Unnamed2
Patient Initials
text
Protocol Number ECOG
text
Patient ID ECOG
text
Study Number Participating Group
text
Institution Name
text
Trial subject ID Participating Group
text
Unnamed3
Data amended
text
Data amended date
date
On Treatment
Cycle number
text
Off Treatment
PersonOff-TreatmentTimePeriodType
text
Unnamed4
AdverseEventCurrentAssessmentInd
text
CTCAdverseEventReportBeginDate
date
CTCAdverseEventReportEndDate
date
Unnamed5
CommonToxicityCriteriaAdverseEventTermType
text
CommonToxicityCriteriaAdverseEventGrade
float
CTCAdverseEventAttributionScale
text
Unnamed6
CommonToxicityCriteriaAdverseEventTermType
text
CommonToxicityCriteriaAdverseEventGrade
float
CTCAdverseEventAttributionScale
text
Iii. Infections
CommonToxicityCriteriaAdverseEventGrade
float
CommonToxicityCriteriaAdverseEventShortNameType
text
CTCAdverseEventAttributionScale
text
CTCAdverseEventSpecifiedTermType
text
Other Adverse Events
CommonToxicityCriteriaAdverseEventGrade
float
CTCAdverseEventAttributionScale
text
CTCAdverseEventTermSpecify
text
CTCAdverseEventClassificationSpecify
text
Comments
Investigator Signature
text
Investigator Signature Date
date