ID

8563

Beschreibung

Primary Brain Cancer - On-Study Form Recurrent Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DA7FB-264B-3B94-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DA7FB-264B-3B94-E034-0003BA3F9857

Stichworte

Versionen (3)
  1. 19.09.12 19.09.12 -
  2. 09.01.15 09.01.15 - Martin Dugas
  3. 09.01.15 09.01.15 - Martin Dugas
Hochgeladen am

9. Januar 2015

DOI

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Lizenz

Creative Commons BY-NC 3.0 Legacy
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On-Study - Primary Brain Cancer - On-Study Form Recurrent Treatment - 2293986v3.0

Englisch

No Instruction available.

1 Formulare  
  1. StudyEvent: Primary Brain Cancer - On-Study Form Recurrent Treatment
    1. No Instruction available.
Crf Header
Beschreibung

Crf Header

Coordinating Group Protocol No.
Beschreibung

Protocol ID Coordinating Group

Datentyp

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
Beschreibung

Coordinating Group Code

Datentyp

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
Beschreibung

Protocol Title

Datentyp

text

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

Patient Study ID

Datentyp

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
Beschreibung

Institution Name

Datentyp

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
Beschreibung

Trial subject ID Participating Group

Datentyp

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
Beschreibung

ParticipatingGroupIdentifierCode

Datentyp

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)
Beschreibung

Patient Name

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1299487
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25364
Brain: Form Administration
Beschreibung

Brain: Form Administration

Person Completing Form
Beschreibung

Person Completing Form

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Are data amended (If data are amended, please circle in red when using paper form)
Beschreibung

Data amended

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Brain: Recurrent Disease Description
Beschreibung

Brain: Recurrent Disease Description

Date of Initial Diagnosis of Primary Tumor (MM DD YYYY)
Beschreibung

FirstBiopsyPositiveDate

Datentyp

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
Basis of Diagnosis
Beschreibung

DiagnosisMethodType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C15220
UMLS 2011AA ObjectClass
C0011900
Basis of Diagnosis
Beschreibung

DiagnosisMethodType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C15220
UMLS 2011AA ObjectClass
C0011900
Histologic Type (most recent)
Beschreibung

BrainTumorHistologicCategory

Datentyp

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
Histologic Type (most recent)
Beschreibung

BrainTumorHistologicCategory

Datentyp

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
Advanced Disease Status at Registration
Beschreibung

AdvancedDiseaseRegistrationStatus

Datentyp

text

Alias
NCI Thesaurus Property
C25646
UMLS 2011AA Property
C1514821
NCI Thesaurus ObjectClass
C25411
UMLS 2011AA ObjectClass
C0205179
NCI Thesaurus ObjectClass-2
C2991
UMLS 2011AA ObjectClass-2
C0012634
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Date of Progression (MM DD YYYY)
Beschreibung

DiseaseProgressionDate

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus Property
C25331
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
Date of Most Recent Pathologic Diagnosis (MM DD YYYY)
Beschreibung

PathologicDiagnosisAssessedMostRecentDate

Datentyp

date

Alias
NCI Thesaurus ObjectClass
C25610
UMLS 2011AA ObjectClass
C1521733
NCI Thesaurus ObjectClass-2
C15220
UMLS 2011AA ObjectClass-2
C0011900
NCI Thesaurus Property
C25217
UMLS 2011AA Property
C1516048
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25577
UMLS 2011AA ValueDomain-2
C1513491
Other specify
Beschreibung

Histologic Type, other

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C1299220
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus Property
C25526
NCI Thesaurus Property-2
C25161
Other specify
Beschreibung

Histologic Type, other

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C1299220
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus Property
C25526
NCI Thesaurus Property-2
C25161
Site of Lesion (current lesion; check all that apply)
Beschreibung

BrainLesionSite

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3824
UMLS 2011AA ObjectClass
C0221198
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus ObjectClass-2
C12439
UMLS 2011AA ObjectClass-2
C0006104
Other specify
Beschreibung

Primary Disease Site

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C0449695
NCI Thesaurus Property
C25341
NCI Thesaurus ObjectClass
C25251
NCI Thesaurus ObjectClass-2
C2991
Side
Beschreibung

