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8322

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Sarcoma - Treatment Summary Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E298C5A0-38B0-0A67-E034-0003BA12F5E7

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E298C5A0-38B0-0A67-E034-0003BA12F5E7

Nyckelord

  1. 2012-09-20 2012-09-20 -
  2. 2015-01-08 2015-01-08 - Martin Dugas
  3. 2015-01-09 2015-01-09 - Martin Dugas
Uppladdad den

9 januari 2015

DOI

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Creative Commons BY-NC 3.0 Legacy

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    Treatment - Sarcoma - Treatment Summary Form - 2288541v3.0

    No Instruction available.

    1. StudyEvent: Sarcoma - Treatment Summary Form
      1. No Instruction available.
    Crf Header
    Beskrivning

    Crf Header

    Coordinating Group Protocol No.
    Beskrivning

    Protocol ID Coordinating Group

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1711341
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Coordinating Group Code
    Beskrivning

    Coordinating Group Code

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS CUI-1
    C1711341
    NCI Thesaurus ObjectClass
    C17005
    UMLS CUI-2
    C0805701
    NCI Thesaurus ObjectClass-2
    C25462
    NCI Thesaurus Property
    C25364
    Protocol Title
    Beskrivning

    Protocol Title

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986303
    NCI Thesaurus ObjectClass
    C25320
    NCI Thesaurus Property
    C42774
    Patient Study ID
    Beskrivning

    Patient Study ID

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Institution/Affiliate
    Beskrivning

    Institution Name

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Other Patient ID
    Beskrivning

    Trial subject ID Participating Group

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Participating Group Code
    Beskrivning

    ParticipatingGroupIdentifierCode

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus ObjectClass
    C25608
    UMLS 2011AA ObjectClass
    C0679823
    NCI Thesaurus ObjectClass-2
    C17005
    UMLS 2011AA ObjectClass-2
    C1257890
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Patient Name (initials acceptable)
    Beskrivning

    Patient Name

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1299487
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25364
    Sarcoma: Treatment Plan
    Beskrivning

    Sarcoma: Treatment Plan

    First Date (any modality of) Protocol Therapy Was Given (MM DD YYYY)
    Beskrivning

    Treatment Start Date

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ObjectClass-2
    C25509
    UMLS CUI-1
    C3173309
    NCI Thesaurus Property
    C25431
    NCI Thesaurus Property-2
    C25275
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25431
    Last Date (any modality of) protocol therapy was given (MM DD YYYY)
    Beskrivning

    Treatment End Date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C1531784
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property
    C25275
    NCI Thesaurus Property-2
    C25496
    Reason Treatment Ended
    Beskrivning

    Off Treatment Reason

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS CUI-1
    C1518544
    NCI Thesaurus ObjectClass
    C25601
    UMLS CUI-2
    C0566251
    NCI Thesaurus Property
    C25365
    Other (specify)
    Beskrivning

    Off Treatment Reason, specify

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS CUI-1
    C1518544
    NCI Thesaurus ObjectClass
    C25601
    UMLS CUI-2
    C0566251
    NCI Thesaurus Property
    C25365
    UMLS CUI-3
    C1521902
    Sarcoma: Surgical Treatment
    Beskrivning

    Sarcoma: Surgical Treatment

    Did the patient have surgery as part of protocol treatment? (definitive or therapeutic)
    Beskrivning

    ProtocolSurgeryPerformedInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass
    C15329
    UMLS 2011AA ObjectClass
    C0543467
    NCI Thesaurus ObjectClass-2
    C42651
    UMLS 2011AA ObjectClass-2
    C0442711
    Protocol Surgery Date (MM DD YYYY)
    Beskrivning

    ProtocolSurgeryDate

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C15329
    UMLS 2011AA ObjectClass
    C0543467
    NCI Thesaurus ObjectClass-2
    C42651
    UMLS 2011AA ObjectClass-2
    C0442711
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    Protocol Surgery Type
    Beskrivning

    ProtocolSurgeryTypeText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15329
    UMLS 2011AA ObjectClass
    C0543467
    NCI Thesaurus ObjectClass-2
    C42651
    UMLS 2011AA ObjectClass-2
    C0442711
    NCI Thesaurus Property
    C25365
    UMLS 2011AA Property
    C0678257
    Do surgery results qualify patient for further protocol therapy
    Beskrivning

