Description:

E5103 ECOG Off-Treatment Form Doxorubicin, Cyclophosphamide, and Paclitaxel With or Without Bevacizumab in Treating Patients With Lymph Node-Positive or High-Risk, Lymph Node-Negative Breast Cancer NCT00433511 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=22B14F38-F180-6454-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=22B14F38-F180-6454-E044-0003BA3F9857

Keywords:
Versions (2) ▾
  1. 8/26/12
  2. 1/7/15
Uploaded on:

January 7, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00433511 Off Treatment - E5103 ECOG Off-Treatment Form - 2544731v1.0

INSTRUCTIONS: After patient is off treatment, complete this form for each required follow-up report period (see forms submission schedule).

Header
Reporting Period
Vital Status
Patient's Vital Status
Primary Cause of Death (if applicable)
Treatment
Did patient receive protocol therapy?
Reason Treatment Ended
Reason treatment never started

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