BrainTumorSideType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12439
UMLS 2011AA ObjectClass-2
C0006104
NCI Thesaurus Property
C25306
UMLS 2011AA Property
C0441987
Does analysis of tissue show evidence of therapeutic effects?
Beschreibung

SpecimenTherapeuticEffectInd-3

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C38032
UMLS 2011AA Property
C1527144
Type of Therapeutic Effect (If Yes,)
Beschreibung

TreatmentTherapeuticEffectType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C38032
UMLS 2011AA Property
C1527144
Other specify
Beschreibung

TreatmentTherapeuticEffectSpecify

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C38032
UMLS 2011AA Property
C1527144
Histologic Grade (WHO)
Beschreibung

BrainTumorWHOHistologicGrade

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12439
UMLS 2011AA ObjectClass-2
C0006104
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Metathesaurus Property
C0043237
NCI Thesaurus ValueDomain
C25526
UMLS 2011AA ValueDomain
C0205462
NCI Thesaurus ValueDomain-2
C18000
UMLS 2011AA ValueDomain-2
C0919553
CSF Cytology
Beschreibung

CerebrospinalFluidCytologyPerformedInd

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C16491
UMLS 2011AA ObjectClass
C0010819
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass-2
C12692
UMLS 2011AA ObjectClass-2
C0007806
CSF Involvement
Beschreibung

CerebrospinalFluidInvolvementInd

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C12692
UMLS 2011AA ObjectClass
C0007806
NCI Thesaurus Property
C25548
UMLS 2011AA Property
C1314939
Brain: Neurologic Function
Beschreibung

Brain: Neurologic Function

Neurologic Function Status
Beschreibung

NeurologicalFunctionStatus

Datentyp

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
Brain: Concomitant Medications
Beschreibung

Brain: Concomitant Medications

Is the person receiving anti-convulsant medication?
Beschreibung

AnticonvulsantMedicationAdministrationInd-3

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
NCI Thesaurus ObjectClass-2
C264
UMLS 2011AA ObjectClass-2
C0003286
Agent Name (If Yes,)
Beschreibung

Agent

Datentyp

text

Alias
NCI Thesaurus Property
C25364
UMLS CUI-1
C1521826
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ValueDomain
C1708
NCI Thesaurus ValueDomain-2
C42614
Agent Name (If Yes,)
Beschreibung

Agent

Datentyp

text

Alias
NCI Thesaurus Property
C25364
UMLS CUI-1
C1521826
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ValueDomain
C1708
NCI Thesaurus ValueDomain-2
C42614
Agent Name (If Yes,)
Beschreibung

Agent

Datentyp

text

Alias
NCI Thesaurus Property
C25364
UMLS CUI-1
C1521826
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ValueDomain
C1708
NCI Thesaurus ValueDomain-2
C42614
Agent Start Date (MM DD YYYY)
Beschreibung

Medication Start Date

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1521826
NCI Thesaurus ValueDomain-2
C25431
UMLS CUI-2
C0808070
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property
C25275
Agent Start Date (MM DD YYYY)
Beschreibung

Medication Start Date

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1521826
NCI Thesaurus ValueDomain-2
C25431
UMLS CUI-2
C0808070
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property
C25275
Agent Start Date (MM DD YYYY)
Beschreibung

Medication Start Date

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1521826
NCI Thesaurus ValueDomain-2
C25431
UMLS CUI-2
C0808070
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property
C25275
Is this anti-convulsant medication enzyme-inducing?
Beschreibung

AnticonvulsantMedicationEnzymePresentInd-3

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus ObjectClass-2
C264
UMLS 2011AA ObjectClass-2
C0003286
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C16554
UMLS 2011AA Property-2
C0014442
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Is the patient receiving corticosteroids?
Beschreibung

CorticosteroidAdministrationInd-3

Datentyp

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
Agent Total Dose (per day)
Beschreibung

Agent Total Dose

Datentyp

float

Alias
NCI Thesaurus ValueDomain
C25304
UMLS CUI-1
C2986497
NCI Thesaurus Property
C25379
NCI Thesaurus ValueDomain-2
C25488
NCI Thesaurus ObjectClass
C1708
Is the patient receiving other medications?
Beschreibung

OtherMedicationAdministrationInd-3

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass-2
C459
UMLS 2011AA ObjectClass-2
C0013227
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
Brain: Prior Health History
Beschreibung