    ProtocolSurgeryQualifyingResultInd

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C15329
    UMLS 2011AA ObjectClass
    C0543467
    NCI Thesaurus ObjectClass-2
    C42651
    UMLS 2011AA ObjectClass-2
    C0442711
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus Property-2
    C25635
    NCI Metathesaurus ValueDomain
    C0021212
    Sarcoma: Treatment Summary - Radiation Therapy
    Beskrivning

    Sarcoma: Treatment Summary - Radiation Therapy

    Type of Radiation Therapy Administered (check all that apply)
    Beskrivning

    Radiation Therapy Type

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C0683312
    NCI Thesaurus Property
    C25382
    Other specify
    Beskrivning

    Radiotherapy type

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C1521902
    NCI Thesaurus Property
    C25365
    Method of Brachytherapy Application
    Beskrivning

    BrachytherapyDoseMethodType

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus Property
    C16847
    UMLS 2011AA Property
    C0449851
    NCI Thesaurus ObjectClass
    C15195
    UMLS 2011AA ObjectClass
    C0006098
    NCI Thesaurus ObjectClass-2
    C25488
    UMLS 2011AA ObjectClass-2
    C0178602
    Brachytherapy Start Date (MM DD YYYY)
    Beskrivning

    BrachytherapyBeginDate

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C15195
    UMLS 2011AA ObjectClass
    C0006098
    NCI Thesaurus ValueDomain-2
    C25431
    UMLS 2011AA ValueDomain-2
    C0439659
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    Brachytherapy End Date (MM DD YYYY)
    Beskrivning

    BrachytherapyEndDate

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C15195
    UMLS 2011AA ObjectClass
    C0006098
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    Brachytherapy Isotope
    Beskrivning

    BrachytherapyIsotopeText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15195
    UMLS 2011AA ObjectClass
    C0006098
    NCI Metathesaurus Property
    C0022262
    Brachytherapy Site(s) (protocol specific)
    Beskrivning

    BrachytherapyLocationText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ObjectClass
    C15195
    UMLS 2011AA ObjectClass
    C0006098
    Total Number of Brachytherapy Applications
    Beskrivning

    BrachytherapyImplantTotalCount

    Datatyp

    float

    Alias
    NCI Thesaurus ValueDomain
    C25304
    UMLS 2011AA ValueDomain
    C0439810
    NCI Thesaurus ObjectClass
    C15195
    UMLS 2011AA ObjectClass
    C0006098
    NCI Thesaurus ValueDomain-2
    C25463
    UMLS 2011AA ValueDomain-2
    C0750480
    NCI Thesaurus Property
    C17948
    UMLS 2011AA Property
    C0013183
    Radiation Therapy Start Date (MM DD YYYY)
    Beskrivning

    Radiation Therapy Start Date

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-1
    C1522449
    NCI Thesaurus Property
    C25431
    UMLS CUI-2
    C0808070
    NCI Thesaurus Property-2
    C25275
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25367
    Radiation Therapy End Date (MM DD YYYY)
    Beskrivning

    Radiation Therapy End Date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C0806020
    NCI Thesaurus Property
    C25275
    NCI Thesaurus Property-2
    C25496
    Radiation Therapy Site (protocol specific)
    Beskrivning

    Radiation Therapy Body Site

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1997599
    NCI Thesaurus Property
    C25341
    NCI Thesaurus ObjectClass
    C15313
    RT Total Dose Per Field (Gy)
    Beskrivning

    RTFieldTotalDose

    Datatyp

    float

    Alias
    NCI Thesaurus ValueDomain
    C25304
    UMLS 2011AA ValueDomain
    C0439810
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus ValueDomain-2
    C25488
    UMLS 2011AA ValueDomain-2
    C0178602
    NCI Thesaurus Property
    C25507
    UMLS 2011AA Property
    C1521738
    RT Total Dose Per Field (Gy)
    Beskrivning

    RTFieldTotalDose

    Datatyp

    float

    Alias
    NCI Thesaurus ValueDomain
    C25304
    UMLS 2011AA ValueDomain
    C0439810
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus ValueDomain-2
    C25488
    UMLS 2011AA ValueDomain-2
    C0178602
    NCI Thesaurus Property
    C25507
    UMLS 2011AA Property
    C1521738
    Total Number of Fractions
    Beskrivning

