ID

43492

Description

RTOG-0412 I1 Rev1: Initial Evaluation Form NCT00113386 Cisplatin and Docetaxel With or Without Radiation Therapy in Treating Patients Who Are Undergoing Surgery for Newly Diagnosed Stage III Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ED65A888-399B-7059-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ED65A888-399B-7059-E034-0003BA3F9857

Keywords

Lung Neoplasms

Clinical Trial

On-Study Form

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.

Back to model comments

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

RTOG-0412 I1 Rev1: Initial Evaluation Form NCT00113386

model
Details

Radiation Therapy Oncology Group Phase III Lung Pre-Op Chemotherapy vs. Pre-Op Concurrent Chemoradiation for NSCLC

1 forms

StudyEvent: RTOG-0412 I1 Rev1: Initial Evaluation Form
1. Radiation Therapy Oncology Group Phase III Lung Pre-Op Chemotherapy vs. Pre-Op Concurrent Chemoradiation for NSCLC

Name

Type

Description | Question | Decode (Coded Value)

Data type

Alias

Header

Item Group

Header

Protocol ID RTOG

Item

RTOG Study No.

text

C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Item

Case #

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)

Institution Name

Item

Institution

text

C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)

Institution Number

Item

Institution No.

text

C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)

Patient Initials

Item

Patient Initials

text

C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)

Trial subject ID RTOG

Item

Patient Study I.D.

text

C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

Data amended

Item

Amended Data (Instructions: Submit this form at patient's entry on study. Dates are recorded mm-dd-yyyy unless otherwise specified.)

boolean

C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)

PRE-TREATMENT CHACTERISTICS

Item Group

Pre-treatment Chacteristics

Patient Birth Date

Item

PATIENT BIRTH DATE

date

C25164 (NCI Thesaurus ValueDomain)
C0421451 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C25155 (NCI Thesaurus Property)

ECOG Performance Status

Item

Performance Status (Zubrod)

text

C25664 (NCI Thesaurus ValueDomain)
C1520224 (UMLS CUI-1)
C25367 (NCI Thesaurus Property)
C25491 (NCI Thesaurus ValueDomain-2)
C20641 (NCI Thesaurus ObjectClass)

CL.2

Code List

Performance Status (Zubrod)

CL Item

Restricted In Physically Strenuous Activity But Ambulatory And Able To Carry Out Work Of A Light Or Sedentary Nature, E.g., Light Housework, Office Work. (1)

CL Item

Ambulatory And Capable Of All Selfcare But Unable To Carry Out Any Work Activities. Up And About More Than 50% Of Waking Hours. (2)

CL Item

Capable Of Only Limited Selfcare, Confined To Bed Or Chair More Than 50% Of Waking Hours. (3)

CL Item

Completely Disabled. Cannot Carry On Any Selfcare. Totally Confined To Bed Or Chair. (4)

CL Item

Dead (5)

CL Item

Fully Active, Able To Carry On All Pre-disease Performance Without Restriction. (0)

Weight Loss past six months

Item

Weight loss in previous 6 Months

float

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)

PatientPriorMalignantNeoplasmHistoryInd-2

Item

HISTORY OF PRIOR MALIGNANCY (within past 3 years)

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C9305 (NCI Thesaurus Property)
C0006826 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

PatientPriorMalignantNeoplasmHistorySpecify

Item

Yes, specify site

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C9305 (NCI Thesaurus Property)
C0006826 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)

ChronicDiseasePulmonaryInd-3

Item

PULMONARY

boolean

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)
CL317978 (NCI Metathesaurus Property)

ChronicDiseaseInfectionInd-2

Item

INFECTION

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)

ChronicDiseaseHepaticInsufficiencyInd-2

Item

HEPATIC INSUFFICIENCY

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)
C1306571 (NCI Metathesaurus Property)

ChronicDiseaseCardiovascularInd-2

Item

CARDIOVASCULAR

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25292 (NCI Thesaurus Property)
C0007226 (UMLS 2011AA Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)