Brain: Prior Health History

Has the patient experienced an intracranial hemorrhage?
Beschreibung

IntracranialBrainHemorrhageOccurrenceInd-3

Datentyp

boolean

Alias
NCI Thesaurus ObjectClass
C12439
UMLS 2011AA ObjectClass
C0006104
NCI Thesaurus ObjectClass-2
C38236
UMLS 2011AA ObjectClass-2
C1522213
NCI Thesaurus Property
C26791
UMLS 2011AA Property
C0019080
NCI Thesaurus Property-2
C25275
UMLS 2011AA Property-2
C2745955
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Date of Most Recent (MM DD YYYY)
Beschreibung

BrainHemorrhageObservedMostRecentDate

Datentyp

date

Alias
NCI Thesaurus ObjectClass
C12439
UMLS 2011AA ObjectClass
C0006104
NCI Thesaurus Property
C26791
UMLS 2011AA Property
C0019080
NCI Thesaurus Property-2
C25599
UMLS 2011AA Property-2
C1441672
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25577
UMLS 2011AA ValueDomain-2
C1513491
Has the patient experienced an intraocular hemorrhage?
Beschreibung

EyeHemorrhageOccurrenceInd-3

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus Property
C26791
UMLS 2011AA Property
C0019080
NCI Thesaurus Property-2
C25275
UMLS 2011AA Property-2
C2745955
NCI Metathesaurus ObjectClass
C0015392
Date of Most Recent (MM DD YYYY)
Beschreibung

EyeHemorrhageObservedMostRecentDate

Datentyp

date

Alias
NCI Metathesaurus ObjectClass
C0015392
NCI Thesaurus Property
C26791
UMLS 2011AA Property
C0019080
NCI Thesaurus Property-2
C25599
UMLS 2011AA Property-2
C1441672
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25577
UMLS 2011AA ValueDomain-2
C1513491
Current Medical Conditions (currently symptomatic or on medications for)
Beschreibung

PatientMedicalConditionCurrentType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25261
UMLS 2011AA Property
C0205476
NCI Thesaurus Property-2
C25457
UMLS 2011AA Property-2
C0348080
Other malignancies specify
Beschreibung

MalignantDiseaseOtherPresentSpecify

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C14143
UMLS 2011AA ObjectClass
C0205282
NCI Thesaurus ObjectClass-2
C2991
UMLS 2011AA ObjectClass-2
C0012634
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus Property-2
C25626
UMLS 2011AA Property-2
C0150312
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Other specify
Beschreibung

PatientMedicalConditionCurrentSpecify

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25261
UMLS 2011AA Property
C0205476
NCI Thesaurus Property-2
C25457
UMLS 2011AA Property-2
C0348080
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain-2
C25471
UMLS 2011AA ValueDomain-2
C0521116
Brain: Prior Treatment
Beschreibung

Brain: Prior Treatment

Prior Treatment?
Beschreibung

CancerPriorTreatmentInd-3

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Thesaurus Property-2
C15368
Prior Systemic Chemotherapy?
Beschreibung

PriorChemotherapyAdministeredInd-3

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15632
UMLS 2011AA ObjectClass
C0392920
NCI Thesaurus ObjectClass-2
C25629
UMLS 2011AA ObjectClass-2
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Prior Immunotherapy?
Beschreibung

PriorImmunotherapyAdministeredInd-3

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15262
UMLS 2011AA ObjectClass
C0021083
NCI Thesaurus ObjectClass-2
C25629
UMLS 2011AA ObjectClass-2
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Prior Radiation Therapy?
Beschreibung

Prior Radiation Therapy

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C1522449
NCI Thesaurus ObjectClass
C15313
UMLS CUI-2
C0332152
NCI Thesaurus ObjectClass-2
C25629
NCI Thesaurus Property
C25382
Prior Surgery?
Beschreibung

Prior Surgery

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0744961
NCI Thesaurus Property
C38000
NCI Thesaurus ObjectClass
C15329
NCI Thesaurus ObjectClass-2
C25629
Prior Radiosurgery?
Beschreibung

PriorRadiationSurgeryAdministeredInd-3

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15696
UMLS 2011AA ObjectClass-2
C0085203
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Prior Radiosensitizer Therapy?
Beschreibung