    Total Number of Fractions

    Datatyp

    float

    Alias
    NCI Thesaurus Property
    C25304
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C1264633
    NCI Thesaurus ValueDomain
    C25463
    UMLS CUI-3
    C0750480
    NCI Thesaurus Property-2
    C25514
    Boost Field(s) treated by Radiation Therapy
    Beskrivning

    RTBoostSiteType

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus Property-2
    C25438
    UMLS 2011AA Property-2
    C1511253
    Other specify
    Beskrivning

    RTBoostSiteSpecify

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus Property-2
    C25438
    UMLS 2011AA Property-2
    C1511253
    RT Total Dose to Boost Field (s Gy)
    Beskrivning

    RadiationTherapyBoostAdministeredTotalDose

    Datatyp

    float

    Alias
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    NCI Thesaurus Property-2
    C25438
    UMLS 2011AA Property-2
    C1511253
    NCI Thesaurus ValueDomain
    C25304
    UMLS 2011AA ValueDomain
    C0439810
    NCI Thesaurus ValueDomain-2
    C25488
    UMLS 2011AA ValueDomain-2
    C0178602
    Total Number of Fractions to Boost Field (s)
    Beskrivning

    RTTotalFractionBoostCount

    Datatyp

    float

    Alias
    NCI Thesaurus Property
    C25304
    UMLS 2011AA Property
    C0439810
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus ValueDomain
    C25463
    UMLS 2011AA ValueDomain
    C0750480
    NCI Thesaurus Property-2
    C25514
    UMLS 2011AA Property-2
    C1264633
    Were there any unscheduled interruptions in radiation therapy?
    Beskrivning

    Unscheduled Interruptions in Radiation Therapy

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS CUI-1
    C1522449
    NCI Thesaurus ObjectClass
    C15313
    UMLS CUI-2
    C1512900
    NCI Thesaurus Property
    C25542
    RT Interruptions Reason
    Beskrivning

    RadiationTherapyInterruptionReason

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus Property
    C25542
    UMLS 2011AA Property
    C1512900
    Sarcoma: Treatment Summary - Systemic Therapy
    Beskrivning

    Sarcoma: Treatment Summary - Systemic Therapy

    Date of First Dose of Protocol Systemic Therapy (MM DD YYYY)
    Beskrivning

    FirstDoseSystemicProtocolDate

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C25509
    UMLS 2011AA ObjectClass
    C1279901
    NCI Thesaurus ObjectClass-2
    C25488
    UMLS 2011AA ObjectClass-2
    C0178602
    NCI Thesaurus Property
    C25320
    UMLS 2011AA Property
    C1507394
    NCI Thesaurus Property-2
    C13310
    UMLS 2011AA Property-2
    C0205373
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    Date of Last Dose of Protocol Systemic Therapy (MM DD YYYY)
    Beskrivning

    LastDoseSystemicProtocolDate

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C25488
    UMLS 2011AA ObjectClass
    C0178602
    NCI Thesaurus ObjectClass-2
    C25551
    UMLS 2011AA ObjectClass-2
    C1517741
    NCI Thesaurus Property
    C25320
    UMLS 2011AA Property
    C1507394
    NCI Thesaurus Property-2
    C13310
    UMLS 2011AA Property-2
    C0205373
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    Agent Total Cumulative Dose
    Beskrivning

    Cumulative Dose Agent

    Datatyp

    float

    Alias
    NCI Thesaurus ObjectClass
    C1708
    UMLS CUI-1
    C2986497
    NCI Thesaurus ObjectClass-2
    C25470
    UMLS CUI-2
    C1521826
    NCI Thesaurus Property
    C25304
    NCI Thesaurus Property-2
    C25256
    NCI Thesaurus ValueDomain
    C25304
    NCI Thesaurus ValueDomain-2
    C25488
    Units
    Beskrivning

    Units

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C1708
    UMLS CUI-1
    C1519795
    NCI Thesaurus Property
    C25256
    NCI Thesaurus ValueDomain
    C25709
    Agent Name (protocol specific)
    Beskrivning

    Agent

    Datatyp

    text

    Alias
    NCI Thesaurus Property
    C25364
    UMLS CUI-1
    C1521826
    NCI Thesaurus ObjectClass
    C1708
    NCI Thesaurus ValueDomain
    C1708
    NCI Thesaurus ValueDomain-2
    C42614
    Were there any dose modifications or additions/omissions to protocol treatment? (check one)
    Beskrivning

