GOG-0249 Follow-Up Period Adverse Event Reporting Form Pelvic Radiation Therapy or Vaginal Implant Radiation Therapy, Paclitaxel, and Carboplatin in Treating Patients With High-Risk Stage I or Stage II Endometrial Cancer Source Form: NCI FormBuilder:


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  1. 9/19/12
  2. 1/9/15
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January 9, 2015

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Creative Commons BY-NC 3.0 Legacy
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Endometrial Cancer NCT00807768 Toxicity - GOG-0249 Follow-Up Period Adverse Event Reporting Form - 2760083v1.0

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  1. StudyEvent: GOG-0249 Follow-Up Period Adverse Event Reporting Form
    1. No Instruction available.
Header Module
Adverse Events - Section 1
Are there any adverse events to report
Were adverse events assessed during most recent period
Was patient hospitalized as a result of reported adverse events? (during this reporting period)
Adverse Events - Section 3
CTC Adverse Event Attribution Code (Attribution Codes for Relationship of Event to Treatment: 1=Unrelated, 2=Unlikely, 3=Possibly, 4=Probably, 5=Definitely)
SAE report submitted
Present Status

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