ID

6471

Beskrivning

Phase II Consortium - PHASE II LUNG CANCER - TREATMENT BY CYCLE SUMMARY FORM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF93BE54-D125-5058-E034-0003BA3F9857

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF93BE54-D125-5058-E034-0003BA3F9857

Nyckelord

Versioner (2)
  1. 2012-09-19 2012-09-19 -
  2. 2014-12-30 2014-12-30 - Martin Dugas
Uppladdad den

30 december 2014

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0 Legacy
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Treatment - PHASE II LUNG CANCER ¿ TREATMENT BY CYCLE SUMMARY FORM - 2400140v1.0

Engelsk

No Instruction available.

1 Formulär  
  1. StudyEvent: PHASE II LUNG CANCER TREATMENT BY CYCLE SUMMARY FORM
    1. No Instruction available.
CRF Header
Beskrivning

CRF Header

Alias
UMLS CUI-1
C1320722
Coordinating Group Protocol No.
Beskrivning

Protocol ID Coordinating Group

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1711341
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Coordinating Group Code
Beskrivning

Coordinating Group Code

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI-1
C1711341
NCI Thesaurus ObjectClass
C17005
UMLS CUI-2
C0805701
NCI Thesaurus ObjectClass-2
C25462
NCI Thesaurus Property
C25364
Protocol Title
Beskrivning

Protocol Title

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ObjectClass
C25320
NCI Thesaurus Property
C42774
UMLS CUI-1
C2986303
Patient Study ID
Beskrivning

Patient Study ID

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
UMLS CUI-1
C2348585
Registering Group Code
Beskrivning

Registering Group Code

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI-1
C2347449
NCI Thesaurus ObjectClass
C17005
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass-2
C25645
Patient Medical Record Number
Beskrivning

Medical Record Number

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301894
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25261
NCI Thesaurus Property-2
C25198
Other Patient ID
Beskrivning

Trial subject ID Participating Group

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Institution/Affiliate
Beskrivning

Institution Name

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Registering Institution Code
Beskrivning

Registering Institution Code

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass-2
C25645
Physician of Record
Beskrivning

Investigator Name

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2826892
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C17089
NCI Thesaurus ObjectClass-2
C25644
Person Completing Form
Beskrivning

Person Completing Form

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Date Form Completed
Beskrivning

Date Form Completed

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1115437
NCI Thesaurus ObjectClass
C40988
NCI Thesaurus Property
C25250
NCI Thesaurus ValueDomain-2
C25367
Are data amended (If data are amended, please circle in red when using paper form)
Beskrivning

Data amended

Datatyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
UMLS CUI-1
C0680532
Treatment Plan
Beskrivning

Treatment Plan

Alias
UMLS CUI-1
C0599880
Cycle Number
Beskrivning

Cycle Number

Datatyp

integer

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2045829
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25379
Body Surface Area (m^2)
Beskrivning

Body Surface Area

Datatyp

float

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0005902
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25157
First Date (any modality of) protocol therapy was given (for this cycle)
Beskrivning

Treatment Start Date

Datatyp

date

Alias
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus ObjectClass-2
C25509
UMLS CUI-1
C3173309
NCI Thesaurus Property
C25431
NCI Thesaurus Property-2
C25275
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25431
Last Date (any modality of) protocol therapy was given (for this cycle)
Beskrivning

Treatment End Date

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1531784
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25275
NCI Thesaurus Property-2
C25496
Agent Delayed
Beskrivning

Agent Delayed

Datatyp

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus Property
C25477
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property-2
C25409
UMLS CUI-1
C1521826
UMLS CUI-2
C0205421
Reason Cycle was Delayed
Beskrivning

Reasons for treatment delay

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C1298642
NCI Thesaurus Property
C25477
NCI Thesaurus Property-2
C25472
NCI Thesaurus ObjectClass
C15368
Concomitant Medications
Beskrivning

Concomitant Medications

Alias
UMLS CUI-1
C2347852
Were concomitant medications used during this cycle? (including alternative medicines)
Beskrivning

