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass-2)
    C1521733 (UMLS CUI-2)
    C25610 (NCI Thesaurus Property)
    C25580 (NCI Thesaurus Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    M Stage pathologic
    Item
    M Stage, Pathologic (leave blank if not done)
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0456533 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass-2)
    C1521733 (UMLS CUI-2)
    C25610 (NCI Thesaurus Property)
    C25727 (NCI Thesaurus Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    Primary Site MedDRA Code
    Item
    MedDRA Code (for Primary Disease Site)
    text
    C41331 (NCI Thesaurus ObjectClass)
    C0449695 (UMLS CUI-1)
    C71886 (NCI Thesaurus ObjectClass-2)
    C1552878 (UMLS CUI-2)
    C25162 (NCI Thesaurus Property)
    C43820 (NCI Thesaurus Property-2)
    C25162 (NCI Thesaurus ValueDomain)
    C41331 (NCI Thesaurus ValueDomain-2)
    C45255 (NCI Thesaurus ValueDomain-3)
    C43820 (NCI Thesaurus ValueDomain-4)
    C25714 (NCI Thesaurus ValueDomain-5)
    Lesion Site, Primary
    Item
    Lesion Site (Primary at diagnosis)
    text
    C13717 (NCI Thesaurus ValueDomain)
    C0449695 (UMLS CUI-1)
    C3824 (NCI Thesaurus ObjectClass)
    C25341 (NCI Thesaurus Property)
    Longest Diameter of Lesion
    Item
    Longest Diameter of Lesion(s)
    float
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS CUI-1)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS CUI-2)
    C25558 (NCI Thesaurus Property-2)
    C1522425 (UMLS CUI-3)
    C25209 (NCI Thesaurus ValueDomain)
    C25285 (NCI Thesaurus ValueDomain-2)
    Mediastinoscopy with biopsy
    Item
    Pathologic Stage based on Mediastinoscopy?
    boolean
    C19157 (NCI Thesaurus ObjectClass)
    C0198422 (UMLS CUI-1)
    C3200 (NCI Thesaurus ObjectClass-2)
    C16829 (NCI Thesaurus Property)
    C25452 (NCI Thesaurus Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    Bronchoscopy with biopsy
    Item
    Pathologic Stage based on Bronchoscopy?
    boolean
    C19157 (NCI Thesaurus ObjectClass)
    C0189396 (UMLS CUI-1)
    C3200 (NCI Thesaurus ObjectClass-2)
    C16366 (NCI Thesaurus Property)
    C25452 (NCI Thesaurus Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    Open biopsy of pleura
    Item
    Pathologic Stage based on Thoracotomy/Sternotomy?
    boolean
    C19157 (NCI Thesaurus ObjectClass)
    C0189517 (UMLS CUI-1)
    C3200 (NCI Thesaurus ObjectClass-2)
    C15537 (NCI Thesaurus Property)
    C25452 (NCI Thesaurus Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    Item
    Histologic Type
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0449574 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass-2)
    C25526 (NCI Thesaurus Property)
    C25161 (NCI Thesaurus Property-2)
    C25372 (NCI Thesaurus ValueDomain)
    C25526 (NCI Thesaurus ValueDomain-2)
    CL.10
    Code List
    Histologic Type
    CL Item
    Squamous Cell Carcinoma (Squamous cell carcinoma)
    C2929 (NCI Thesaurus)
    C0007137 (UMLS 2011AA)
    CL Item
    Adenocarcinoma (Adenocarcinoma)
    C2852 (NCI Thesaurus)
    C0001418 (UMLS 2011AA)
    CL Item
    Adenocarcinoma With Bac Features (Adenocarcinoma with BAC features)
    CL Item
    Large Cell Undifferentiated (Large cell undifferentiated)
    CL Item
    Bronchoalveolar (bac) (Bronchoalveolar carcinoma (BAC))
    CL Item
    Non-small Cell Lung Cancer (nsclc), Nos (Non-small cell lung cancer NOS)
    CL Item
    Large Cell With Neuroendocrine Features (Large cell with neuroendocrine features)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    C17649 (NCI Thesaurus-3)
    C0205394 (UMLS 2011AA-4)
    Histologic Type, other
    Item
    Specify Other Histologic Type
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1299220 (UMLS CUI-1)
    C3262 (NCI Thesaurus ObjectClass)
    C25526 (NCI Thesaurus Property)
    C25161 (NCI Thesaurus Property-2)
    Surgical resection attempted
    Item
    Was resection attempted?
