ID
506
Beskrivning
AMC-045 Type III Adverse Event Reporting Form (TAE) Cisplatin, Fluorouracil, Cetuximab, and Radiation Therapy in Treating Patients With HIV and Stage I, Stage II, or Stage III Anal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1C146B28-823F-583B-E044-0003BA3F9857
Länk
Nyckelord
Versioner (4)
- 2012-08-26 2012-08-26 -
- 2014-11-26 2014-11-26 - Martin Dugas
- 2021-04-13 2021-04-13 - Dr. rer. medic Philipp Neuhaus
- 2021-04-13 2021-04-13 - Ahmed Rafee, MD
Uppladdad den
26 augusti 2012
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0 Legacy
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
Anal Cancer NCT00324415 Toxicity - AMC-045 Type III Adverse Event Reporting Form (TAE) - 2516535v1.0
This form should be completed at week 18 for Type III Adverse Events. Type III Adverse Event - (1) any interruption in radiation therapy lasting more that 7 days, (2) failure to complete at least 6 courses of cetuximab and 2 cycles of cisplatin and 5-FU due to toxicity, (3) failure to complete the prescribed course of irradiation due to toxicity
- StudyEvent: AMC-045 Type III Adverse Event Reporting Form (TAE)
Beskrivning
Type Iii Adverse Events
Beskrivning
ProtocolSpecifiedAdverseEventOccurrenceInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass
- C38024
- UMLS 2011AA ObjectClass
- C0205369
- NCI Metathesaurus Property
- CL209504
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
RadiationTherapyInterruptionInd-2
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus Property
- C25542
- UMLS 2011AA Property
- C1512900
Beskrivning
TreatmentInterruptionDayDuration
Datatyp
double
Alias
- NCI Thesaurus ValueDomain
- C25301
- UMLS 2011AA ValueDomain
- C0439228
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ValueDomain
- C25330
- UMLS 2011AA ValueDomain
- C0449238
- NCI Thesaurus Property
- C25542
- UMLS 2011AA Property
- C1512900
Beskrivning
CetuximabCisplatinFluorouracilChemotherapyRegimenInterruptedToxicityInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ObjectClass
- C376
- UMLS 2011AA ObjectClass
- C0008838
- NCI Thesaurus ObjectClass
- C1723
- UMLS 2011AA ObjectClass
- C0879636
- NCI Thesaurus ObjectClass
- C505
- UMLS 2011AA ObjectClass
- C0016360
- NCI Thesaurus Property
- C27990
- UMLS 2011AA Property
- C0600688
- NCI Thesaurus Property
- C15697
- UMLS 2011AA Property
- C0040808
- NCI Metathesaurus Property
- CL212531
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
RadiationTherapyRegimenInterruptedToxicityInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus Property
- C27990
- UMLS 2011AA Property
- C0600688
- NCI Thesaurus Property
- C15697
- UMLS 2011AA Property
- C0040808
- NCI Metathesaurus Property
- CL212531
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
Comments
Similar models
This form should be completed at week 18 for Type III Adverse Events. Type III Adverse Event - (1) any interruption in radiation therapy lasting more that 7 days, (2) failure to complete at least 6 courses of cetuximab and 2 cycles of cisplatin and 5-FU due to toxicity, (3) failure to complete the prescribed course of irradiation due to toxicity
- StudyEvent: AMC-045 Type III Adverse Event Reporting Form (TAE)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
C1507394 (UMLS 2011AA ObjectClass)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C38024 (NCI Thesaurus ObjectClass)
C0205369 (UMLS 2011AA ObjectClass)
CL209504 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1512698 (UMLS 2011AA ValueDomain)
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25542 (NCI Thesaurus Property)
C1512900 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439228 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
C25542 (NCI Thesaurus Property)
C1512900 (UMLS 2011AA Property)
C0392920 (UMLS 2011AA ObjectClass)
C376 (NCI Thesaurus ObjectClass)
C0008838 (UMLS 2011AA ObjectClass)
C1723 (NCI Thesaurus ObjectClass)
C0879636 (UMLS 2011AA ObjectClass)
C505 (NCI Thesaurus ObjectClass)
C0016360 (UMLS 2011AA ObjectClass)
C27990 (NCI Thesaurus Property)
C0600688 (UMLS 2011AA Property)
C15697 (NCI Thesaurus Property)
C0040808 (UMLS 2011AA Property)
CL212531 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1522449 (UMLS 2011AA ObjectClass)
C27990 (NCI Thesaurus Property)
C0600688 (UMLS 2011AA Property)
C15697 (NCI Thesaurus Property)
C0040808 (UMLS 2011AA Property)
CL212531 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)