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

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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

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
Reason treatment never started

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