ChronicDiseaseCoronaryArteryInd-3

Item

CORONARY ARTERY DISEASE

boolean

ChronicDiseaseOtherDiagnosisInd-2

Item

OTHER

boolean

C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

ChronicDiseaseDiagnosisSpecify

Item

OTHER, SPECIFY

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain-2)
C0205394 (UMLS 2011AA ValueDomain-2)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)

LungForcedExpiratoryVolume1TestSpecifiedValue

Item

Forced Expiratory Volume (FEV1)

float

C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
C38084 (NCI Thesaurus Property-2)
C0849974 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0205369 (UMLS 2011AA ValueDomain-2)

LungCarbonMonoxideDiffusingCapabilityTestAssessmentPredictiveValuePercentageValue

Item

% DIFFUSION CAPACITY (DLCO)

float

C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C38083 (NCI Thesaurus Property-2)
C1516251 (UMLS 2011AA Property-2)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
C16238 (NCI Thesaurus ValueDomain-3)
C1514307 (UMLS 2011AA ValueDomain-3)

Post-operativeLungFEV1TestSpecifiedValue

Item

Predicted Postresection FEV1 based on Quantitative V/Q Scan

float

C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C25623 (NCI Thesaurus ObjectClass-2)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
C38084 (NCI Thesaurus Property-2)
C0849974 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)

Prior Radiation Therapy

Item

PRIOR RADIATION THERAPY AS TREATMENT FOR THIS CANCER

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)

PriorChemotherapyAdministeredInd-3

Item

PRIOR CHEMOTHERAPY AS TREATMENT FOR THIS CANCER

boolean

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)

T Stage clinical

Item

T Stage, Clinical

text

C3262 (NCI Thesaurus ObjectClass)
C0475455 (UMLS CUI-1)
C12468 (NCI Thesaurus ObjectClass-2)
C0205210 (UMLS CUI-2)
C25398 (NCI Thesaurus Property)
C25728 (NCI Thesaurus Property-2)
C16899 (NCI Thesaurus ValueDomain)

CL.12

Code List

T Stage, Clinical

CL Item

No Evidence Of Primary Tumor (T0)

CL Item

Tumor 3 Cm Or Less In Greatest Dimension, Surrounded By Lung Or Visceral Pleura, Invasion More Proximal Than The Lobar Bronchus, (i.e., Not In The Main Bronchus) (T1)

CL Item

Tumor With Any Of The Following Features Of Size Or Extent: More Than 3cm In Greatest Dimension; Invades The Visceral Pleura; Associated With Atelectasis Or Obstructive Pneumonitis That Extends To The Hilar Region But Does Not Involve The Entire Lung (T2)

CL Item

Tumor Of Any Size That Directly Invades Any Of The Following: Chest Wall (including Superior Sulcus Tumors), Diaphragm, Mediastinal Pleura, Parietal Pericardium; Or Tumor In The Main Bronchus Less Than 2 Cm Distal To The Carina, But Without Involvement O* (T4)

CL Item

Carcinoma In Situ (Tis)

C2917 (NCI Thesaurus)
C0007099 (UMLS 2011AA)

CL Item

Primary Tumor Cannot Be Assessed, Or Tumor Proven By The Presence Of Malignant Cells In Sputum Or Bronchial Washings But Not Visualized By Imaging Or Bronchoscopy (Tx)

CL Item

N Stage clinical

Item

N STAGE, CLINICAL (N2)

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)

CL.13

Code List

N STAGE, CLINICAL (N2)

CL Item

No Regional Lymph Node Metastasis (N0)

CL Item

Metastasis To Ipsilateral Peribronchial And/or Ipsilateral Hilar Lymph Nodes, And Intrapulmonary Nodes Including Involvement By Direct Extension Of The Primary Tumor (N1)

CL Item

Metastasis To Ipsilateral Mediastinal And/or Subcarinal Lymph Node(s) (N2)

CL Item

Metastasis To Contralateral Mediastinal, Contralateral Hilar, Ipsilateral Or Contralateral Scalene, Or Supraclavicular Lymph Node(s) (N3)

CL Item

Regional Lymph Nodes Cannot Be Assessed (NX)

M Stage clinical

Item

M STAGE, CLINICAL (MO)

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)