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C0015252 (UMLS CUI-1)
    C25698 (NCI Thesaurus ObjectClass)
    C15232 (NCI Thesaurus ObjectClass-2)
    C1516084 (UMLS CUI-2)
    C39769 (NCI Thesaurus Property)
    Item
    Status of Primary Tumor (If resected,)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0449522 (UMLS CUI-1)
    C3262 (NCI Thesaurus ObjectClass)
    C0677930 (UMLS CUI-2)
    C25251 (NCI Thesaurus ObjectClass-2)
    C15232 (NCI Thesaurus Property)
    CL.12
    Code List
    Status of Primary Tumor (If resected,)
    CL Item
    Unresected (Unresected)
    CL Item
    Not Recurrent, Resected, No Residual Tumor (Resected, no residual tumor)
    CL Item
    Not Recurrent, Resected, Residual Tumor (Resected, residual tumor)
    CL Item
    Recurrent (Recurrent)
    C14173 (NCI Thesaurus)
    C2945760 (UMLS 2011AA)
    Neoplasm Recurrence, locoregional
    Item
    Has the patient been diagnosed with first local-regional recurrence
    boolean
    C19987 (NCI Thesaurus ObjectClass)
    C0027643 (UMLS CUI-1)
    C25388 (NCI Thesaurus Property)
    C25509 (NCI Thesaurus Property-2)
    C15220 (NCI Thesaurus Property-3)
    C38148 (NCI Thesaurus ValueDomain)
    Surgical margin involved by tumor
    Item
    Does the tumor involve the surgical margin
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0332649 (UMLS CUI-1)
    C25698 (NCI Thesaurus ObjectClass)
    C25547 (NCI Thesaurus Property)
    C41227 (NCI Thesaurus ObjectClass-2)
    Residual tumor stage R0
    Item
    Was all gross tumor removed
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0475288 (UMLS CUI-1)
    C3262 (NCI Thesaurus ObjectClass)
    C25326 (NCI Thesaurus Property)
    C25650 (NCI Thesaurus Property-2)
    Measurable Disease
    Item
    Is measurable disease present? (only applicable in studies where there is disease at baseline)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1513041 (UMLS CUI-1)
    C25626 (NCI Thesaurus Property)
    C2991 (NCI Thesaurus ObjectClass)
    C37894 (NCI Thesaurus ObjectClass-2)
    Non-Measurable Disease
    Item
    Is non-measurable disease present? (only applicable in studies where there is disease at baseline)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1334988 (UMLS CUI-1)
    C25626 (NCI Thesaurus Property)
    C2991 (NCI Thesaurus ObjectClass)
    C25589 (NCI Thesaurus ObjectClass-2)
    Item Group
    Lung: Prior Treatment (CDUS Module) NSCLC Stage I-III
    Item
    Prior therapy type (per CDUS reporting guidelines check all that apply)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C1514463 (UMLS CUI-1)
    C25629 (NCI Thesaurus ObjectClass)
    C15368 (NCI Thesaurus ObjectClass-2)
    C25365 (NCI Thesaurus Property)
    CL.18
    Code List
    Prior therapy type (per CDUS reporting guidelines check all that apply)
    CL Item
    Agents Administered To Control The Replication And/or Spread Of Viruses (Anti-retroviral therapy)
    CL Item
    Treatment With An Agent That Prevents Or Impairs The Translation Of The Genetic Message For Production Of A Specific Protein (Antisense)
    CL Item
    High Dose Chemotherapy Combined With Transplantation Of Bone Marrow Cells (Bone marrow transplant)
    CL Item
    Non-systemic Chemotherapy Treatment Or Chemotherapy Not Described By Chemotherapy Single Agent Systemic Or Multi-agent Systemic (Chemotherapy (NOS))
    CL Item
    Systemic Chemotherapy With A Regimen Containing Multiple Agents (Chemotherapy multiple agents systemic)
    CL Item
    Prior Therapy With Agents That Are Not Known To Cause Damage To Cycling Cells (Chemotherapy non-cytotoxic)
    CL Item
    Systemic Chemotherapy With A Single Agent Regimen (Chemotherapy single agent systemic)
    CL Item
    Treatment Of Human Disease By Gene Transfer (Gene transfer)
    CL Item
    Cancer Therapy Which Incorporates Hormonal Manipulation (Hormonal therapy)
    CL Item
    Drug And/or Immunotherapy (Drug and/or Immunotherapy)
    CL Item
    No Previous Exposure To Drug (nos) (No prior therapy)
    CL Item
    Anticancer Treatment With A Live, Replication-competent Virus (Oncolytic virotherapy)
    CL Item