    Dose Modification

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS CUI-1
    C1707811
    NCI Thesaurus ObjectClass
    C25256
    NCI Thesaurus Property
    C25572
    NCI Thesaurus ValueDomain-2
    C25572
    Name of Therapy (If yes,)
    Beskrivning

    Therapy Modification

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1299575
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property
    C25572
    Reason for Therapy Modification
    Beskrivning

    Reason for Therapy Modification

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS CUI-1
    C1299575
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property
    C25572
    UMLS CUI-2
    C0392360
    Sarcoma: Treatment Summary - Non-protocol Therapy
    Beskrivning

    Sarcoma: Treatment Summary - Non-protocol Therapy

    Was any non-protocol therapy given during protocol treatment?
    Beskrivning

    Non-protocol therapy

    Datatyp

    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
    Non-Protocol Chemotherapy
    Beskrivning

    Non-protocolChemotherapyAdministeredInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C15632
    UMLS 2011AA ObjectClass
    C0392920
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Yes specify
    Beskrivning

    Non-protocolChemotherapyAdministeredText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15632
    UMLS 2011AA ObjectClass
    C0392920
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Non-Protocol Hormonal Therapy?
    Beskrivning

    Non-protocolHormonalTherapyAdministeredInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C15445
    UMLS 2011AA ObjectClass
    C0279025
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Yes specify
    Beskrivning

    Non-protocolHormonalTherapyAdministeredText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15445
    UMLS 2011AA ObjectClass
    C0279025
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Non-Protocol Immunotherapy?
    Beskrivning

    Non-ProtocolImmunotherapyAdministeredInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C15262
    UMLS 2011AA ObjectClass
    C0021083
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Yes specify
    Beskrivning

    Non-ProtocolImmunotherapyAdministeredText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15262
    UMLS 2011AA ObjectClass
    C0021083
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Non-Protocol Radiation Therapy?
    Beskrivning

    Non-protocolRadiationTherapyAdministeredInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Yes specify
    Beskrivning

    Non-ProtocolRTAdministeredText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15313
    UMLS 2011AA ObjectClass
    C1522449
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Non-Protocol Surgery?
    Beskrivning

    Non-protocolSurgeryPerformedInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass
    C15329
    UMLS 2011AA ObjectClass
    C0543467
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    Yes specify
    Beskrivning

    Non-ProtocolSurgeryProcedureText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15329
    UMLS 2011AA ObjectClass
    C0543467
    NCI Thesaurus Property
    C15368
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass-2
    C1518384
    Other Non-Protocol Therapy
    Beskrivning

    Non-protocolTherapyOtherAdministeredInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass
    C1518384
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus Property-2
    C25382
    UMLS 2011AA Property-2
    C1521801
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Name of Other Non-Protocol Therapy (If yes,)
    Beskrivning

    Non-protocolTherapyOtherAdministeredName

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ObjectClass-2
    C25590
    UMLS 2011AA ObjectClass
    C1518384
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus Property-2
    C25382
    UMLS 2011AA Property-2
    C1521801
    NCI Thesaurus ValueDomain
    C42614
    UMLS 2011AA ValueDomain
    C0027365

    Similar models

    No Instruction available.

