ID

6308

Beskrivning

Z4032 Brachytherapy Report Surgery With or Without Internal Radiation Therapy in Treating Patients With Stage I Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F21E5540-6368-6874-E034-0003BA3F9857

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F21E5540-6368-6874-E034-0003BA3F9857

Nyckelord

Versioner (2)
  1. 2014-12-18 2014-12-18 - Martin Dugas
  2. 2015-01-09 2015-01-09 - Martin Dugas
Uppladdad den

18 december 2014

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00107172 Treatment - Z4032 Brachytherapy Report - 2306538v3.0

Engelsk

No Instruction available.

1 Formulär  
  1. StudyEvent: Z4032 Brachytherapy Report
    1. No Instruction available.
Header Module
Beskrivning

Header Module

Visit
Beskrivning

AmericanCollegeofSurgeonsOncologyGroupVisitPeriodAmericanCollegeofSurgeonsOncologyGroupVisitPeriodType

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C19712
UMLS 2011AA ObjectClass
C1515944
NCI Thesaurus ObjectClass
C25716
UMLS 2011AA ObjectClass
C0545082
Patient ID
Beskrivning

PatientCoordinatingIdentifierNumber

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Initials
Beskrivning

PatientInitialsName

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Institution No.
Beskrivning

InstitutionIdentifierNumber

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution Name
Beskrivning

InstitutionName

Datatyp

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
Unnamed1
Beskrivning

Unnamed1

Date of Procedure (OR)
Beskrivning

BrachtherapyApplicationDate

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C25397
UMLS 2011AA Property
C0185125
Not Done
Beskrivning

RadiationTherapyNotPerformedText

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15313
UMLS 2011AA ObjectClass
C1522449
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
Staple line length (CM)
Beskrivning

LungLobeExcisionSurgicalMarginMeasurement

Datatyp

double

Måttenheter
  • cm
Alias
NCI Thesaurus ObjectClass
C12468
UMLS 2011AA ObjectClass
C0024109
NCI Thesaurus ObjectClass
C13393
UMLS 2011AA ObjectClass
C0796494
NCI Thesaurus Property
C15232
UMLS 2011AA Property
C0728940
NCI Thesaurus Property
C41227
UMLS 2011AA Property
C0229985
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
cm
Brachytherapy technique (check only one box)
Beskrivning

BrachytherapyDeliveryTechniqueType

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C61560
Mesh Width (Mesh only)
Beskrivning

BrachytherapyImplantWidthMeasurement

Datatyp

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C41075
UMLS 2011AA Property
C0021102
NCI Thesaurus Property
C25345
UMLS 2011AA Property
C0487742
Mesh Length (cm)
Beskrivning

BrachytherapyImplantLengthMeasurement

Datatyp

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C41075
UMLS 2011AA Property
C0021102
NCI Thesaurus Property
C25334
UMLS 2011AA Property
C1444754
Mesh type used
Beskrivning

BrachytherapyImplantType

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C17948
UMLS 2011AA Property
C0013183
Strand distance from resection margin (double strand only)
Beskrivning

BrachytherapySeedImplantationExcisionSurgicalMarginMeasurement

Datatyp

double

Måttenheter
  • cm
Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C15232
UMLS 2011AA Property
C0728940
NCI Thesaurus Property
C41227
UMLS 2011AA Property
C0229985
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
cm
Total number of strands
Beskrivning

BrachytherapySeedImplantationAdministeredTotalNumber

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
Strand
Beskrivning

BrachytherapySeedImplantationSutureMaterialSequenceNumber

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C25673
UMLS 2011AA ValueDomain
C1519249
Length (double strand only)
Beskrivning

BrachytherapySeedImplantationMeasurement

Datatyp

double

Måttenheter
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C16219
UMLS 2011AA Property
C1519225
cm
Seeds per strand
Beskrivning

BrachytherapySeedImplantationSutureMaterialNumber

Datatyp

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Activity per strand
Beskrivning

BrachytherapySeedImplantationSuturedMaterialDose

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Total activity
Beskrivning

BrachytherapySeedImplantationSuturedMaterialTotalDose

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Total # Seeds
Beskrivning

BrachytherapySeedImplantationSutureMaterialTotalAdministrationNumber

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25409
UMLS 2011AA ValueDomain
C1533734
Total Activity (mCi)
Beskrivning

BrachytherapySeedImplantationSutureMaterialTotalAdministrationDose

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ValueDomain
C25409
UMLS 2011AA ValueDomain
C1533734
Prescription (Gy)
Beskrivning

BrachytherapySeedImplantationSutureMaterialDose

Datatyp

double

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass
C16219
UMLS 2011AA ObjectClass
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Date of post-implant CT (mm/dd/yyyy)
Beskrivning

CTPostBrachytherapyDate

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C17204
UMLS 2011AA ObjectClass
C0040405
NCI Thesaurus Property
C38008
UMLS 2011AA Property
C0687676
NCI Metathesaurus Property
CL054378
Have the 3D dosimetry images, the post implant planning CT, and Dose Volume Histograms for CTV, PTV-1 and PTV-2 been sent to Quality Assurance Review Center (copied or printed copy QARC)
Beskrivning

QualityAssuranceCenterSubmissionInd-2

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25445
UMLS 2011AA Property
C0205099
NCI Thesaurus Property
C25694
UMLS 2011AA Property
C1515022
NCI Metathesaurus ObjectClass
C0178932
Footer Module
Beskrivning

Footer Module

Completed by
Beskrivning

ResponsiblePersonName

Datatyp

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 Form Completed (mm/dd/yyyy)
Beskrivning

FormCompleteDate

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus ValueDomain
C25367
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Similar models

No Instruction available.