PriorRadiosensitizerAdministeredInd-3

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ObjectClass-2
C798
UMLS 2011AA ObjectClass-2
C0034541
Any Other Prior Therapy?
Beschreibung

PriorTherapyOtherAdministeredInd-3

Datentyp

boolean

Alias
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
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 prior therapies (If yes,)
Beschreibung

PriorTherapyOtherName

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus Property-2
C25364
UMLS 2011AA Property-2
C0600091
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Brain: Prior Treatment - Systemic Regimens
Beschreibung

Brain: Prior Treatment - Systemic Regimens

Prior Treatment Regimen Name (Drug, Agent, Biologic)
Beschreibung

PriorTreatmentRegimenName

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus Property
C15697
UMLS 2011AA Property
C0040808
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Prior Treatment Regimen Start Date (MM DD YYYY)
Beschreibung

PriorTreatmentRegimenBeginDate

Datentyp

date

Alias
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus Property
C15697
UMLS 2011AA Property
C0040808
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25431
UMLS 2011AA ValueDomain-2
C0439659
Prior Treatment Regimen End Date (MM DD YYYY)
Beschreibung

PriorTreatmentRegimenEndDate

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus Property
C15697
UMLS 2011AA Property
C0040808
Prior Treatment Regimen Type (Adjuvant, High Dose)
Beschreibung

PriorTreatmentRegimenText

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus Property
C15697
UMLS 2011AA Property
C0040808
Comments
Beschreibung