CL.14

Code List

M STAGE, CLINICAL (MO)

CL Item

No Distant Metastasis (M0)

CL Item

Distant Metastasis Present (M1)

CL Item

Distant Metastasis Cannot Be Assessed (MX)

Histologic Type

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.15

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

Large Cell Undifferentiated (Large cell undifferentiated)

CL Item

Bronchoalveolar (bac) (Bronchoalveolar carcinoma)

CL Item

Non-small Cell Lung Cancer (nsclc), Nos (Non-small cell lung cancer NOS)

SpecimenCollectedMethodType

Item

HOW WAS SPECIMEN OBTAINED

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property-2)

CL.16

Code List

HOW WAS SPECIMEN OBTAINED

CL Item

Sample Or Specimen Collected Via Biopsy (Biopsy)

CL Item

Sample Or Specimen Collected Via Fine Needle Aspiration (Fine needle aspiration)

CL Item

Sample Or Specimen Collected Via Induced Sputum (Sputum)

SpecimenCollectionMethod,FineNeedleAspiration

Item

Fine needle aspiration, specify site

text

LYMPH NODE ASSESSMENT

Item Group

Lymph Node Assessment

LungLymphNodeInvolvedSite

Item

LYMPH NODE TYPES

text

C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass-2)
C0024204 (UMLS 2011AA ObjectClass-2)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)

CL.17

Code List

LYMPH NODE TYPES

CL Item

Highest Mediastinal (Highest mediastinal (1))

CL Item

Right Upper Paratracheal Node (Right upper paratracheal (2R))

CL Item

Left Upper Paratracheal Node (Left upper paratracheal (2L))

CL Item

Pre And Retro Paratracheal Node (Pre and retro paratracheal (3))

CL Item

Right Lower Paratracheal Node (Right lower paratracheal (4R))

CL Item

Left Lower Paratracheal Node (Left lower paratracheal (4L))

CL Item

Subaortic Node (Subaortic (5))

CL Item

Para-aortic Node (Para-aortic (6))

CL Item

Subcarinal Node (Subcarinal (7))

CL Item

Paraesophageal Node (Paraesophageal (8))

CL Item

Pulmonary Ligament (Pulmonary ligament (9))

C0225794 (NCI Metathesaurus)

CL Item

Right Hilar Node (Right hilar (10R))

CL Item

Left Hilar Node (Left hilar (10L))

CL Item

Interlobar Node (Interlobar (11))

CL Item

Right Lobar Node (Right lobar (12R))

CL Item

Left Lobar Node (Left lobar (12L))

CL Item

Right Segmental Node (Right segmental (13R))

CL Item

Left Segmental Node (Left segmental (13L))

CL Item

Right Subsegmental Node (Right subsegmental (14R))

CL Item

Left Subsegmental Node (Left subsegmental (14L))

LymphNodeClinicalInvolvementType

Item

CLINICAL LYMPH NODE ASSESSMENT

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property-2)
C1314939 (UMLS 2011AA Property-2)

CL.18

Code List

CLINICAL LYMPH NODE ASSESSMENT

CL Item

Not Evaluated (Not evaluated)

CL Item

Positive (Positive)

C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)

CL Item

Negative (Negative)

C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)

CL Item

Equivocal (Equivocal)

C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

LymphNodePathologicInvolvementType

Item

PATHOLOGIC LYMPH NODE ASSESSMENT

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property-2)
C1314939 (UMLS 2011AA Property-2)

CL.19

Code List

PATHOLOGIC LYMPH NODE ASSESSMENT

CL Item

Not Evaluated (Not evaluated)

CL Item

Positive (Positive)

C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)

CL Item

Negative (Negative)

C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)

CL Item

Equivocal (Equivocal)

C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

NodalBiopsyVocalCordParalysisNotPerformedInd-2

Item

PARALYZED LEFT TRUE VOCAL CORD ON BRONCHOSCOPY OR INDIRECT LARYNGOSCOPY

boolean

C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25323 (NCI Thesaurus ObjectClass-2)
C0443268 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C3310 (NCI Thesaurus Property-2)
C0522224 (UMLS 2011AA Property-2)
CL052458 (NCI Metathesaurus Property)
C12822 (NCI Thesaurus Property-3)
C0042930 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

