ID
7826
Beschrijving
E1208 Treatment Form Chemoembolization With or Without Sorafenib Tosylate in Treating Patients With Liver Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6FCB9730-7048-93EE-E040-BB89AD434904
Link
Trefwoorden
Versies (4)
- 19-09-12 19-09-12 -
- 08-01-15 08-01-15 - Martin Dugas
- 09-01-15 09-01-15 - Martin Dugas
- 16-06-15 16-06-15 -
Geüploaded op
9 januari 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Liver Cancer NCT01004978 Treatment - E1208 Treatment Form - 2924404v1.0
INSTRUCTIONS: Complete this form at the end of each cycle. Submit original to the ECOG Coordinating Center. Keep a copy for your files
Beschrijving
Header
Beschrijving
Protocol Number ECOG
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Beschrijving
Generic drug form
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C3242750
- NCI Thesaurus Property
- C19464
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus ObjectClass-2
- C25452
Beschrijving
Registration Number
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1514821
- NCI Thesaurus ObjectClass
- C25646
- UMLS CUI-2
- C0237753
- NCI Thesaurus Property
- C16154
- NCI Thesaurus ValueDomain-2
- C16154
Beschrijving
Cycle number
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25214
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ObjectClass
- C15368
Beschrijving
Patient ID ECOG
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Beschrijving
Chemotherapy cycle
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25214
- UMLS CUI-1
- C1302181
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ValueDomain
- C25685
- NCI Thesaurus ValueDomain-2
- C25472
- NCI Thesaurus ValueDomain-3
- C25275
Beschrijving
Unnamed4
Beschrijving
Data amended
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Beschrijving
Data amended date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
Vital Status
Beschrijving
Patient Status
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C3846084
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
Beschrijving
Date last contact
Datatype
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C0805839
- NCI Thesaurus Property
- C25461
- NCI Thesaurus Property-2
- C25551
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
Primary Cause of Death
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C28554
- NCI Thesaurus ValueDomain-2
- C25251
Beschrijving
Cause of Death, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1521902
- NCI Thesaurus Property
- C28554
Beschrijving
Patient Characteristics
Beschrijving
Reporting Period Start Date
Datatype
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25616
- UMLS CUI-1
- C2361257
- NCI Thesaurus Property-2
- C25651
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Beschrijving
Reporting Period End Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2361259
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25651
Beschrijving
ECOG Performance Status
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
Beschrijving
Patient Weight
Datatype
float
Maateenheden
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Beschrijving
Body Surface Area
Datatype
float
Maateenheden
- m2
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS CUI-1
- C0005902
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property
- C25157
Beschrijving
Bilirubin, Total ULN
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201913
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C38037
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Beschrijving
LaboratoryProcedureTotalBilirubinResultValue
Datatype
float
Maateenheden
- mg/dL
Alias
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property-2
- C38037
- UMLS 2011AA Property-2
- C0201913
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beschrijving
Therapy Administered - Section I
Beschrijving
Concomitant Medication Start Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2826734
- NCI Thesaurus ValueDomain-2
- C25431
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25275
Beschrijving
Concomitant Medication End Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2826744
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25275
Beschrijving
Patient Diary complete
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C3259162
- NCI Thesaurus Property
- C25250
- NCI Metathesaurus ObjectClass
- C0030705
Beschrijving
AgentDailyQuantityPrescriptionDose
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property-2
- C28180
- UMLS 2011AA Property-2
- C1521941
- NCI Thesaurus Property-3
- C25256
- UMLS 2011AA Property-3
- C1265611
- NCI Thesaurus ValueDomain
- C25488
- UMLS 2011AA ValueDomain
- C0178602
Beschrijving
DoseModificationDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25488
- UMLS 2011AA ObjectClass
- C0178602
- NCI Thesaurus Property
- C25572
Beschrijving
DoseModificationDailyDose
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25473
- UMLS 2011AA ValueDomain
- C0332173
- NCI Thesaurus ObjectClass
- C25488
- UMLS 2011AA ObjectClass
- C0178602
- NCI Thesaurus ValueDomain-2
- C25488
- UMLS 2011AA ValueDomain-2
- C0178602
- NCI Thesaurus Property
- C25572
Beschrijving
Dose Modification Reason
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C0392360
- NCI Thesaurus Property
- C25572
Beschrijving
Dose Modification Reason, other
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C3840932
- NCI Thesaurus Property
- C25572
Beschrijving
Tace Administration
Beschrijving
Agent administered during reporting period
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C0450442
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property
- C25382
Beschrijving
Agent Administered Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0450442
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property
- C25382
- UMLS CUI-3
- C0011008
Beschrijving
Agent
Datatype
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
Beschrijving
Medication Dose
Datatype
float
Alias
- NCI Thesaurus ValueDomain
- C25488
- UMLS CUI-1
- C3174092
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain-2
- C1708
- NCI Thesaurus Property
- C25382
Beschrijving
AgentNotAdministeredText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property-2
- C25409
- UMLS 2011AA Property-2
- C1533734
Beschrijving
TherapyArteryChemoembolizationAdministrationType
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C12372
- UMLS 2011AA Property
- C0003842
- NCI Thesaurus Property-2
- C25409
- UMLS 2011AA Property-2
- C1533734
- NCI Thesaurus Property-3
- C15752
- UMLS 2011AA Property-3
- C0796679
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beschrijving
Section E: Non-protocol Therapy
Beschrijving
Non-protocol therapy
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-1
- C1518384
- NCI Thesaurus ObjectClass-2
- C16212
- UMLS CUI-2
- C0087111
- NCI Thesaurus Property
- C25320
- NCI Thesaurus Property-2
- C49236
- NCI Thesaurus Property-3
- C25456
- NCI Thesaurus Property-4
- C25382
- NCI Thesaurus ValueDomain
- C38148
Beschrijving
Comments
Beschrijving
Investigator Signature
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Beschrijving
Investigator Signature Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
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INSTRUCTIONS: Complete this form at the end of each cycle. Submit original to the ECOG Coordinating Center. Keep a copy for your files
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C25491 (NCI Thesaurus Property-2)
C25214 (NCI Thesaurus Property)
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C25685 (NCI Thesaurus ValueDomain)
C25472 (NCI Thesaurus ValueDomain-2)
C25275 (NCI Thesaurus ValueDomain-3)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
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C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C3846084 (UMLS CUI-1)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
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C25616 (NCI Thesaurus Property)
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C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
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C25651 (NCI Thesaurus Property-2)
C1520224 (UMLS CUI-1)
C25367 (NCI Thesaurus Property)
C25491 (NCI Thesaurus ValueDomain-2)
C20641 (NCI Thesaurus ObjectClass)
C0005910 (UMLS CUI-1)
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C25208 (NCI Thesaurus Property)
C0005902 (UMLS CUI-1)
C25712 (NCI Thesaurus ValueDomain)
C25157 (NCI Thesaurus Property)
C0201913 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C38037 (NCI Thesaurus Property-2)
C0201913 (UMLS 2011AA Property-2)
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C0178602 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain-2)
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C25572 (NCI Thesaurus Property)
C1707811 (UMLS CUI-1)
C25488 (NCI Thesaurus ObjectClass)
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