ID
6485
Descrição
CALGB: 80802 Treatment Form Sorafenib Tosylate With or Without Doxorubicin Hydrochloride in Treating Patients With Locally Advanced or Metastatic Liver Cancer NCT01015833 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=741A6270-CE1B-C531-E040-BB89AD431F2C
Link
Palavras-chave
Versões (2)
- 19/09/2012 19/09/2012 -
- 03/01/2015 03/01/2015 - Martin Dugas
Transferido a
3 de janeiro de 2015
DOI
Para um pedido faça login.
Licença
Creative Commons BY-NC 3.0 Legacy
Comentários do modelo :
Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.
Comentários do grupo de itens para :
Comentários do item para :
Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.
Treatment Form Liver Cancer CALGB 80802
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
Descrição
Treatment Data
Descrição
Cycle Number
Tipo de dados
integer
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25379
Descrição
Body Surface Area
Tipo de dados
float
Unidades de medida
- m2
Alias
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property
- C25157
- UMLS CUI-1
- C0005902
Descrição
Doxorubicin dose received this cycle
Tipo de dados
float
Alias
- NCI Thesaurus ObjectClass
- C456
- UMLS CUI-1
- C0013089
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS CUI-2
- C0178602
- NCI Thesaurus Property
- C25379
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25488
Descrição
Agent dose administered
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C0678766
- NCI Thesaurus Property
- C25616
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property-2
- C25375
- NCI Thesaurus Property-3
- C25431
- NCI Thesaurus Property-4
- C25256
- NCI Thesaurus ValueDomain
- C25488
Descrição
Drug administration method
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C0449311
- NCI Metathesaurus ObjectClass
- CL111054
- NCI Thesaurus Property
- C25409
Descrição
Doxorubicin dose reduced this cycle
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C456
- UMLS CUI-1
- C0013089
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS CUI-2
- C1707814
- NCI Thesaurus Property
- C25640
- NCI Thesaurus Property-2
- C25472
- NCI Thesaurus Property-3
- C25256
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus ValueDomain-2
- C25488
Descrição
Sorafenib dose received this cycle
Tipo de dados
float
Alias
- NCI Thesaurus ValueDomain
- C25304
- UMLS CUI-1
- C1516119
- NCI Thesaurus Property
- C25379
- UMLS CUI-2
- C0178602
- NCI Thesaurus ValueDomain-2
- C25488
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ObjectClass-2
- C61948
Descrição
Sorafenib dose reduced
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C1516119
- NCI Thesaurus ObjectClass-2
- C61948
- UMLS CUI-2
- C1707814
- NCI Thesaurus Property
- C25640
- NCI Thesaurus Property-2
- C25472
- NCI Thesaurus Property-3
- C25256
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus ValueDomain-2
- C25488
Descrição
SorafenibAgentCycleMissingDoseIndicator
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ObjectClass-2
- C61948
- NCI Thesaurus Property
- C54031
- NCI Thesaurus Property-2
- C25472
- NCI Thesaurus Property-3
- C25256
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus ValueDomain-2
- C25488
- UMLS CUI-1
- C1516119
- UMLS CUI-2
- C1709043
Descrição
SorafenibAgentNotAdministeredTotalDoseCount
Tipo de dados
integer
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ObjectClass-2
- C61948
- NCI Thesaurus Property
- C25594
- NCI Thesaurus Property-2
- C25382
- NCI Thesaurus ValueDomain
- C25463
- UMLS CUI-1
- C1516119
- UMLS CUI-2
- C0750480
- UMLS CUI-3
- C1709043
Descrição
G-CSF or GM-CSF
Tipo de dados
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0796404
- NCI Thesaurus ObjectClass
- C20586
- NCI Thesaurus Property
- C25340
Descrição
G-CSF or GM-CSF start date
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0796404
- NCI Thesaurus ObjectClass
- C20586
- UMLS CUI-2
- C0808070
- NCI Thesaurus Property
- C25340
Descrição
Protocol Deviation Description
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C1705236
- NCI Thesaurus ObjectClass
- C50996
- NCI Thesaurus Property
- C25365
Descrição
Supportive Care non-Protocol
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0344211
- NCI Thesaurus Property
- C15368
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-2
- C1518384
- NCI Thesaurus ObjectClass-2
- C37902
Descrição
Supportive Care non-Protocol, specify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0344211
- NCI Thesaurus Property
- C15368
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-2
- C1518384
- NCI Thesaurus ObjectClass-2
- C37902
- UMLS CUI-3
- C1521902
Descrição
Off Treatment Reason
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
Descrição
Off Treatment Reason, specify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
- UMLS CUI-3
- C1521902
Descrição
Alternative therapy, specify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0949216
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25415
- NCI Thesaurus Property
- C25382
Similar models
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property-2)
C1265611 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
C1302181 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C0806020 (UMLS CUI-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property-2)
C0205313 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C2045829 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C25712 (NCI Thesaurus ValueDomain)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS CUI-1)
C0013089 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C0178602 (UMLS CUI-2)
C25379 (NCI Thesaurus Property)
C25304 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C0678766 (UMLS CUI-1)
C25616 (NCI Thesaurus Property)
C1521801 (UMLS CUI-2)
C25375 (NCI Thesaurus Property-2)
C25431 (NCI Thesaurus Property-3)
C25256 (NCI Thesaurus Property-4)
C25488 (NCI Thesaurus ValueDomain)
C0449311 (UMLS CUI-1)
CL111054 (NCI Metathesaurus ObjectClass)
C25409 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA)
C0013089 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C1707814 (UMLS CUI-2)
C25640 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C25256 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C1516119 (UMLS CUI-1)
C25379 (NCI Thesaurus Property)
C0178602 (UMLS CUI-2)
C25488 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
C61948 (NCI Thesaurus ObjectClass-2)
C1516119 (UMLS CUI-1)
C61948 (NCI Thesaurus ObjectClass-2)
C1707814 (UMLS CUI-2)
C25640 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C25256 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C61948 (NCI Thesaurus ObjectClass-2)
C54031 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C25256 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1516119 (UMLS CUI-1)
C1709043 (UMLS CUI-2)
C1298908 (UMLS 2011AA)
C61948 (NCI Thesaurus ObjectClass-2)
C25594 (NCI Thesaurus Property)
C25382 (NCI Thesaurus Property-2)
C25463 (NCI Thesaurus ValueDomain)
C1516119 (UMLS CUI-1)
C0750480 (UMLS CUI-2)
C1709043 (UMLS CUI-3)
C0796404 (UMLS CUI-1)
C20586 (NCI Thesaurus ObjectClass)
C25340 (NCI Thesaurus Property)
C0796404 (UMLS CUI-1)
C20586 (NCI Thesaurus ObjectClass)
C0808070 (UMLS CUI-2)
C25340 (NCI Thesaurus Property)
C1705236 (UMLS CUI-1)
C50996 (NCI Thesaurus ObjectClass)
C25365 (NCI Thesaurus Property)
C0344211 (UMLS CUI-1)
C15368 (NCI Thesaurus Property)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS CUI-2)
C37902 (NCI Thesaurus ObjectClass-2)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0344211 (UMLS CUI-1)
C15368 (NCI Thesaurus Property)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS CUI-2)
C37902 (NCI Thesaurus ObjectClass-2)
C1521902 (UMLS CUI-3)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C1521902 (UMLS CUI-3)
C0949216 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25415 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)