ID
7511
Description
I1 RTOG Phase III - Multiple Brain Mets Initial Evaluation Form Radiation Therapy and Stereotactic Radiosurgery With or Without Temozolomide or Erlotinib in Treating Patients With Brain Metastases Secondary to Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D81B6746-376F-61E1-E034-0003BA12F5E7
Link
Keywords
Versions (2)
- 9/19/12 9/19/12 -
- 1/9/15 1/9/15 - Martin Dugas
Uploaded on
January 9, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00096265 On-Study - I1 RTOG Phase III - Multiple Brain Mets Initial Evaluation Form - 2277804v3.0
No Instruction available.
- StudyEvent: I1 RTOG Phase III - Multiple Brain Mets Initial Evaluation Form
Description
Module 1
Description
Patient Characteristics
Description
PerformanceStatusScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C25361
- UMLS 2011AA ObjectClass
- C0597198
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
NeurologicalFunctionStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25262
- UMLS 2011AA ObjectClass
- C0205494
- NCI Thesaurus ObjectClass-2
- C25518
- UMLS 2011AA ObjectClass-2
- C0542341
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
FirstBiopsyPositiveDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C15189
- UMLS 2011AA ObjectClass
- C0005558
- NCI Thesaurus ObjectClass-2
- C25509
- UMLS 2011AA ObjectClass-2
- C1279901
- NCI Thesaurus Property
- C25246
- UMLS 2011AA Property
- C1446409
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property-2
- C2745955
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
Description
BrainTumorHistologicCategory
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C12439
- UMLS 2011AA ObjectClass-2
- C0006104
- NCI Thesaurus Property
- C25526
- UMLS 2011AA Property
- C0205462
- NCI Thesaurus Property-2
- C25161
- UMLS 2011AA Property-2
- C0008902
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
Description
BrainMetastaticInvolvementType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C14174
- UMLS 2011AA Property
- C0036525
- NCI Thesaurus ObjectClass
- C12439
- UMLS 2011AA ObjectClass
- C0006104
- NCI Thesaurus Property-2
- C25548
- UMLS 2011AA Property-2
- C1314939
Description
PriorSurgeryPerformedText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ObjectClass
- C15329
- UMLS 2011AA ObjectClass
- C0543467
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
Description
AgentTotalDose(perday)
Data type
float
Description
CorticosteroidAdministrationInd-3
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25629
- UMLS 2011AA Property
- C0332152
- NCI Thesaurus ObjectClass
- C2322
- UMLS 2011AA ObjectClass
- C0001617
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
Description
Agent
Data type
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
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
Description
Units
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C1519795
- NCI Thesaurus Property
- C25256
- NCI Thesaurus ValueDomain
- C25709
Description
LesionSiteNumber
Data type
float
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C3824
- UMLS 2011AA ObjectClass
- C0221198
- NCI Thesaurus Property
- C25341
- UMLS 2011AA Property
- C0450429
Description
Size Of Lesion(s)
Description
LesionAssessmentDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C3824
- UMLS 2011AA ObjectClass
- C0221198
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
Description
Longest Diameter of Lesion
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ObjectClass
- C3824
- UMLS CUI-1
- C0221198
- NCI Thesaurus Property
- C25285
- UMLS CUI-2
- C1301886
- NCI Thesaurus Property-2
- C25558
- UMLS CUI-3
- C1522425
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus ValueDomain-2
- C25285
Description
Longest Diameter of Lesion
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ObjectClass
- C3824
- UMLS CUI-1
- C0221198
- NCI Thesaurus Property
- C25285
- UMLS CUI-2
- C1301886
- NCI Thesaurus Property-2
- C25558
- UMLS CUI-3
- C1522425
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus ValueDomain-2
- C25285
Description
Longest Diameter of Lesion
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ObjectClass
- C3824
- UMLS CUI-1
- C0221198
- NCI Thesaurus Property
- C25285
- UMLS CUI-2
- C1301886
- NCI Thesaurus Property-2
- C25558
- UMLS CUI-3
- C1522425
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus ValueDomain-2
- C25285
Description
TumorSecondDimensionMeasurement
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS 2011AA ValueDomain
- C0242485
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25666
- UMLS 2011AA Property
- C0205436
- NCI Thesaurus Property-2
- C25483
- UMLS 2011AA Property-2
- C0439534
Description
TumorSecondDimensionMeasurement
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS 2011AA ValueDomain
- C0242485
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25666
- UMLS 2011AA Property
- C0205436
- NCI Thesaurus Property-2
- C25483
- UMLS 2011AA Property-2
- C0439534
Description
TumorSecondDimensionMeasurement
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS 2011AA ValueDomain
- C0242485
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25666
- UMLS 2011AA Property
- C0205436
- NCI Thesaurus Property-2
- C25483
- UMLS 2011AA Property-2
- C0439534
Description
Module 4
Description
Research Comments
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Description
Person Completing Form
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Description
Form Completion Date
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C19464
- UMLS CUI-1
- C1549507
- NCI Thesaurus Property
- C25250
- NCI Thesaurus Property-2
- C25604
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Similar models
No Instruction available.
- StudyEvent: I1 RTOG Phase III - Multiple Brain Mets Initial Evaluation Form
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
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C25364 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0349674 (UMLS 2011AA ValueDomain)
C25361 (NCI Thesaurus ObjectClass)
C0597198 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0205494 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus ObjectClass-2)
C0542341 (UMLS 2011AA ObjectClass-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0005558 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus ObjectClass-2)
C1279901 (UMLS 2011AA ObjectClass-2)
C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0027651 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C0001418 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C14174 (NCI Thesaurus Property)
C0036525 (UMLS 2011AA Property)
C12439 (NCI Thesaurus ObjectClass)
C0006104 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property-2)
C1314939 (UMLS 2011AA Property-2)
C1527021 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C1512699 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C2322 (NCI Thesaurus ObjectClass)
C0001617 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
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)
C1519795 (UMLS CUI-1)
C25256 (NCI Thesaurus Property)
C25709 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0221198 (UMLS CUI-1)
C25285 (NCI Thesaurus Property)
C1301886 (UMLS CUI-2)
C25558 (NCI Thesaurus Property-2)
C1522425 (UMLS CUI-3)
C25209 (NCI Thesaurus ValueDomain)
C25285 (NCI Thesaurus ValueDomain-2)
C0221198 (UMLS CUI-1)
C25285 (NCI Thesaurus Property)
C1301886 (UMLS CUI-2)
C25558 (NCI Thesaurus Property-2)
C1522425 (UMLS CUI-3)
C25209 (NCI Thesaurus ValueDomain)
C25285 (NCI Thesaurus ValueDomain-2)
C0221198 (UMLS CUI-1)
C25285 (NCI Thesaurus Property)
C1301886 (UMLS CUI-2)
C25558 (NCI Thesaurus Property-2)
C1522425 (UMLS CUI-3)
C25209 (NCI Thesaurus ValueDomain)
C25285 (NCI Thesaurus ValueDomain-2)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25666 (NCI Thesaurus Property)
C0205436 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property-2)
C0439534 (UMLS 2011AA Property-2)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25666 (NCI Thesaurus Property)
C0205436 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property-2)
C0439534 (UMLS 2011AA Property-2)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25666 (NCI Thesaurus Property)
C0205436 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property-2)
C0439534 (UMLS 2011AA Property-2)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)