    Prior Therapy (nos) (Prior therapy NOS)
    CL Item
    Targeted Ionizing Radiation Therapy Utilizing Radioactive Implants Or Seeds (Radiation therapy)
    CL Item
    Surgical Procedure, Or Operation, With Therapeutic Intent (Surgery)
    CL Item
    Therapy Nos (Therapy (NOS))
    CL Item
    Substance Or Group Of Substances Administered To Induce The Immune System To Recognize And Destroy Tumors Or Microorganisms (Vaccine)
    Number of prior therapy regimens
    Item
    Number of prior therapy regimens (For example, planned treatment of chemotherapy + RT = 1 regimen)
    integer
    C25629 (NCI Thesaurus ObjectClass)
    C0750480 (UMLS CUI-1)
    C15368 (NCI Thesaurus ObjectClass-2)
    C25463 (NCI Thesaurus ValueDomain)
    C0040808 (UMLS CUI-2)
    C15697 (NCI Thesaurus Property)
    C0332152 (UMLS CUI-3)
    Primary Site MedDRA Code
    Item
    MedDRA Code (for Primary Disease Site)
    text
    C41331 (NCI Thesaurus ObjectClass)
    C0449695 (UMLS CUI-1)
    C71886 (NCI Thesaurus ObjectClass-2)
    C1552878 (UMLS CUI-2)
    C25162 (NCI Thesaurus Property)
    C43820 (NCI Thesaurus Property-2)
    C25162 (NCI Thesaurus ValueDomain)
    C41331 (NCI Thesaurus ValueDomain-2)
    C45255 (NCI Thesaurus ValueDomain-3)
    C43820 (NCI Thesaurus ValueDomain-4)
    C25714 (NCI Thesaurus ValueDomain-5)
    Item Group
    Lung: Prior Systemic Therapy NSCLC Advanced
    Prior systemic therapy
    Item
    Prior systemic therapy
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1515119 (UMLS CUI-1)
    C15698 (NCI Thesaurus ObjectClass)
    C0332152 (UMLS CUI-2)
    C25629 (NCI Thesaurus ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    Number of prior therapy regimens
    Item
    Number of prior therapy regimens (For example, planned treatment of chemotherapy + RT = 1 regimen)
    integer
    C25629 (NCI Thesaurus ObjectClass)
    C0750480 (UMLS CUI-1)
    C15368 (NCI Thesaurus ObjectClass-2)
    C25463 (NCI Thesaurus ValueDomain)
    C0040808 (UMLS CUI-2)
    C15697 (NCI Thesaurus Property)
    C0332152 (UMLS CUI-3)
    Agent
    Item
    Agent Name
    text
    C25364 (NCI Thesaurus Property)
    C1521826 (UMLS CUI-1)
    C1708 (NCI Thesaurus ObjectClass)
    C1708 (NCI Thesaurus ValueDomain)
    C42614 (NCI Thesaurus ValueDomain-2)
    Concomitant Medication Start Date
    Item
    Agent Start Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2826734 (UMLS CUI-1)
    C25431 (NCI Thesaurus ValueDomain-2)
    C1708 (NCI Thesaurus ObjectClass)
    C25275 (NCI Thesaurus Property)
    Concomitant Medication End Date
    Item
    Agent End Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2826744 (UMLS CUI-1)
    C1708 (NCI Thesaurus ObjectClass)
    C25275 (NCI Thesaurus Property)
    Cumulative Dose Agent
    Item
    Agent Total Cumulative Dose
    float
    C1708 (NCI Thesaurus ObjectClass)
    C2986497 (UMLS CUI-1)
    C25470 (NCI Thesaurus ObjectClass-2)
    C1521826 (UMLS CUI-2)
    C25304 (NCI Thesaurus Property)
    C25256 (NCI Thesaurus Property-2)
    C25304 (NCI Thesaurus ValueDomain)
    C25488 (NCI Thesaurus ValueDomain-2)
    Units
    Item
    Units
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1519795 (UMLS CUI-1)
    C44278 (NCI Thesaurus ValueDomain-2)
    C1708 (NCI Thesaurus ObjectClass)
    C25256 (NCI Thesaurus Property)
    Overall Response Duration
    Item
    Overall Response Duration (weeks)
    float
    C25755 (NCI Thesaurus ObjectClass)
    C0237585 (UMLS CUI-1)
    C25605 (NCI Thesaurus Property)
    C25275 (NCI Thesaurus Property-2)
    C25605 (NCI Thesaurus ValueDomain)
    C25330 (NCI Thesaurus ValueDomain-2)
    Item Group
    Procedure Description
    Prior Surgery
    Item
    Prior Surgery
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0744961 (UMLS CUI-1)
    C38000 (NCI Thesaurus Property)
    C15329 (NCI Thesaurus ObjectClass)
    C25629 (NCI Thesaurus ObjectClass-2)
    Item
    Surgical Approach
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0449446 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass)
    C15329 (NCI Thesaurus ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    CL.21
    Code List
    Surgical Approach