NodalBiopsyVisibleNodeNotPerformedInd-2

Item

NODES VISIBLE IN THE AP REGION ON CT SCAN (LEVEL 5)

boolean

C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25323 (NCI Thesaurus ObjectClass-2)
C0443268 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
CL052458 (NCI Metathesaurus Property)
C45804 (NCI Thesaurus Property-2)
C0746922 (UMLS 2011AA Property-2)
C48173 (NCI Thesaurus Property-3)
C0205379 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

NodalBiopsySeparateNeoplasmNotPerformedInd-2

Item

DISTINCT PRIMARY TUMOR SEPARATE FROM NODES VISIBLE ON CT SCAN

boolean

C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25323 (NCI Thesaurus ObjectClass-2)
C0443268 (UMLS 2011AA ObjectClass-2)
C3262 (NCI Thesaurus Property)
C0027651 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
CL052458 (NCI Metathesaurus Property)
C0443299 (NCI Metathesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

NodalBiopsySubcarinalNodeNotPerformedInd-2

Item

SUBCARINAL NODES NOT VISIBLE ON CT SCAN

boolean

C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25323 (NCI Thesaurus ObjectClass-2)
C0443268 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
CL052458 (NCI Metathesaurus Property)
C45804 (NCI Thesaurus Property-2)
C0746922 (UMLS 2011AA Property-2)
C25691 (NCI Thesaurus Property-3)
C1515009 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

TumorLungAreaType

Item

TUMOR LOCATION, AREA

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus Property)
C0024109 (UMLS 2011AA Property)
C25244 (NCI Thesaurus Property-2)
C0205146 (UMLS 2011AA Property-2)

CL.24

Code List

TUMOR LOCATION, AREA

CL Item

Carina (Carina)

C25264 (NCI Thesaurus)
C0225594 (UMLS 2011AA)

CL Item

Lower Lobe (left) (Lower Lobe (left))

CL Item

Lower Lobe (right) (Lower Lobe (right))

CL Item

Upper Lobe (left) (Upper Lobe (left))

CL Item

Upper Lobe (right) (Upper Lobe (right))

CL Item

Middle Lobe (right) (Middle Lobe (right))

CL Item

Mainstem Bronchus (right) (Mainstem Bronchus (right))

CL Item

Mainstem Bronchus (left) (Mainstem Bronchus (left))

CL Item

Other, Specify (Other)

TumorAreaSpecify

Item

Other, specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25244 (NCI Thesaurus Property)
C0205146 (UMLS 2011AA Property)

Pleural Effusion

Item

IS PLEURAL EFFUSION PRESENT (must complete 14a)

boolean

C38148 (NCI Thesaurus ValueDomain)
C0032227 (UMLS CUI-1)
C12468 (NCI Thesaurus ObjectClass)
C3003 (NCI Thesaurus Property)
C25223 (NCI Thesaurus Property-2)

Malignant Pleural Effusion

Item

IS IT MALIGNANT (not tapped)

text

C12468 (NCI Thesaurus ObjectClass)
C0080032 (UMLS CUI-1)
C3003 (NCI Thesaurus Property)
C25223 (NCI Thesaurus Property-2)
C14143 (NCI Thesaurus ValueDomain)
C0021212 (NCI Metathesaurus ValueDomain)

CL.26

Code List

IS IT MALIGNANT (not tapped)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

Comments

Item Group

Comments

Research Comments

Item

Comments

text

C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)

Person Completing Form

Item

Person completing form

text

C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)

Form Completion Date

Item

Form completion date, original

date

C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

Back to the top of the page

ID

Description

Link

Keywords

Versions (4)

Uploaded on

DOI

License

Model comments :

Itemgroup comments for :

Item comments for :

RTOG-0412 I1 Rev1: Initial Evaluation Form NCT00113386

Radiation Therapy Oncology Group Phase III Lung Pre-Op Chemotherapy vs. Pre-Op Concurrent Chemoradiation for NSCLC

Description

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Measurement units

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Alias

Description

Data type

Measurement units

Alias