1 Formulär
  1. StudyEvent: Z4032 Brachytherapy Report
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Header Module
Item
Visit
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
CL.1
Code List
Visit
CL Item
Day 0 (Day 0)
PatientCoordinatingIdentifierNumber
Item
Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
InstitutionIdentifierNumber
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
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)
Item Group
Unnamed1
BrachtherapyApplicationDate
Item
Date of Procedure (OR)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25397 (NCI Thesaurus Property)
C0185125 (UMLS 2011AA Property)
RadiationTherapyNotPerformedText
Item
Not Done
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
LungLobeExcisionSurgicalMarginMeasurement
Item
Staple line length (CM)
double
C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C13393 (NCI Thesaurus ObjectClass)
C0796494 (UMLS 2011AA ObjectClass)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C41227 (NCI Thesaurus Property)
C0229985 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
Item
Brachytherapy technique (check only one box)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C61560 (NCI Thesaurus Property)
CL.2
Code List
Brachytherapy technique (check only one box)
CL Item
Mesh (Mesh)
CL Item
Double Strand (Double strand)
BrachytherapyImplantWidthMeasurement
Item
Mesh Width (Mesh only)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C41075 (NCI Thesaurus Property)
C0021102 (UMLS 2011AA Property)
C25345 (NCI Thesaurus Property)
C0487742 (UMLS 2011AA Property)
BrachytherapyImplantLengthMeasurement
Item
Mesh Length (cm)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C41075 (NCI Thesaurus Property)
C0021102 (UMLS 2011AA Property)
C25334 (NCI Thesaurus Property)
C1444754 (UMLS 2011AA Property)
Item
Mesh type used
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C17948 (NCI Thesaurus Property)
C0013183 (UMLS 2011AA Property)
CL.3
Code List
Mesh type used
CL Item
Mesh Pre-fabricated By Manufacturer (Mesh pre-fabricated by manufacturer)
CL Item
Mesh Seeds Manually Threaded (Mesh seeds manually threaded)
BrachytherapySeedImplantationExcisionSurgicalMarginMeasurement
Item
Strand distance from resection margin (double strand only)
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C41227 (NCI Thesaurus Property)
C0229985 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
BrachytherapySeedImplantationAdministeredTotalNumber
Item
Total number of strands
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
BrachytherapySeedImplantationSutureMaterialSequenceNumber
Item
Strand
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25673 (NCI Thesaurus ValueDomain)
C1519249 (UMLS 2011AA ValueDomain)
BrachytherapySeedImplantationMeasurement
Item
Length (double strand only)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus Property)
C1519225 (UMLS 2011AA Property)
BrachytherapySeedImplantationSutureMaterialNumber
Item
Seeds per strand
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
BrachytherapySeedImplantationSuturedMaterialDose
Item
Activity per strand
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
BrachytherapySeedImplantationSuturedMaterialTotalDose
Item
Total activity
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
BrachytherapySeedImplantationSutureMaterialTotalAdministrationNumber
Item
Total # Seeds
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus ValueDomain)
C1533734 (UMLS 2011AA ValueDomain)
BrachytherapySeedImplantationSutureMaterialTotalAdministrationDose
Item
Total Activity (mCi)
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus ValueDomain)
C1533734 (UMLS 2011AA ValueDomain)
BrachytherapySeedImplantationSutureMaterialDose
Item
Prescription (Gy)
double
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C16219 (NCI Thesaurus ObjectClass)
C1519225 (UMLS 2011AA ObjectClass)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
CTPostBrachytherapyDate
Item
Date of post-implant CT (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C38008 (NCI Thesaurus Property)
C0687676 (UMLS 2011AA Property)
CL054378 (NCI Metathesaurus Property)
Item
Have the 3D dosimetry images, the post implant planning CT, and Dose Volume Histograms for CTV, PTV-1 and PTV-2 been sent to Quality Assurance Review Center (copied or printed copy QARC)
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25445 (NCI Thesaurus Property)
C0205099 (UMLS 2011AA Property)
C25694 (NCI Thesaurus Property)
C1515022 (UMLS 2011AA Property)
C0178932 (NCI Metathesaurus ObjectClass)
CL.4
Code List
Have the 3D dosimetry images, the post implant planning CT, and Dose Volume Histograms for CTV, PTV-1 and PTV-2 been sent to Quality Assurance Review Center (copied or printed copy QARC)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Footer Module
ResponsiblePersonName
Item
Completed by
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)
FormCompleteDate
Item
Date Form Completed (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain)
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