ID
43433
Beschreibung
E5204 Adverse Event Form (CTCAE v3.0) Combination Chemotherapy With or Without Bevacizumab in Treating Patients Who Have Had Surgery for Stage II or Stage III Rectal Cancer NCT00303628 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=089B4062-6B32-38B1-E044-0003BA3F9857
Link
Stichworte
Versionen (6)
- 27.08.12 27.08.12 -
- 08.01.15 08.01.15 - Martin Dugas
- 09.01.15 09.01.15 - Martin Dugas
- 09.01.15 09.01.15 - Martin Dugas
- 31.03.15 31.03.15 - Martin Dugas
- 20.09.21 20.09.21 -
Hochgeladen am
20. September 2021
DOI
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Creative Commons BY-NC 3.0 Legacy
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Colorectal Cancer Toxicity NCT00303628 E5204
INSTRUCTIONS: Complete this form as indicated below and at the end of all protocol therapy. Submit original to the ECOG Coordinating Center. Keep a copy for your files.
- StudyEvent: E5204 Adverse Event Form (CTCAE v3.0)
Beschreibung
Adverse event
Alias
- UMLS CUI-1
- C0877248
Beschreibung
Cycle number
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25214
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ObjectClass
- C15368
Beschreibung
PersonOff-TreatmentTimePeriodType
Datentyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus Property
- C25616
- NCI Thesaurus Property-2
- C25601
- NCI Thesaurus Property-3
- C25207
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C1518544
- UMLS CUI-2
- C1948053
Beschreibung
AdverseEventCurrentAssessmentInd
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus Property
- C20989
- NCI Thesaurus Property-2
- C25471
- NCI Thesaurus ObjectClass
- C41331
- UMLS CUI-1
- C0877248
- UMLS CUI-2
- C1516048
Beschreibung
Adverse Event Start Date
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2697888
- NCI Thesaurus Property
- C25375
- NCI Thesaurus ValueDomain-2
- C25431
- NCI Thesaurus ObjectClass
- C49704
Beschreibung
Adverse Event End Date
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2697886
- NCI Thesaurus Property
- C25375
- NCI Thesaurus ObjectClass
- C49704
Beschreibung
Adverse event blood, bone marrow lab
Alias
- UMLS CUI-1
- C0877248
Beschreibung
CTC Adverse Event Term
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C1516728
- NCI Thesaurus ObjectClass
- C49704
- UMLS CUI-2
- C2826934
- NCI Thesaurus Property
- C45559
Beschreibung
CTC Adverse Event Grade (this report period)
Datentyp
integer
Alias
- NCI Thesaurus ObjectClass
- C49704
- NCI Thesaurus ValueDomain
- C18000
- NCI Thesaurus Property
- C25365
- UMLS CUI-1
- C2985911
Beschreibung
CTC Adverse Event Attribution Scale
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- NCI Thesaurus ObjectClass
- C49704
- NCI Thesaurus Property
- C25358
- UMLS CUI-1
- C1706735
Beschreibung
Adverse event infections
Alias
- UMLS CUI-1
- C0877248
Beschreibung
CommonToxicityCriteriaAdverseEventShortNameType
Datentyp
text
Alias
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ObjectClass
- C49704
- NCI Metathesaurus ValueDomain
- C0332307
- NCI Thesaurus Property-2
- C25249
- UMLS CUI-1
- C1516728
Beschreibung
CTC Adverse Event Term
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C1516728
- NCI Thesaurus ObjectClass
- C49704
- UMLS CUI-2
- C2826934
- NCI Thesaurus Property
- C38024
- NCI Thesaurus Property-2
- C45559
Beschreibung
Other Adverse Events
Alias
- UMLS CUI-1
- C0877248
Beschreibung
CTC Adverse Event Term
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1516728
- NCI Thesaurus ObjectClass
- C49704
- UMLS CUI-2
- C2826934
- NCI Thesaurus Property
- C45559
Beschreibung
CTC Adverse Event Reported Term
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1516728
- NCI Thesaurus ObjectClass
- C49704
- UMLS CUI-2
- C2699044
- NCI Thesaurus Property
- C25161
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INSTRUCTIONS: Complete this form as indicated below and at the end of all protocol therapy. Submit original to the ECOG Coordinating Center. Keep a copy for your files.
- StudyEvent: E5204 Adverse Event Form (CTCAE v3.0)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
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C25491 (NCI Thesaurus Property-2)
C3242750 (UMLS CUI-1)
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C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)
C2045829 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C25601 (NCI Thesaurus Property-2)
C25207 (NCI Thesaurus Property-3)
C25284 (NCI Thesaurus ValueDomain)
C1518544 (UMLS CUI-1)
C1948053 (UMLS CUI-2)
C20989 (NCI Thesaurus Property)
C25471 (NCI Thesaurus Property-2)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS CUI-1)
C1516048 (UMLS CUI-2)
C2697888 (UMLS CUI-1)
C25375 (NCI Thesaurus Property)
C25431 (NCI Thesaurus ValueDomain-2)
C49704 (NCI Thesaurus ObjectClass)
C2697886 (UMLS CUI-1)
C25375 (NCI Thesaurus Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C45559 (NCI Thesaurus Property)
C0003123 (UMLS 2011AA)
C0009806 (UMLS 2011AA)
C0010200 (UMLS 2011AA)
C0011175 (UMLS 2011AA)
C0011168 (UMLS 2011AA)
C0015672 (UMLS 2011AA)
C0014591 (UMLS 2011AA)
C0038362 (UMLS 2011AA)
C0027497 (UMLS 2011AA)
C0151313 (UMLS 2011AA)
C0008031 (UMLS 2011AA)
C0034069 (UMLS 2011AA)
C18000 (NCI Thesaurus ValueDomain)
C25365 (NCI Thesaurus Property)
C2985911 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C25358 (NCI Thesaurus Property)
C1706735 (UMLS CUI-1)
C0445356 (UMLS CUI-1)
C0332149 (UMLS CUI-1)
C1709683 (UMLS CUI-1)
C1704787 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C0332307 (NCI Metathesaurus ValueDomain)
C25249 (NCI Thesaurus Property-2)
C1516728 (UMLS CUI-1)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C38024 (NCI Thesaurus Property)
C45559 (NCI Thesaurus Property-2)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C45559 (NCI Thesaurus Property)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2699044 (UMLS CUI-2)
C25161 (NCI Thesaurus Property)