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ACNS0122: Relapse/Progression Worksheet Neoadjuvant Chemotherapy With or Without Second-Look Surgery Followed by Radiation Therapy With or Without Peripheral Stem Cell Transplantation in Treating Patients With Intracranial Germ Cell Tumors Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C3107FBD-6347-26E8-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C3107FBD-6347-26E8-E034-0003BA12F5E7

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Versionen (3)
  1. 26.08.12 26.08.12 -
  2. 09.01.15 09.01.15 - Martin Dugas
  3. 16.06.15 16.06.15 -
Hochgeladen am

26. August 2012

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    Brain and Central Nervous System Tumors NCT00047320 Follow-Up - ACNS0122: Relapse/Progression Worksheet - 2173669v3.0

    Englisch

    No Instruction available.

    1 Formulare  
    1. StudyEvent: ACNS0122: Relapse/Progression Worksheet
      1. No Instruction available.
    Unnamed1
    Beschreibung

    Unnamed1

    Institution Name
    Beschreibung

    InstitutionName

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C21541
    UMLS 2011AA ObjectClass
    C0018704
    NCI Thesaurus ValueDomain
    C21541
    UMLS 2011AA ValueDomain
    C0018704
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Institution Personnel
    Beschreibung

    ResponsiblePersonName

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25657
    UMLS 2011AA ObjectClass
    C1273518
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Date of Birth
    Beschreibung

    PatientBirthDate

    Datentyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus ValueDomain
    C25367
    NCI Thesaurus Property
    C25155
    UMLS 2011AA Property
    C0005615
    COG Study No
    Beschreibung

    ProtocolCOGIdentifierNumber

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25320
    UMLS 2011AA ObjectClass
    C1507394
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    COG Patient ID
    Beschreibung

    PatientCOGIdentifierNumber

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property
    C39353
    UMLS 2011AA Property
    C1516477
    Patient Accession Number
    Beschreibung

    PatientAccessionNumber

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25402
    UMLS 2011AA Property
    C1510755
    Form Original Complete Date
    Beschreibung

    FormOriginalCompleteDate

    Datentyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C19464
    UMLS 2011AA ObjectClass
    C0376315
    NCI Thesaurus Property
    C25250
    UMLS 2011AA Property
    C0205197
    NCI Thesaurus Property
    C25604
    UMLS 2011AA Property
    C0205313
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain
    C25367
    Date From Amended
    Beschreibung

    FormAmendedCompleteDate

    Datentyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C19464
    UMLS 2011AA ObjectClass
    C0376315
    NCI Thesaurus Property
    C25250
    UMLS 2011AA Property
    C0205197
    NCI Thesaurus Property
    C25416
    UMLS 2011AA Property
    C1691222
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain
    C25367
    Unnamed2
    Beschreibung

    Unnamed2

    Date of relapse or progression
    Beschreibung

    ProgressionRelapseBeginDate

    Datentyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25331
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    Type Of Recurrence/progression
    Beschreibung

    Type Of Recurrence/progression

    Recurrence/progression of original involved sites?
    Beschreibung

    CancerProgressionFirstLocalDiagnosisInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C19987
    UMLS 2011AA ObjectClass
    C0242656
    NCI Thesaurus Property
    C67263
    UMLS 2011AA Property
    C0205276
    NCI Thesaurus Property
    C25509
    UMLS 2011AA Property
    C1279901
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Recurrence/progression in previously uninvolved neural site?
    Beschreibung

    CancerProgressionFirstLocal-RegionalDiagnosisInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C19987
    UMLS 2011AA ObjectClass
    C0242656
    NCI Thesaurus Property
    C25388
    UMLS 2011AA Property
    C1947913
    NCI Thesaurus Property
    C25509
    UMLS 2011AA Property
    C1279901
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Extra-neural recurrence/progression?
    Beschreibung

    FirstProgressionDistantPresentInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C19987
    UMLS 2011AA ObjectClass
    C0242656
    NCI Thesaurus Property
    C25321
    UMLS 2011AA Property
    C0443203
    NCI Thesaurus Property
    C25509
    UMLS 2011AA Property
    C1279901
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Sites Of Involvement
    Beschreibung

    Sites Of Involvement

    Supratentorial [involved?]
    Beschreibung

    SupratentorialInvolvementInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    NCI Thesaurus ObjectClass
    C12923
    UMLS 2011AA ObjectClass
    C0441938
    Supratentorial [indicate sites involved]
    Beschreibung