Concomitant Medication used

Datatyp

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ObjectClass-2
C25730
NCI Thesaurus Property
C25382
UMLS CUI-1
C2347852
UMLS CUI-2
C1521801
Reason for Administration
Beskrivning

Concomitant Medication Use Indication

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C459
UMLS CUI-1
C2826696
NCI Thesaurus ObjectClass-2
C25730
NCI Thesaurus Property
C25382
NCI Thesaurus ValueDomain
C25704
NCI Thesaurus ValueDomain-2
C25638
Concomitant Agent Name
Beskrivning

Concomitant Agent

Datatyp

text

Alias
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ValueDomain
C1708
NCI Thesaurus ValueDomain-2
C42614
UMLS CUI-1
C2347852
Was growth factor administered?
Beskrivning

GrowthFactorAdministeredInd-3

Datatyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus ObjectClass
C20424
NCI Thesaurus Property
C25382
UMLS CUI-1
C0018284
UMLS CUI-2
C1521801
Specify growth factor
Beskrivning

Specify growth factor

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0018284
NCI Thesaurus ObjectClass
C20424
UMLS CUI-2
C2360065
NCI Thesaurus ObjectClass-2
C25590
NCI Thesaurus Property
C25382
Radiation Therapy
Beskrivning

Radiation Therapy

Alias
UMLS CUI-1
C1522449
Has the patient received radiation therapy?
Beskrivning

PatientRadiationTherapyReceivedInd-2

Datatyp

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C15313
NCI Thesaurus Property-2
C25639
UMLS CUI-1
C1522449
UMLS CUI-2
C1514756
Specify reason
Beskrivning

Reason for no radiation therapy

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25638
UMLS CUI-1
C3846110
NCI Thesaurus ObjectClass
C15313
UMLS CUI-2
C0566251
NCI Thesaurus Property
C25382
NCI Metathesaurus Property
CL052458
Radiation Therapy Start Date
Beskrivning

Radiation Therapy Start Date

Datatyp

date

Alias
NCI Thesaurus ObjectClass
C15313
UMLS CUI-1
C1522449
NCI Thesaurus Property
C25431
UMLS CUI-2
C0808070
NCI Thesaurus Property-2
C25275
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
Radiation Therapy End Date
Beskrivning

Radiation Therapy End Date

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1522449
NCI Thesaurus ObjectClass
C15313
UMLS CUI-2
C0806020
NCI Thesaurus Property
C25275
NCI Thesaurus Property-2
C25496
RT Administered Type
Beskrivning

Radiation Therapy Type

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C1522449
NCI Thesaurus ObjectClass
C15313
UMLS CUI-2
C0683312
NCI Thesaurus Property
C25382
Other, specify
Beskrivning

Radiation Therapy, other

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C0436308
NCI Thesaurus ObjectClass
C15313
NCI Thesaurus Property
C25382
Radiation Therapy Site
Beskrivning

Radiation Therapy Body Site

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1997599
NCI Thesaurus Property
C25341
NCI Thesaurus ObjectClass
C15313
RT Total Dose
Beskrivning

Radiation Therapy Total Dose

Datatyp

float

Alias
NCI Thesaurus ValueDomain
C25304
UMLS CUI-1
C2169193
NCI Thesaurus ObjectClass
C15313
NCI Thesaurus ValueDomain-2
C25488
NCI Thesaurus Property
C25382
Were there any unscheduled interruptions in radiation therapy?
Beskrivning

Unscheduled Interruptions in Radiation Therapy

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1522449
NCI Thesaurus ObjectClass
C15313
UMLS CUI-2
C1512900
NCI Thesaurus Property
C25542
Specify RT interruption reason
Beskrivning

Radiation Therapy Interruption Reason

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C15313
UMLS CUI-1
C1522449
NCI Thesaurus Property
C25594
UMLS CUI-2
C3538832
NCI Thesaurus Property-2
C25211
NCI Thesaurus Property-3
C25542
NCI Thesaurus ValueDomain
C25685
Systemic Therapy
Beskrivning