    CL Item
    Thoracotomy (thoracotomy)
    CL Item
    Thoracoscopy / Video-assisted (vats) (Thoracoscopy / Video-assisted (VATS))
    CL Item
    Thoracoscopy / Video-assisted (vats), With Conversion To Thoracotomy (Thoracoscopy / Video-assisted (VATS), with conversion to Thoracotomy)
    Item
    Primary Surgery Type
    text
    C25251 (NCI Thesaurus ObjectClass)
    C0944781 (UMLS CUI-1)
    C12468 (NCI Thesaurus ObjectClass-2)
    C15329 (NCI Thesaurus ObjectClass-3)
    C38000 (NCI Thesaurus Property)
    C25284 (NCI Thesaurus ValueDomain)
    CL.22
    Code List
    Primary Surgery Type
    CL Item
    Exploration, No Resection (Exploration, No Resection)
    CL Item
    Segmentectomy (Segmentectomy)
    CL Item
    Wedge Resection (Wedge Resection)
    CL Item
    Lobectomy (Lobectomy)
    C15272 (NCI Thesaurus)
    C0023928 (UMLS 2011AA)
    CL Item
    Bilobectomy (Bilobectomy)
    CL Item
    Pneumonectomy (Pneumonectomy)
    C15305 (NCI Thesaurus)
    C0032284 (UMLS 2011AA)
    Item
    Surgery Details
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0543467 (UMLS CUI-1)
    C15329 (NCI Thesaurus ObjectClass)
    C25480 (NCI Thesaurus Property)
    CL.23
    Code List
    Surgery Details
    CL Item
    Bronchial Sleeve Resection (Bronchial sleeve resection)
    CL Item
    Intrapericardial Reconstruction (Intrapericardial reconstruction)
    CL Item
    Vascular Sleeve Resection (Vascular sleeve resection)
    CL Item
    Chest Wall Resection, No Reconstruction (Chest wall resection, no reconstruction)
    CL Item
    Chest Wall Resection, With Reconstruction (Chest wall resection, with reconstruction)
    CL Item
    Major Vascular Resection, No Reconstruction (Major vascular resection, no reconstruction)
    CL Item
    Other, Specify (Other, specify)
    Operative Surgical Procedures, specify
    Item
    Other, specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C0543467 (UMLS CUI-1)
    C15329 (NCI Thesaurus ObjectClass)
    C1521902 (UMLS CUI-2)
    C25480 (NCI Thesaurus Property)
    Surgery Date
    Item
    Surgery Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1628561 (UMLS CUI-1)
    C25367 (NCI Thesaurus ValueDomain-2)
    C15329 (NCI Thesaurus ObjectClass)
    C25275 (NCI Thesaurus Property)
    Duration of Surgery
    Item
    Duration of Surgery (enter hours and minutes elapsed)
    durationDatetime
    C15329 (NCI Thesaurus ObjectClass)
    C0488629 (UMLS CUI-1)
    C25275 (NCI Thesaurus Property)
    C25330 (NCI Thesaurus ValueDomain)
    Item Group
    Lung: Prior Radiation Therapy NSCLC Advanced
    Prior Radiation Therapy
    Item
    Prior Radiation Therapy
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C0332152 (UMLS CUI-2)
    C25629 (NCI Thesaurus ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    Total Dose to Lung
    Item
    Total Dose to Lung (cGy)
    float
    C15313 (NCI Thesaurus ObjectClass)
    C2169193 (UMLS CUI-1)
    C12468 (NCI Thesaurus Property)
    C0024109 (UMLS CUI-2)
    C25382 (NCI Thesaurus Property-2)
    C25304 (NCI Thesaurus ValueDomain)
    C25488 (NCI Thesaurus ValueDomain-2)
    Radiation Therapy End Date
    Item
    Radiation Therapy End Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C0806020 (UMLS CUI-2)
    C25275 (NCI Thesaurus Property)
    C25496 (NCI Thesaurus Property-2)
    Item
    Were there any unscheduled interruptions in radiation therapy?
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C1512900 (UMLS CUI-2)
    C25542 (NCI Thesaurus Property)
    CL.25
    Code List
    Were there any unscheduled interruptions in radiation therapy?
    CL Item
    Yes, Due To Toxicity (Yes, due to toxicity)
    CL Item
    Yes, Due To Other Reason (Yes, due to other reasons)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Radiation Therapy Interruptions Reason
    Item
    RT Interruptions Reason (Specify)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C1512900 (UMLS CUI-2)
    C25542 (NCI Thesaurus Property)
    C0566251 (UMLS CUI-3)
    Item Group
    Comments
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
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