    SupratentorialInvolvedSite

    Datentyp

    text

    Alias
    NCI Metathesaurus Property
    CL111053
    specify [other supratentorial site] (If 1, 2 or 3)
    Beschreibung

    SupratentorialInvolvedSiteSpecify

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Metathesaurus Property
    CL111053
    Infratentorial [involved?]
    Beschreibung

    InfratentorialInvolvementInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    NCI Metathesaurus ObjectClass
    CL211504
    Infratentorial [indicate sites involved]
    Beschreibung

    InfratentorialInvolvedSite

    Datentyp

    text

    Alias
    NCI Metathesaurus Property
    CL111053
    specify [other infratentorial site] (If 1, 2 or 3)
    Beschreibung

    InfratentorialInvolvedSiteSpecify

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Metathesaurus Property
    CL111053
    Unnamed question [type of involvement]
    Beschreibung

    DiseaseInvolvementType

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    Unnamed question [type of involvement]
    Beschreibung

    DiseaseInvolvementType

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    Unnamed question [type of involvement]
    Beschreibung

    DiseaseInvolvementType

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    Unnamed question [type of involvement]
    Beschreibung

    DiseaseInvolvementType

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    SPINAL CORD [involved?]
    Beschreibung

    SpinalCordInvolvementInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    SPINAL CORD [indicate sites involved]
    Beschreibung

    SpinalCordInvolvedSite

    Datentyp

    text

    Alias
    NCI Metathesaurus Property
    CL111053
    specify [other spinal cord site] (If 1, 2 or 3)
    Beschreibung

    SpinalCordInvolvedSiteSpecify

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Metathesaurus Property
    CL111053
    DURA [involved?] (Incl. Falx and Tentorium)
    Beschreibung

    DuraInvolvementInd-3

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    DURA [indicate sites involved]
    Beschreibung

    DuraInvolvementType

    Datentyp

    text

    Alias
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    Was CSF positive?
    Beschreibung

    CerebrospinalFluidInvolvementInd

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C12692
    UMLS 2011AA ObjectClass
    C0007806
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    Unnamed3
    Beschreibung

    Unnamed3

    Comments
    Beschreibung

    ResearchCommentsText

    Datentyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    UMLS 2011AA Property
    C0282411
    Ccrr Module For Acns0122: Relapse/progression Worksheet
    Beschreibung

