ID
7024
Description
North Central Cancer Treatment Group N0577 Concurrent Steroid and Anticonvulsant Treatment Form - Active Monitoring Phase Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C07E8C3-32D4-293D-E044-0003BA3F9857
Link
Keywords
Versions (2)
- 8/26/12 8/26/12 -
- 1/8/15 1/8/15 - Martin Dugas
Uploaded on
January 8, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Brain and Central Nervous System Tumors NCT00887146 Treatment - North Central Cancer Treatment Group N0577 Concurrent Steroid and Anticonvulsant Treatment Form - Active Monitoring Phase - 2745245v1.0
ALL ITEMS MUST BE COMPLETED
- StudyEvent: North Central Cancer Treatment Group N0577 Concurrent Steroid and Anticonvulsant Treatment Form - Active Monitoring Phase
Description
Header
Description
Cycle Number Chemotherapeutics
Data type
integer
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25471
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25379
Description
Assessment Date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2985720
- NCI Thesaurus ObjectClass
- C25367
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C38000
Description
Concomitant Treatmet
Description
ConcomitantMedicationCorticosteroidAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C2322
- UMLS 2011AA Property
- C0001617
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationDexamethasoneAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C422
- UMLS 2011AA Property
- C0011777
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOtherCorticosteroidAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C2322
- UMLS 2011AA Property-2
- C0001617
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOtherCorticosteroidAdministeredSpecify
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C2322
- UMLS 2011AA Property-2
- C0001617
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Description
ConcomitantMedicationAnticonvulsantAgentAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C264
- UMLS 2011AA Property-2
- C0003286
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationGabapentinAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C1108
- UMLS 2011AA Property
- C0060926
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationPhenytoinAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C741
- UMLS 2011AA Property-2
- C0031507
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationCarbamazepineAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C341
- UMLS 2011AA Property-2
- C0006949
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationValproicAcidAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C29536
- UMLS 2011AA Property-2
- C0042291
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationPhenobarbitalAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C739
- UMLS 2011AA Property-2
- C0031412
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationLevetiracetamAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C47581
- UMLS 2011AA Property-2
- C0377265
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOtherAnticonvulsantAgentAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus Property-3
- C264
- UMLS 2011AA Property-3
- C0003286
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOtherAnticonvulsantAgentAdministeredSpecify
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus Property-3
- C264
- UMLS 2011AA Property-3
- C0003286
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Description
ConcomitantMedicationAntiemeticAgentAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C267
- UMLS 2011AA Property
- C0003297
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationProchlorperazineMaleateAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C775
- UMLS 2011AA Property-2
- C0033231
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationGranisetronAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C62031
- UMLS 2011AA Property-2
- C0061863
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOndansetronAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C1119
- UMLS 2011AA Property-2
- C0061851
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationLorazepamAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus Property-2
- C619
- UMLS 2011AA Property-2
- C0024002
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOtherAntiemeticAgentAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C267
- UMLS 2011AA Property-2
- C0003297
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ConcomitantMedicationOtherAntiemeticAgentAdministeredSpecify
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25730
- UMLS 2011AA ObjectClass-2
- C0521115
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C267
- UMLS 2011AA Property-2
- C0003297
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Description
Concomitant Medication Daily Dose
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25473
- UMLS CUI-1
- C2826638
- NCI Thesaurus ObjectClass-2
- C1708
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25488
- NCI Thesaurus ValueDomain-2
- C1708
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ALL ITEMS MUST BE COMPLETED
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C0205394 (UMLS 2011AA Property)
C267 (NCI Thesaurus Property-2)
C0003297 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C2826638 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25488 (NCI Thesaurus ValueDomain)
C1708 (NCI Thesaurus ValueDomain-2)