Comments

Comments
Beschreibung

Research Comments

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
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  1. StudyEvent: Primary Brain Cancer - On-Study Form Recurrent Treatment
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Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
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
Brain: Form Administration
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Brain: Recurrent Disease Description
FirstBiopsyPositiveDate
Item
Date of Initial Diagnosis of Primary Tumor (MM DD YYYY)
date
C15189 (NCI Thesaurus ObjectClass)
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)
Item
Basis of Diagnosis
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15220 (NCI Thesaurus ObjectClass)
C0011900 (UMLS 2011AA ObjectClass)
CL.5
Code List
Basis of Diagnosis
CL Item
Histology (Histology)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
C16681 (NCI Thesaurus-3)
C0019638 (UMLS 2011AA-4)
CL Item
Imaging Only (Imaging only)
Item
Basis of Diagnosis
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15220 (NCI Thesaurus ObjectClass)
C0011900 (UMLS 2011AA ObjectClass)
CL.5
Code List
Basis of Diagnosis
CL Item
Histology (Histology)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
C16681 (NCI Thesaurus-3)
C0019638 (UMLS 2011AA-4)
CL Item
Imaging Only (Imaging only)
Item
Histologic Type (most recent)
text
C3262 (NCI Thesaurus ObjectClass)
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)
CL.6
Code List
Histologic Type (most recent)
CL Item
Diffuse Astrocytoma (Diffuse astrocytoma)
C7173 (NCI Thesaurus)
C0280785 (UMLS 2011AA)
CL Item
9420-3 Fibrillary Astrocytoma (c71._) (Fibrillary astrocytoma)
CL Item
9410-3 Protoplasmic Astrocytoma (c71._) (Protoplasmic astrocytoma)
CL Item
9411-3 Gemistocytic Astrocytoma (c71._) (Gemistocytic astrocytoma)
CL Item
9401-3 Astrocytoma, Anaplastic (c71._) (Anaplastic astrocytoma)
CL Item
9440-3 Glioblastoma, Nos (c71._) (Glioblastoma)
CL Item
9441-3 Giant Cell Glioblastoma (c71._) (Giant cell glioblastoma)
CL Item
9442-3 Gliosarcoma (c71._) (Gliosarcoma)
CL Item
9421-1 Pilocytic Astrocytoma (c71._) (Pilocytic astrocytoma)
CL Item
9424-3 Pleomorphic Xanthoastrocytoma (c71._) (Pleomorphic xanthoastrocytoma)
CL Item
9384-1 Subependymal Giant Cell Astrocytoma (c71._) (Subependymal giant cell astrocytoma)
CL Item
9450-3 Oligodendroglioma, Nos (c71._) (Oligodendroglioma)
CL Item
9451-3 Oligodendroglioma, Anaplastic (c71._) (Anaplastic oligodendroglioma)
CL Item
Oligoastrocytoma (Oligoastrocytoma)
CL Item
Anaplastic Oligoastrocytoma (Anaplastic oligoastrocytoma)
C6959 (NCI Thesaurus)
C0431108 (UMLS 2011AA)
CL Item
9391-3 Ependymoma, Nos (c71._) (Ependymoma)
CL Item
9392-3 Ependymoma, Anaplastic (c71._) (Anaplastic ependymoma)
CL Item
9394-1 Myxopapillary Ependymoma (c72.0) (Myxopapillary ependymoma)
CL Item
9383-1 Subependymoma (c71._) (Subependymoma)
CL Item
9390-0 Choroid Plexus Papilloma, Nos (c71.5) (Choroid plexus papilloma)
CL Item
9390-3 Choroid Plexus Carcinoma (c71.5) (Choroid plexus carcinoma)
CL Item
9430-3 Astroblastoma (c71._) (Astroblastoma)
CL Item
9381-3 Gliomatosis Cerebri (c71._) (Gliomatosis cerebri)
CL Item
Chordoid Glioma Of The Third Ventricle (Chordoid glioma of the third ventricle)
C6961 (NCI Thesaurus)
C1322252 (UMLS 2011AA)
CL Item
9492-0 Gangliocytoma (Gangliocytoma)
CL Item
9493-0 Dysplastic Gangliocytoma Of Cerebellum (lhermitte-duclos) (c71.6) (Dysplastic gangliocytoma of cerebellum)
CL Item
Desmoplastic Infantile Astrocytoma/ganglioma (Desmoplastic infantile astrocytoma/ganglioma)
CL Item
Low Grade Astrocytoma, Nos (Low grade astrocytoma NOS)
CL Item
9413-0 Dysembryoplastic Neuroepithelial Tumor (Dysembryoplastic neuroepithelial tumor)
CL Item
9505-1 Ganglioglioma, Nos (Ganglioglioma)