    Ccrr Module For Acns0122: Relapse/progression Worksheet

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    1 Formulare
    1. StudyEvent: ACNS0122: Relapse/Progression Worksheet
      1. No Instruction available.
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datentyp
    Alias
    Item Group
    Unnamed1
    InstitutionName
    Item
    Institution Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C21541 (NCI Thesaurus ObjectClass)
    C0018704 (UMLS 2011AA ObjectClass)
    C21541 (NCI Thesaurus ValueDomain)
    C0018704 (UMLS 2011AA ValueDomain)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    ResponsiblePersonName
    Item
    Institution Personnel
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25657 (NCI Thesaurus ObjectClass)
    C1273518 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    PatientBirthDate
    Item
    Date of Birth
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25367 (NCI Thesaurus ValueDomain)
    C25155 (NCI Thesaurus Property)
    C0005615 (UMLS 2011AA Property)
    ProtocolCOGIdentifierNumber
    Item
    COG Study No
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25320 (NCI Thesaurus ObjectClass)
    C1507394 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    PatientCOGIdentifierNumber
    Item
    COG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C39353 (NCI Thesaurus Property)
    C1516477 (UMLS 2011AA Property)
    PatientAccessionNumber
    Item
    Patient Accession Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25402 (NCI Thesaurus Property)
    C1510755 (UMLS 2011AA Property)
    FormOriginalCompleteDate
    Item
    Form Original Complete Date
    date
    C19464 (NCI Thesaurus ObjectClass)
    C0376315 (UMLS 2011AA ObjectClass)
    C25250 (NCI Thesaurus Property)
    C0205197 (UMLS 2011AA Property)
    C25604 (NCI Thesaurus Property)
    C0205313 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain)
    FormAmendedCompleteDate
    Item
    Date From Amended
    date
    C19464 (NCI Thesaurus ObjectClass)
    C0376315 (UMLS 2011AA ObjectClass)
    C25250 (NCI Thesaurus Property)
    C0205197 (UMLS 2011AA Property)
    C25416 (NCI Thesaurus Property)
    C1691222 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain)
    Item Group
    Unnamed2
    ProgressionRelapseBeginDate
    Item
    Date of relapse or progression
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25331 (NCI Thesaurus ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    Item Group
    Type Of Recurrence/progression
    Item
    Recurrence/progression of original involved sites?
    text
    C19987 (NCI Thesaurus ObjectClass)
    C0242656 (UMLS 2011AA ObjectClass)
    C67263 (NCI Thesaurus Property)
    C0205276 (UMLS 2011AA Property)
    C25509 (NCI Thesaurus Property)
    C1279901 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.1
    Code List
    Recurrence/progression of original involved sites?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Recurrence/progression in previously uninvolved neural site?
    text
    C19987 (NCI Thesaurus ObjectClass)
    C0242656 (UMLS 2011AA ObjectClass)
    C25388 (NCI Thesaurus Property)
    C1947913 (UMLS 2011AA Property)
    C25509 (NCI Thesaurus Property)
    C1279901 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.2
    Code List
    Recurrence/progression in previously uninvolved neural site?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Extra-neural recurrence/progression?
    text
    C19987 (NCI Thesaurus ObjectClass)
    C0242656 (UMLS 2011AA ObjectClass)
    C25321 (NCI Thesaurus Property)
    C0443203 (UMLS 2011AA Property)
    C25509 (NCI Thesaurus Property)
    C1279901 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.3
    Code List
    Extra-neural recurrence/progression?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item Group
    Sites Of Involvement
    Item
    Supratentorial [involved?]
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    C12923 (NCI Thesaurus ObjectClass)
    C0441938 (UMLS 2011AA ObjectClass)
    CL.4
    Code List
    Supratentorial [involved?]
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Supratentorial [indicate sites involved]
    text
    CL111053 (NCI Metathesaurus Property)
    CL.5
    Code List
    Supratentorial [indicate sites involved]
    CL Item
    Frontal Lobe (Frontal lobe)
    C12352 (NCI Thesaurus)
    C0016733 (UMLS 2011AA)
    CL Item
    Parietal Lobe (Parietal lobe)
    C12354 (NCI Thesaurus)
    C0030560 (UMLS 2011AA)
    CL Item
    Temporal Lobe (Temporal lobe)
    C12353 (NCI Thesaurus)
    C0039485 (UMLS 2011AA)
    CL Item
    Occipital Lobe (Occipital lobe)
    C12355 (NCI Thesaurus)
    C0028785 (UMLS 2011AA)
    CL Item
    Basal Ganglia-thalamus (Basal ganglia-thalamus)
    CL Item
    Hypothalamus-optic Chiasm (Hypothalamus-optic chiasm)
    CL Item
    Optic Nerve (Optic nerve)
    C12761 (NCI Thesaurus)
    C0029130 (UMLS 2011AA)
    CL Item
    Pineal (Pineal)
    CL Item
    Corpus Callosum (Corpus callosum)
    C12446 (NCI Thesaurus)
    C0010090 (UMLS 2011AA)
    CL Item
    Suprasellar (Suprasellar)
    CL095451 (NCI Metathesaurus)
    CL Item
    Lateral Ventricle (Lateral ventricle)
    C12834 (NCI Thesaurus)
    C0152279 (UMLS 2011AA)
    CL Item
    Third Ventricle (Third ventricle)
    C12827 (NCI Thesaurus)
    C0149555 (UMLS 2011AA)
    CL Item
    Aqueduct Of Sylvius (Aqueduct of sylvius)
    C32135 (NCI Thesaurus)