    1. StudyEvent: Sarcoma - Treatment Summary Form
      1. No Instruction available.
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datatyp
    Alias
    Item Group
    Crf Header
    Protocol ID Coordinating Group
    Item
    Coordinating Group Protocol No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1711341 (UMLS CUI-2)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Coordinating Group Code
    Item
    Coordinating Group Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C1711341 (UMLS CUI-1)
    C17005 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25462 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    Protocol Title
    Item
    Protocol Title
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986303 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C42774 (NCI Thesaurus Property)
    Patient Study ID
    Item
    Patient Study ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Institution Name
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Trial subject ID Participating Group
    Item
    Other Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    ParticipatingGroupIdentifierCode
    Item
    Participating Group Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C25608 (NCI Thesaurus ObjectClass)
    C0679823 (UMLS 2011AA ObjectClass)
    C17005 (NCI Thesaurus ObjectClass-2)
    C1257890 (UMLS 2011AA ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    Patient Name
    Item
    Patient Name (initials acceptable)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1299487 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Item Group
    Sarcoma: Treatment Plan
    Treatment Start Date
    Item
    First Date (any modality of) Protocol Therapy Was Given (MM DD YYYY)
    date
    C15368 (NCI Thesaurus ObjectClass)
    C25509 (NCI Thesaurus ObjectClass-2)
    C3173309 (UMLS CUI-1)
    C25431 (NCI Thesaurus Property)
    C25275 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25431 (NCI Thesaurus ValueDomain-2)
    Treatment End Date
    Item
    Last Date (any modality of) protocol therapy was given (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1531784 (UMLS CUI-1)
    C15368 (NCI Thesaurus ObjectClass)
    C25275 (NCI Thesaurus Property)
    C25496 (NCI Thesaurus Property-2)
    Item
    Reason Treatment Ended
    text
    C25638 (NCI Thesaurus ValueDomain)
    C1518544 (UMLS CUI-1)
    C25601 (NCI Thesaurus ObjectClass)
    C0566251 (UMLS CUI-2)
    C25365 (NCI Thesaurus Property)
    Code List
    Reason Treatment Ended
    CL Item
    Treatment Completed Per Protocol Criteria (Treatment completed per protocol criteria)
    CL Item
    Disease Progression, Relapse During Active Treatment (Disease progression, relapse during active treatment)
    CL Item
    Adverse Event/side Effects/complications (Adverse Event/Side Effects/Complications)
    CL Item
    Death On Study (Death on study)
    CL Item
    Patient Withdrawal Or Refusal After Beginning Protocol Therapy (Patient withdrawal/refusal after beginning protocol therapy)
    CL Item
    Patient Withdrawal Or Refusal Before Beginning Protocol Therapy (Patient withdrawal/refusal prior to beginning protocol therapy)
    CL Item
    Alternative Therapy (Alternative therapy)
    CL Item
    Patient Off-treatment For Other Complicating Disease (Patient off-treatment for other complicating disease)
    CL Item
    Lost To Follow-up (Lost to follow-up)
    CL310949 (NCI Metathesaurus)
    CL Item
    Cytogenetic Resistance (Cytogenetic Resistance)
    CL Item
    Disease Progression Before Active Treatment (Disease Progression before active treatment)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    Off Treatment Reason, specify
    Item
    Other (specify)
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1518544 (UMLS CUI-1)
    C25601 (NCI Thesaurus ObjectClass)
    C0566251 (UMLS CUI-2)
    C25365 (NCI Thesaurus Property)
    C1521902 (UMLS CUI-3)
    Item Group
    Sarcoma: Surgical Treatment
    ProtocolSurgeryPerformedInd-3
    Item
    Did the patient have surgery as part of protocol treatment? (definitive or therapeutic)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C15329 (NCI Thesaurus ObjectClass)
    C0543467 (UMLS 2011AA ObjectClass)
    C42651 (NCI Thesaurus ObjectClass-2)
    C0442711 (UMLS 2011AA ObjectClass-2)
    ProtocolSurgeryDate
    Item
    Protocol Surgery Date (MM DD YYYY)
    date
    C15329 (NCI Thesaurus ObjectClass)
    C0543467 (UMLS 2011AA ObjectClass)
    C42651 (NCI Thesaurus ObjectClass-2)
    C0442711 (UMLS 2011AA ObjectClass-2)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    ProtocolSurgeryTypeText