CL Item
9505-3 Ganglioglioma, Anaplastic (Anaplastic ganglioglioma)
CL Item
9506-1 Central Neurocytoma (Central neurocytoma)
CL Item
Cerebellar Liponeurocytoma (Cerebellar liponeurocytoma)
C6905 (NCI Thesaurus)
C1370507 (UMLS 2011AA)
CL Item
Paraganglioma Of The Filum Terminale (Paraganglioma of the filum terminale)
CL Item
9522-3 Olfactory Neuroblastoma (c30.0) (Olfactory neuroblastoma)
CL Item
9523-3 Olfactory Neuroepithelioma (c30.0) (Olfactory neuroepithelioma)
CL Item
Neuroblastomas Of The Adrenal Gland And Sympathetic Nervous System (Neuroblastomas of the adrenal gland and sympathetic nervous system)
CL Item
9361-1 Pineocytoma (c75.3) (Pineocytoma)
CL Item
9362-3 Pineoblastoma (c75.3) (Pineoblastoma)
CL Item
Pineal Parenchymal Tumor Of Indeterminate Differentiation (Pineal parenchymal tumor of indeterminate differentiation)
CL Item
9501-3 Medulloepithelioma, Nos (Medulloepithelioma)
CL Item
Ependymoblastoma (Ependymoblastoma)
C4915 (NCI Thesaurus)
C0700367 (UMLS 2011AA)
CL Item
9470-3 Medulloblastoma, Nos (c71.6) (Medulloblastoma)
CL Item
Desmoplastic Medulloblastoma (Desmoplastic medulloblastoma)
C4956 (NCI Thesaurus)
C0751291 (UMLS 2011AA)
CL Item
9474-3 Large Cell Medulloblastoma (c71.6) (Large cell medulloblastoma)
CL Item
9472-3 Medullomyoblastoma (c71.6) (Medullomyoblastoma)
CL Item
Melanotic Medulloblastoma (Melanotic medulloblastoma)
C9497 (NCI Thesaurus)
C1275668 (UMLS 2011AA)
CL Item
Supratentorial Primitive Neuroectodermal Tumor (pnet) (Supratentorial primitive neuroectodermal tumor)
CL Item
9500-3 Neuroblastoma, Nos (Neuroblastoma)
CL Item
9490-3 Ganglioneuroblastoma (Ganglioneuroblastoma)
CL Item
9508-3 Atypical Teratoid-rhabdoid Tumor (c71._) (Atypical teratoid/rhabdoid tumor)
CL Item
Schwannoma (neurilemmoma, Neurinoma) (Schwannoma)
CL Item
High Grade Astrocytoma, Nos (High grade astrocytoma NOS)
CL Item
9064-3 Germinoma (Germinoma)
CL Item
Embryonal Carcinoma (Embryonal carcinoma)
C3752 (NCI Thesaurus)
C0026705 (UMLS 2011AA)
CL Item
Yolk Sac Tumor (Yolk sac tumor)
C3011 (NCI Thesaurus)
C0014145 (UMLS 2011AA)
CL Item
Choriocarcinoma (Choriocarcinoma)
C2948 (NCI Thesaurus)
C0008497 (UMLS 2011AA)
CL Item
Teratoma (Teratoma)
C3403 (NCI Thesaurus)
C0039538 (UMLS 2011AA)
CL Item
Mixed Germ Cell Tumor (Mixed germ cell tumors)
C4285 (NCI Thesaurus)
CL Item
9350-1 Craniopharyngioma (c75.2) (Craniopharyngioma)
CL Item
9351-1 Craniopharyngioma, Adamantinomatous (c75.2) (Adamantinomatous)
CL Item
9352-1 Craniopharyngioma, Papillary (c75.2) (Papillary)
CL Item
9580-0 Granular Cell Tumor, Nos (Granular cell tumor)
CL Item
9531-0 Meningothelial Meningioma (Meningothelial meningioma)
CL Item
9532-0 Fibrous Meningioma (Fibrous meningioma)
CL Item
9537-0 Transitional Meningioma (Transitional meningioma)
CL Item
9533-0 Psammomatous Meningioma (Psammomatous meningioma)
CL Item
9534-0 Angiomatous Meningioma (Angiomatous meningioma)
CL Item
Microcystic Meningioma (Microcystic meningioma)
CL Item
Secretory Meningioma (Secretory meningioma)
CL Item
Lymphoplasmacyte-rich Meningioma (Lymphoplasmacyte-rich meningioma)
CL Item
Metaplastic Meningioma (Metaplastic meningioma)
CL Item
9539-1 Atypical Meningioma (Atypical meningioma)
CL Item
9538-1 Clear Cell Meningioma (Clear cell meningioma)
CL Item
Chordoid Meningioma (Chordoid meningioma)
CL Item
Rhabdoid Meningioma (Rhabdoid meningioma)
CL Item
9538-3 Papillary Meningioma (Papillary meningioma)
CL Item
Anaplastic Meningioma (Anaplastic meningioma)
CL Item
Other, Specify (Other specify)
Item
Histologic Type (most recent)
text
C3262 (NCI Thesaurus ObjectClass)
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)
CL.6
Code List
Histologic Type (most recent)
CL Item
Diffuse Astrocytoma (Diffuse astrocytoma)
C7173 (NCI Thesaurus)
C0280785 (UMLS 2011AA)
CL Item
