Description:

ECOG Off-Treatment Form Chemotherapy With or Without Bevacizumab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer NCT00588770 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1A096316-A5E7-28A3-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1A096316-A5E7-28A3-E044-0003BA3F9857

Keywords:
Versions (2) ▾
  1. 9/19/12
  2. 1/7/15
Uploaded on:

January 7, 2015

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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Head and Neck Cancer NCT00588770 Off Treatment - ECOG Off-Treatment Form - 2502331v1.0

Details

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
Vital Status
Primary Cause of Death (if applicable)
Treatment
Did patient receive protocol therapy?
Reason Treatment Ended
4 more items in the detailed view.
Reason treatment never started
4 more items in the detailed view.
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