    Item
    Protocol Surgery Type
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15329 (NCI Thesaurus ObjectClass)
    C0543467 (UMLS 2011AA ObjectClass)
    C42651 (NCI Thesaurus ObjectClass-2)
    C0442711 (UMLS 2011AA ObjectClass-2)
    C25365 (NCI Thesaurus Property)
    C0678257 (UMLS 2011AA Property)
    Item
    Do surgery results qualify patient for further protocol therapy
    text
    C15329 (NCI Thesaurus ObjectClass)
    C0543467 (UMLS 2011AA ObjectClass)
    C42651 (NCI Thesaurus ObjectClass-2)
    C0442711 (UMLS 2011AA ObjectClass-2)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C25635 (NCI Thesaurus Property-2)
    C0021212 (NCI Metathesaurus ValueDomain)
    Code List
    Do surgery results qualify patient for further protocol therapy
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Not Applicable (N/A)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    Item Group
    Sarcoma: Treatment Summary - Radiation Therapy
    Item
    Type of Radiation Therapy Administered (check all that apply)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C0683312 (UMLS CUI-2)
    C25382 (NCI Thesaurus Property)
    Code List
    Type of Radiation Therapy Administered (check all that apply)
    CL Item
    Brachytherapy (Brachytherapy)
    CL054378 (NCI Metathesaurus)
    CL Item
    Photodynamic Therapy (Photodynamic therapy)
    CL Item
    External Beam Radiation (External beam radiation)
    CL Item
    Radiofrequency Ablation (Radiofrequency ablation)
    C0850292 (NCI Metathesaurus)
    CL Item
    Other (Other specify)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    C17649 (NCI Thesaurus-3)
    C0205394 (UMLS 2011AA-4)
    Radiotherapy type
    Item
    Other specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C1521902 (UMLS CUI-2)
    C25365 (NCI Thesaurus Property)
    Item
    Method of Brachytherapy Application
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C16847 (NCI Thesaurus Property)
    C0449851 (UMLS 2011AA Property)
    C15195 (NCI Thesaurus ObjectClass)
    C0006098 (UMLS 2011AA ObjectClass)
    C25488 (NCI Thesaurus ObjectClass-2)
    C0178602 (UMLS 2011AA ObjectClass-2)
    Code List
    Method of Brachytherapy Application
    CL Item
    High Dose Rate (High dose rate)
    CL Item
    Low Dose Rate (Low dose rate)
    BrachytherapyBeginDate
    Item
    Brachytherapy Start Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C15195 (NCI Thesaurus ObjectClass)
    C0006098 (UMLS 2011AA ObjectClass)
    C25431 (NCI Thesaurus ValueDomain-2)
    C0439659 (UMLS 2011AA ValueDomain-2)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    BrachytherapyEndDate
    Item
    Brachytherapy End Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C15195 (NCI Thesaurus ObjectClass)
    C0006098 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    BrachytherapyIsotopeText
    Item
    Brachytherapy Isotope
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15195 (NCI Thesaurus ObjectClass)
    C0006098 (UMLS 2011AA ObjectClass)
    C0022262 (NCI Metathesaurus Property)
    BrachytherapyLocationText
    Item
    Brachytherapy Site(s) (protocol specific)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C15195 (NCI Thesaurus ObjectClass)
    C0006098 (UMLS 2011AA ObjectClass)
    BrachytherapyImplantTotalCount
    Item
    Total Number of Brachytherapy Applications
    float
    C25304 (NCI Thesaurus ValueDomain)
    C0439810 (UMLS 2011AA ValueDomain)
    C15195 (NCI Thesaurus ObjectClass)
    C0006098 (UMLS 2011AA ObjectClass)
    C25463 (NCI Thesaurus ValueDomain-2)
    C0750480 (UMLS 2011AA ValueDomain-2)
    C17948 (NCI Thesaurus Property)
    C0013183 (UMLS 2011AA Property)
    Radiation Therapy Start Date
    Item
    Radiation Therapy Start Date (MM DD YYYY)
    date
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS CUI-1)
    C25431 (NCI Thesaurus Property)
    C0808070 (UMLS CUI-2)
    C25275 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    Radiation Therapy End Date
    Item
    Radiation Therapy End Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C0806020 (UMLS CUI-2)
    C25275 (NCI Thesaurus Property)
    C25496 (NCI Thesaurus Property-2)
    Radiation Therapy Body Site
    Item
    Radiation Therapy Site (protocol specific)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1997599 (UMLS CUI-1)
    C25341 (NCI Thesaurus Property)
    C15313 (NCI Thesaurus ObjectClass)
    RTFieldTotalDose
    Item
    RT Total Dose Per Field (Gy)
    float
    C25304 (NCI Thesaurus ValueDomain)