Systemic Therapy

Alias
UMLS CUI-1
C1515119
No. of Prior Regimens
Beskrivning

Number of Prior Regimens

Datatyp

integer

Alias
NCI Thesaurus ObjectClass
C25629
UMLS CUI-1
C0750480
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus ValueDomain
C25463
UMLS CUI-2
C0040808
NCI Thesaurus Property
C15697
UMLS CUI-3
C0332152
Type of Systemic Therapy (check all that apply)
Beskrivning

Systemic Therapy Type

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C1515119
NCI Thesaurus ObjectClass
C15698
UMLS CUI-2
C0683312
NCI Thesaurus Property
C25365
Other specify
Beskrivning

Therapy Name

Datatyp

text

Alias
NCI Thesaurus Property
C25364
UMLS CUI-1
C2826274
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus ValueDomain
C42614
Concomitant Agent Name
Beskrivning

Concomitant Agent

Datatyp

text

Alias
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ValueDomain
C1708
NCI Thesaurus ValueDomain-2
C42614
UMLS CUI-1
C2347852
Agent Start Date
Beskrivning

Concomitant Medication Start Date

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2826734
NCI Thesaurus ValueDomain-2
C25431
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property
C25275
Agent End Date
Beskrivning

Concomitant Medication End Date

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2826744
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property
C25275
Agent Total Dose
Beskrivning

Agent Total Dose

Datatyp

float

Alias
NCI Thesaurus ValueDomain
C25304
UMLS CUI-1
C2986497
NCI Thesaurus Property
C25379
NCI Thesaurus ValueDomain-2
C25488
NCI Thesaurus ObjectClass
C1708
Units
Beskrivning

Units

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C1519795
NCI Thesaurus ValueDomain-2
C44278
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property
C25256
Overall Response Duration (weeks)
Beskrivning

Overall Response Duration

Datatyp

integer

Alias
NCI Thesaurus ObjectClass
C25755
UMLS CUI-1
C0237585
NCI Thesaurus Property
C25605
NCI Thesaurus Property-2
C25275
NCI Thesaurus ValueDomain
C25605
NCI Thesaurus ValueDomain-2
C25330
Were there any dose modifications or additions/omissions to protocol treatment? (check one)
Beskrivning

Dose Modification

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1707811
NCI Thesaurus ObjectClass
C25256
NCI Thesaurus Property
C25572
NCI Thesaurus ValueDomain-2
C25572
Name of Therapy (If yes,)
Beskrivning

Therapy Modification

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1299575
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25572
Reason for Therapy Modification
Beskrivning

Reason for Therapy Modification

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25638
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25572
UMLS CUI-1
C1299575
UMLS CUI-2
C0392360
Comments
Beskrivning

Comments

Alias
UMLS CUI-1
C0947611
Comments
Beskrivning

Research Comments

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Tillbaka till toppen

Similar models

No Instruction available.

