Description:

NSABP Protocol B-43 Worksheet Protocol Treatment Form (Radiation Therapy and Trastuzumab) Radiation Therapy With or Without Trastuzumab in Treating Women With Ductal Carcinoma In Situ Who Have Undergone Lumpectomy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=38EE2EF6-D07E-1323-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=38EE2EF6-D07E-1323-E044-0003BA3F9857

Keywords:
Versions (3) ▾
  1. 8/27/12
  2. 1/9/15
  3. 9/20/21
Uploaded on:

September 20, 2021

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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00769379 Treatment - NSABP Protocol B-43 Worksheet Protocol Treatment Form (Radiation Therapy and Trastuzumab) - 2675912v1.0

No Instruction available.

  1. StudyEvent: NSABP Protocol B-43 Worksheet Protocol Treatment Form (Radiation Therapy and Trastuzumab)
    1. No Instruction available.
Header
Section A - Radiation Therapy (rt) -- All Patients
Was RT administered
Was accelerated fractionation employed
Was a Boost given?
Was brachytherapy used?
Were there any unscheduled interruptions in radiation therapy?
Was RT interruption possibly, probably, or definitely due to RT toxicity?
Reason RT Treatment Ended
Section B Trastuzumab Administration -- Group 2 Patients Only
Was dose 1 of trastuzumab administered?
Was dose 2 of trastuzumab administered?
Primary reason trastuzumab treatment ended
Adverse Events/side Effects/complications
Adverse Event
Grade
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