    C0007769 (UMLS 2011AA)
    CL Item
    Supratentorial Leptomeninges (Leptomeningeal)
    CL Item
    Other, Specify (Other)
    SupratentorialInvolvedSiteSpecify
    Item
    specify [other supratentorial site] (If 1, 2 or 3)
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    CL111053 (NCI Metathesaurus Property)
    Item
    Infratentorial [involved?]
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL211504 (NCI Metathesaurus ObjectClass)
    CL.7
    Code List
    Infratentorial [involved?]
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    Infratentorial [indicate sites involved]
    text
    CL111053 (NCI Metathesaurus Property)
    CL.8
    Code List
    Infratentorial [indicate sites involved]
    CL Item
    Midbrain (Midbrain)
    C0025462 (NCI Metathesaurus)
    CL Item
    Pons (Pons)
    C0032639 (NCI Metathesaurus)
    CL Item
    Medulla (Medulla)
    CL Item
    Dorsal Exophytic Brainstem (Dorsal exophytic brainstem)
    CL Item
    Cerebellar Peduncle (Cerebellar penducle)
    C0228515 (NCI Metathesaurus)
    CL Item
    Cerebellar Hemisphere (Cerebellar hemisphere)
    C0228465 (NCI Metathesaurus)
    CL Item
    Cerebellar Vermis (Cerebellar vermis)
    CL Item
    Fourth Ventricle (Fourth ventricle)
    C12828 (NCI Thesaurus)
    C0149556 (UMLS 2011AA)
    CL Item
    Cisterna Magna (Cisterna magna)
    C32324 (NCI Thesaurus)
    C0008841 (UMLS 2011AA)
    CL Item
    Infratentorial Leptomeninges (Leptomeningeal)
    CL Item
    Other, Specify (Other)
    InfratentorialInvolvedSiteSpecify
    Item
    specify [other infratentorial site] (If 1, 2 or 3)
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    CL111053 (NCI Metathesaurus Property)
    Item
    Unnamed question [type of involvement]
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.15
    Code List
    Unnamed question [type of involvement]
    CL Item
    Recurrence/progressive Disease (Recurrence/Progressive disease)
    CL Item
    New Tumor/lesion Site (New tumor site)
    CL Item
    Existing/non-progressive Tumor (Existing/Non-progressive tumor)
    CL Item
    Uninvolved (uninvolved)
    Item
    Unnamed question [type of involvement]
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.15
    Code List
    Unnamed question [type of involvement]
    CL Item
    Recurrence/progressive Disease (Recurrence/Progressive disease)
    CL Item
    New Tumor/lesion Site (New tumor site)
    CL Item
    Existing/non-progressive Tumor (Existing/Non-progressive tumor)
    CL Item
    Uninvolved (uninvolved)
    Item
    Unnamed question [type of involvement]
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.15
    Code List
    Unnamed question [type of involvement]
    CL Item
    Recurrence/progressive Disease (Recurrence/Progressive disease)
    CL Item
    New Tumor/lesion Site (New tumor site)
    CL Item
    Existing/non-progressive Tumor (Existing/Non-progressive tumor)
    CL Item
    Uninvolved (uninvolved)
    Item
    Unnamed question [type of involvement]
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.15
    Code List
    Unnamed question [type of involvement]
    CL Item
    Recurrence/progressive Disease (Recurrence/Progressive disease)
    CL Item
    New Tumor/lesion Site (New tumor site)
    CL Item
    Existing/non-progressive Tumor (Existing/Non-progressive tumor)
    CL Item
    Uninvolved (uninvolved)
    Item
    SPINAL CORD [involved?]
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.10
    Code List
    SPINAL CORD [involved?]
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    SPINAL CORD [indicate sites involved]
    text
    CL111053 (NCI Metathesaurus Property)
    CL.11
    Code List
    SPINAL CORD [indicate sites involved]
    CL Item
    Cervical (Cervical)
    C12844 (NCI Thesaurus)
    C0205064 (UMLS 2011AA)
    CL Item
    Thoracic Lumbosacral (Thoracic)
    CL Item
    Conus (Conus)
    C0598489 (NCI Metathesaurus)
    CL Item
    Cauda Equina (Cauda equina)
    C12689 (NCI Thesaurus)
    C0007458 (UMLS 2011AA)
    CL Item
    Spinal Cord Leptomeninges (Leptomeningeal)
    CL Item
    Other, Specify (Other)
    SpinalCordInvolvedSiteSpecify
    Item
    specify [other spinal cord site] (If 1, 2 or 3)
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    CL111053 (NCI Metathesaurus Property)
    Item
    DURA [involved?] (Incl. Falx and Tentorium)
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.13
    Code List
    DURA [involved?] (Incl. Falx and Tentorium)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item
    DURA [indicate sites involved]
    text
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.14
    Code List
    DURA [indicate sites involved]
    CL Item
    Nodular (Nodular)
    CL Item
    Diffuse (Diffuse)
    C14175 (NCI Thesaurus)
    C0205219 (UMLS 2011AA)
    Item
    Was CSF positive?
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C12692 (NCI Thesaurus ObjectClass)
    C0007806 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    CL.16
    Code List
    Was CSF positive?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Not done/Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Item Group
    Unnamed3
    ResearchCommentsText
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    C0282411 (UMLS 2011AA Property)
    Item Group
    Ccrr Module For Acns0122: Relapse/progression Worksheet
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