    C0439810 (UMLS 2011AA ValueDomain)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25488 (NCI Thesaurus ValueDomain-2)
    C0178602 (UMLS 2011AA ValueDomain-2)
    C25507 (NCI Thesaurus Property)
    C1521738 (UMLS 2011AA Property)
    RTFieldTotalDose
    Item
    RT Total Dose Per Field (Gy)
    float
    C25304 (NCI Thesaurus ValueDomain)
    C0439810 (UMLS 2011AA ValueDomain)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25488 (NCI Thesaurus ValueDomain-2)
    C0178602 (UMLS 2011AA ValueDomain-2)
    C25507 (NCI Thesaurus Property)
    C1521738 (UMLS 2011AA Property)
    Total Number of Fractions
    Item
    Total Number of Fractions
    float
    C25304 (NCI Thesaurus Property)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C1264633 (UMLS CUI-2)
    C25463 (NCI Thesaurus ValueDomain)
    C0750480 (UMLS CUI-3)
    C25514 (NCI Thesaurus Property-2)
    Item
    Boost Field(s) treated by Radiation Therapy
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25438 (NCI Thesaurus Property-2)
    C1511253 (UMLS 2011AA Property-2)
    Code List
    Boost Field(s) treated by Radiation Therapy
    CL Item
    Primary Tumor (Primary tumor)
    CL Item
    None (None)
    C41132 (NCI Thesaurus)
    C0549184 (UMLS 2011AA)
    CL Item
    Other, Specify (Other specify)
    RTBoostSiteSpecify
    Item
    Other specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25438 (NCI Thesaurus Property-2)
    C1511253 (UMLS 2011AA Property-2)
    RadiationTherapyBoostAdministeredTotalDose
    Item
    RT Total Dose to Boost Field (s Gy)
    float
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    C25438 (NCI Thesaurus Property-2)
    C1511253 (UMLS 2011AA Property-2)
    C25304 (NCI Thesaurus ValueDomain)
    C0439810 (UMLS 2011AA ValueDomain)
    C25488 (NCI Thesaurus ValueDomain-2)
    C0178602 (UMLS 2011AA ValueDomain-2)
    RTTotalFractionBoostCount
    Item
    Total Number of Fractions to Boost Field (s)
    float
    C25304 (NCI Thesaurus Property)
    C0439810 (UMLS 2011AA Property)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25463 (NCI Thesaurus ValueDomain)
    C0750480 (UMLS 2011AA ValueDomain)
    C25514 (NCI Thesaurus Property-2)
    C1264633 (UMLS 2011AA Property-2)
    Item
    Were there any unscheduled interruptions in radiation therapy?
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522449 (UMLS CUI-1)
    C15313 (NCI Thesaurus ObjectClass)
    C1512900 (UMLS CUI-2)
    C25542 (NCI Thesaurus Property)
    Code List
    Were there any unscheduled interruptions in radiation therapy?
    CL Item
    Yes, Due To Toxicity (Yes, due to toxicity)
    CL Item
    Yes, For Other Reasons, Specify (Yes, for other reasons, specify)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    RadiationTherapyInterruptionReason
    Item
    RT Interruptions Reason
    text
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25542 (NCI Thesaurus Property)
    C1512900 (UMLS 2011AA Property)
    Item Group
    Sarcoma: Treatment Summary - Systemic Therapy
    FirstDoseSystemicProtocolDate
    Item
    Date of First Dose of Protocol Systemic Therapy (MM DD YYYY)
    date
    C25509 (NCI Thesaurus ObjectClass)
    C1279901 (UMLS 2011AA ObjectClass)
    C25488 (NCI Thesaurus ObjectClass-2)
    C0178602 (UMLS 2011AA ObjectClass-2)
    C25320 (NCI Thesaurus Property)
    C1507394 (UMLS 2011AA Property)
    C13310 (NCI Thesaurus Property-2)
    C0205373 (UMLS 2011AA Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    LastDoseSystemicProtocolDate
    Item
    Date of Last Dose of Protocol Systemic Therapy (MM DD YYYY)
    date
    C25488 (NCI Thesaurus ObjectClass)
    C0178602 (UMLS 2011AA ObjectClass)
    C25551 (NCI Thesaurus ObjectClass-2)
    C1517741 (UMLS 2011AA ObjectClass-2)
    C25320 (NCI Thesaurus Property)
    C1507394 (UMLS 2011AA Property)
    C13310 (NCI Thesaurus Property-2)
    C0205373 (UMLS 2011AA Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    Cumulative Dose Agent
    Item
    Agent Total Cumulative Dose
    float
    C1708 (NCI Thesaurus ObjectClass)
    C2986497 (UMLS CUI-1)
    C25470 (NCI Thesaurus ObjectClass-2)
    C1521826 (UMLS CUI-2)
    C25304 (NCI Thesaurus Property)
    C25256 (NCI Thesaurus Property-2)
    C25304 (NCI Thesaurus ValueDomain)
    C25488 (NCI Thesaurus ValueDomain-2)
    Units
    Item
    Units
    text
    C1708 (NCI Thesaurus ObjectClass)
    C1519795 (UMLS CUI-1)
    C25256 (NCI Thesaurus Property)
    C25709 (NCI Thesaurus ValueDomain)
    Agent
    Item
    Agent Name (protocol specific)
    text
    C25364 (NCI Thesaurus Property)
    C1521826 (UMLS CUI-1)
    C1708 (NCI Thesaurus ObjectClass)