1 Formulär
  1. StudyEvent: PHASE II LUNG CANCER TREATMENT BY CYCLE SUMMARY FORM
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
CRF Header
C1320722 (UMLS CUI-1)
Protocol ID Coordinating Group
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1711341 (UMLS CUI-2)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Coordinating Group Code
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C1711341 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25462 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Protocol Title
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus Property)
C2986303 (UMLS CUI-1)
Patient Study ID
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
Registering Group Code
Item
Registering Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C2347449 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25645 (NCI Thesaurus ObjectClass-2)
Medical Record Number
Item
Patient Medical Record Number
text
C25337 (NCI Thesaurus ValueDomain)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
Trial subject ID Participating Group
Item
Other Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Registering Institution Code
Item
Registering Institution Code
text
C25162 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25645 (NCI Thesaurus ObjectClass-2)
Investigator Name
Item
Physician of Record
text
C25191 (NCI Thesaurus ValueDomain)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Date Form Completed
Item
Date Form Completed
date
C25164 (NCI Thesaurus ValueDomain)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
Data amended
Item
Are data amended (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
Item Group
Treatment Plan
C0599880 (UMLS CUI-1)
Cycle Number
Item
Cycle Number
integer
C25337 (NCI Thesaurus ValueDomain)
C2045829 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
Body Surface Area
Item
Body Surface Area (m^2)
float
C25209 (NCI Thesaurus ValueDomain)
C0005902 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25157 (NCI Thesaurus Property)
Treatment Start Date
Item
First Date (any modality of) protocol therapy was given (for this cycle)
date
C15368 (NCI Thesaurus ObjectClass)
C25509 (NCI Thesaurus ObjectClass-2)
C3173309 (UMLS CUI-1)
C25431 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
Treatment End Date
Item
Last Date (any modality of) protocol therapy was given (for this cycle)
date
C25164 (NCI Thesaurus ValueDomain)
C1531784 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C25496 (NCI Thesaurus Property-2)
Agent Delayed
Item
Agent Delayed
boolean
C38147 (NCI Thesaurus ValueDomain)
C25477 (NCI Thesaurus Property)
C1708 (NCI Thesaurus ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1521826 (UMLS CUI-1)
C0205421 (UMLS CUI-2)
Reasons for treatment delay
Item
Reason Cycle was Delayed
text
C25704 (NCI Thesaurus ValueDomain)
C1298642 (UMLS CUI-1)
C25477 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)
Item Group
Concomitant Medications
C2347852 (UMLS CUI-1)
Concomitant Medication used
Item
Were concomitant medications used during this cycle? (including alternative medicines)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C25730 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C2347852 (UMLS CUI-1)
C1521801 (UMLS CUI-2)
Concomitant Medication Use Indication
Item
Reason for Administration
text
C459 (NCI Thesaurus ObjectClass)
C2826696 (UMLS CUI-1)
C25730 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C25704 (NCI Thesaurus ValueDomain)
C25638 (NCI Thesaurus ValueDomain-2)
Concomitant Agent
Item
Concomitant Agent Name
text
C25364 (NCI Thesaurus Property)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C2347852 (UMLS CUI-1)
Growth factor administered
Item
Was growth factor administered?
boolean
C38148 (NCI Thesaurus ValueDomain)
C20424 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C0018284 (UMLS CUI-1)
C1521801 (UMLS CUI-2)
Specify growth factor
Item
Specify growth factor
text
C25704 (NCI Thesaurus ValueDomain)
C0018284 (UMLS CUI-1)
C20424 (NCI Thesaurus ObjectClass)
C2360065 (UMLS CUI-2)
C25590 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
Item Group
Radiation Therapy
C1522449 (UMLS CUI-1)
Patient received radiation therapy
Item
Has the patient received radiation therapy?
boolean
C38147 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C15313 (NCI Thesaurus Property)
C25639 (NCI Thesaurus Property-2)
C1522449 (UMLS CUI-1)
C1514756 (UMLS CUI-2)
Reason for no radiation therapy
Item
Specify reason
text
C25638 (NCI Thesaurus ValueDomain)
C3846110 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25382 (NCI Thesaurus Property)
CL052458 (NCI Metathesaurus Property)
Radiation Therapy Start Date
Item
Radiation Therapy Start Date
date
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS CUI-1)
C25431 (NCI Thesaurus Property)
C0808070 (UMLS CUI-2)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Radiation Therapy End Date
Item
Radiation Therapy End Date
date
C25164 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C0806020 (UMLS CUI-2)