    C1708 (NCI Thesaurus ValueDomain)
    C42614 (NCI Thesaurus ValueDomain-2)
    Item
    Were there any dose modifications or additions/omissions to protocol treatment? (check one)
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1707811 (UMLS CUI-1)
    C25256 (NCI Thesaurus ObjectClass)
    C25572 (NCI Thesaurus Property)
    C25572 (NCI Thesaurus ValueDomain-2)
    Code List
    Were there any dose modifications or additions/omissions to protocol treatment? (check one)
    CL Item
    Yes, Planned (i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned)
    CL Item
    Yes, Unplanned (i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Therapy Modification
    Item
    Name of Therapy (If yes,)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1299575 (UMLS CUI-1)
    C15368 (NCI Thesaurus ObjectClass)
    C25572 (NCI Thesaurus Property)
    Reason for Therapy Modification
    Item
    Reason for Therapy Modification
    text
    C25638 (NCI Thesaurus ValueDomain)
    C1299575 (UMLS CUI-1)
    C15368 (NCI Thesaurus ObjectClass)
    C25572 (NCI Thesaurus Property)
    C0392360 (UMLS CUI-2)
    Item Group
    Sarcoma: Treatment Summary - Non-protocol Therapy
    Non-protocol therapy
    Item
    Was any non-protocol therapy given during protocol treatment?
    boolean
    C25590 (NCI Thesaurus ObjectClass)
    C1518384 (UMLS CUI-1)
    C16212 (NCI Thesaurus ObjectClass-2)
    C0087111 (UMLS CUI-2)
    C25320 (NCI Thesaurus Property)
    C49236 (NCI Thesaurus Property-2)
    C25456 (NCI Thesaurus Property-3)
    C25382 (NCI Thesaurus Property-4)
    C38148 (NCI Thesaurus ValueDomain)
    Non-protocolChemotherapyAdministeredInd-3
    Item
    Non-Protocol Chemotherapy
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C15632 (NCI Thesaurus ObjectClass)
    C0392920 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-protocolChemotherapyAdministeredText
    Item
    Yes specify
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15632 (NCI Thesaurus ObjectClass)
    C0392920 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-protocolHormonalTherapyAdministeredInd-3
    Item
    Non-Protocol Hormonal Therapy?
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C15445 (NCI Thesaurus ObjectClass)
    C0279025 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-protocolHormonalTherapyAdministeredText
    Item
    Yes specify
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15445 (NCI Thesaurus ObjectClass)
    C0279025 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-ProtocolImmunotherapyAdministeredInd-3
    Item
    Non-Protocol Immunotherapy?
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C15262 (NCI Thesaurus ObjectClass)
    C0021083 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-ProtocolImmunotherapyAdministeredText
    Item
    Yes specify
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15262 (NCI Thesaurus ObjectClass)
    C0021083 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-protocolRadiationTherapyAdministeredInd-3
    Item
    Non-Protocol Radiation Therapy?
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-ProtocolRTAdministeredText
    Item
    Yes specify
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15313 (NCI Thesaurus ObjectClass)
    C1522449 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    Non-protocolSurgeryPerformedInd-3
    Item
    Non-Protocol Surgery?
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C15329 (NCI Thesaurus ObjectClass)
    C0543467 (UMLS 2011AA ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    Non-ProtocolSurgeryProcedureText
    Item
    Yes specify
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15329 (NCI Thesaurus ObjectClass)
    C0543467 (UMLS 2011AA ObjectClass)
    C15368 (NCI Thesaurus Property)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass-2)
    Non-protocolTherapyOtherAdministeredInd-3
    Item
    Other Non-Protocol Therapy
    boolean
    C15368 (NCI Thesaurus ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C25382 (NCI Thesaurus Property-2)
    C1521801 (UMLS 2011AA Property-2)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    Non-protocolTherapyOtherAdministeredName
    Item
    Name of Other Non-Protocol Therapy (If yes,)
    text
    C15368 (NCI Thesaurus ObjectClass)
    C25590 (NCI Thesaurus ObjectClass-2)
    C1518384 (UMLS 2011AA ObjectClass)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C25382 (NCI Thesaurus Property-2)
    C1521801 (UMLS 2011AA Property-2)
    C42614 (NCI Thesaurus ValueDomain)
    C0027365 (UMLS 2011AA ValueDomain)

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