C25275 (NCI Thesaurus Property)
C25496 (NCI Thesaurus Property-2)
Item
RT Administered Type
text
C25284 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C0683312 (UMLS CUI-2)
C25382 (NCI Thesaurus Property)
CL.6
Code List
RT Administered Type
CL Item
Brachytherapy (Brachytherapy)
CL054378 (NCI Metathesaurus)
CL Item
Adjuvant (Adjuvant RT)
C25722 (NCI Thesaurus)
C1522673 (UMLS 2011AA)
CL Item
External Beam Radiation (External beam radiation)
CL Item
Neoadjuvant (Neoadjuvant RT)
CL Item
Other (Other specify)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
C17649 (NCI Thesaurus-3)
C0205394 (UMLS 2011AA-4)
Radiation Therapy, other
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C0436308 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
Radiation Therapy Body Site
Item
Radiation Therapy Site
text
C25191 (NCI Thesaurus ValueDomain)
C1997599 (UMLS CUI-1)
C25341 (NCI Thesaurus Property)
C15313 (NCI Thesaurus ObjectClass)
Radiation Therapy Total Dose
Item
RT Total Dose
float
C25304 (NCI Thesaurus ValueDomain)
C2169193 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C25488 (NCI Thesaurus ValueDomain-2)
C25382 (NCI Thesaurus Property)
Item
Were there any unscheduled interruptions in radiation therapy?
text
C25180 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C1512900 (UMLS CUI-2)
C25542 (NCI Thesaurus Property)
CL.7
Code List
Were there any unscheduled interruptions in radiation therapy?
CL Item
Yes, Due To Toxicity (Yes, due to toxicity)
CL Item
Yes, For Other Reasons, Specify (Yes, for other reasons, specify)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Radiation Therapy Interruption Reason
Item
Specify RT interruption reason
text
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS CUI-1)
C25594 (NCI Thesaurus Property)
C3538832 (UMLS CUI-2)
C25211 (NCI Thesaurus Property-2)
C25542 (NCI Thesaurus Property-3)
C25685 (NCI Thesaurus ValueDomain)
Item Group
Systemic Therapy
C1515119 (UMLS CUI-1)
Number of Prior Regimens
Item
No. of Prior Regimens
integer
C25629 (NCI Thesaurus ObjectClass)
C0750480 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C25463 (NCI Thesaurus ValueDomain)
C0040808 (UMLS CUI-2)
C15697 (NCI Thesaurus Property)
C0332152 (UMLS CUI-3)
Item
Type of Systemic Therapy (check all that apply)
text
C25284 (NCI Thesaurus ValueDomain)
C1515119 (UMLS CUI-1)
C15698 (NCI Thesaurus ObjectClass)
C0683312 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
CL.8
Code List
Type of Systemic Therapy (check all that apply)
CL Item
Chemotherapy (Chemotherapy)
C15632 (NCI Thesaurus)
C0392920 (UMLS 2011AA)
CL Item
Immunotherapy (Immunotherapy)
C15262 (NCI Thesaurus)
C0021083 (UMLS 2011AA)
CL Item
Other Specify (Other)
Therapy Name
Item
Other specify
text
C25364 (NCI Thesaurus Property)
C2826274 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C42614 (NCI Thesaurus ValueDomain)
Concomitant Agent
Item
Concomitant Agent Name
text
C25364 (NCI Thesaurus Property)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C2347852 (UMLS CUI-1)
Concomitant Medication Start Date
Item
Agent Start Date
date
C25164 (NCI Thesaurus ValueDomain)
C2826734 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Concomitant Medication End Date
Item
Agent End Date
date
C25164 (NCI Thesaurus ValueDomain)
C2826744 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Agent Total Dose
Item
Agent Total Dose
float
C25304 (NCI Thesaurus ValueDomain)
C2986497 (UMLS CUI-1)
C25379 (NCI Thesaurus Property)
C25488 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
Units
Item
Units
text
C25704 (NCI Thesaurus ValueDomain)
C1519795 (UMLS CUI-1)
C44278 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
C25256 (NCI Thesaurus Property)
Overall Response Duration
Item
Overall Response Duration (weeks)
integer
C25755 (NCI Thesaurus ObjectClass)
C0237585 (UMLS CUI-1)
C25605 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C25605 (NCI Thesaurus ValueDomain)
C25330 (NCI Thesaurus ValueDomain-2)
Item
Were there any dose modifications or additions/omissions to protocol treatment? (check one)
text
C25180 (NCI Thesaurus ValueDomain)
C1707811 (UMLS CUI-1)
C25256 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C25572 (NCI Thesaurus ValueDomain-2)
CL.9
Code List
Were there any dose modifications or additions/omissions to protocol treatment? (check one)
CL Item
Yes, Planned (i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned)
CL Item
Yes, Unplanned (i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Therapy Modification
Item
Name of Therapy (If yes,)
text
C25191 (NCI Thesaurus ValueDomain)
C1299575 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
Reason for Therapy Modification
Item
Reason for Therapy Modification
text
C25638 (NCI Thesaurus ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C1299575 (UMLS CUI-1)
C0392360 (UMLS CUI-2)
Item Group
Comments
C0947611 (UMLS CUI-1)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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