9420-3 Fibrillary Astrocytoma (c71._) (Fibrillary astrocytoma)
CL Item
9410-3 Protoplasmic Astrocytoma (c71._) (Protoplasmic astrocytoma)
CL Item
9411-3 Gemistocytic Astrocytoma (c71._) (Gemistocytic astrocytoma)
CL Item
9401-3 Astrocytoma, Anaplastic (c71._) (Anaplastic astrocytoma)
CL Item
9440-3 Glioblastoma, Nos (c71._) (Glioblastoma)
CL Item
9441-3 Giant Cell Glioblastoma (c71._) (Giant cell glioblastoma)
CL Item
9442-3 Gliosarcoma (c71._) (Gliosarcoma)
CL Item
9421-1 Pilocytic Astrocytoma (c71._) (Pilocytic astrocytoma)
CL Item
9424-3 Pleomorphic Xanthoastrocytoma (c71._) (Pleomorphic xanthoastrocytoma)
CL Item
9384-1 Subependymal Giant Cell Astrocytoma (c71._) (Subependymal giant cell astrocytoma)
CL Item
9450-3 Oligodendroglioma, Nos (c71._) (Oligodendroglioma)
CL Item
9451-3 Oligodendroglioma, Anaplastic (c71._) (Anaplastic oligodendroglioma)
CL Item
Oligoastrocytoma (Oligoastrocytoma)
CL Item
Anaplastic Oligoastrocytoma (Anaplastic oligoastrocytoma)
C6959 (NCI Thesaurus)
C0431108 (UMLS 2011AA)
CL Item
9391-3 Ependymoma, Nos (c71._) (Ependymoma)
CL Item
9392-3 Ependymoma, Anaplastic (c71._) (Anaplastic ependymoma)
CL Item
9394-1 Myxopapillary Ependymoma (c72.0) (Myxopapillary ependymoma)
CL Item
9383-1 Subependymoma (c71._) (Subependymoma)
CL Item
9390-0 Choroid Plexus Papilloma, Nos (c71.5) (Choroid plexus papilloma)
CL Item
9390-3 Choroid Plexus Carcinoma (c71.5) (Choroid plexus carcinoma)
CL Item
9430-3 Astroblastoma (c71._) (Astroblastoma)
CL Item
9381-3 Gliomatosis Cerebri (c71._) (Gliomatosis cerebri)
CL Item
Chordoid Glioma Of The Third Ventricle (Chordoid glioma of the third ventricle)
C6961 (NCI Thesaurus)
C1322252 (UMLS 2011AA)
CL Item
9492-0 Gangliocytoma (Gangliocytoma)
CL Item
9493-0 Dysplastic Gangliocytoma Of Cerebellum (lhermitte-duclos) (c71.6) (Dysplastic gangliocytoma of cerebellum)
CL Item
Desmoplastic Infantile Astrocytoma/ganglioma (Desmoplastic infantile astrocytoma/ganglioma)
CL Item
Low Grade Astrocytoma, Nos (Low grade astrocytoma NOS)
CL Item
9413-0 Dysembryoplastic Neuroepithelial Tumor (Dysembryoplastic neuroepithelial tumor)
CL Item
9505-1 Ganglioglioma, Nos (Ganglioglioma)
CL Item
9505-3 Ganglioglioma, Anaplastic (Anaplastic ganglioglioma)
CL Item
9506-1 Central Neurocytoma (Central neurocytoma)
CL Item
Cerebellar Liponeurocytoma (Cerebellar liponeurocytoma)
C6905 (NCI Thesaurus)
C1370507 (UMLS 2011AA)
CL Item
Paraganglioma Of The Filum Terminale (Paraganglioma of the filum terminale)
CL Item
9522-3 Olfactory Neuroblastoma (c30.0) (Olfactory neuroblastoma)
CL Item
9523-3 Olfactory Neuroepithelioma (c30.0) (Olfactory neuroepithelioma)
CL Item
Neuroblastomas Of The Adrenal Gland And Sympathetic Nervous System (Neuroblastomas of the adrenal gland and sympathetic nervous system)
CL Item
9361-1 Pineocytoma (c75.3) (Pineocytoma)
CL Item
9362-3 Pineoblastoma (c75.3) (Pineoblastoma)
CL Item
Pineal Parenchymal Tumor Of Indeterminate Differentiation (Pineal parenchymal tumor of indeterminate differentiation)
CL Item
9501-3 Medulloepithelioma, Nos (Medulloepithelioma)
CL Item
Ependymoblastoma (Ependymoblastoma)
C4915 (NCI Thesaurus)
C0700367 (UMLS 2011AA)
CL Item
9470-3 Medulloblastoma, Nos (c71.6) (Medulloblastoma)
CL Item
Desmoplastic Medulloblastoma (Desmoplastic medulloblastoma)
C4956 (NCI Thesaurus)
C0751291 (UMLS 2011AA)
CL Item
9474-3 Large Cell Medulloblastoma (c71.6) (Large cell medulloblastoma)
CL Item
9472-3 Medullomyoblastoma (c71.6) (Medullomyoblastoma)
CL Item
Melanotic Medulloblastoma (Melanotic medulloblastoma)
C9497 (NCI Thesaurus)
C1275668 (UMLS 2011AA)
CL Item
Supratentorial Primitive Neuroectodermal Tumor (pnet) (Supratentorial primitive neuroectodermal tumor)
CL Item
9500-3 Neuroblastoma, Nos (Neuroblastoma)
CL Item
9490-3 Ganglioneuroblastoma (Ganglioneuroblastoma)
CL Item
9508-3 Atypical Teratoid-rhabdoid Tumor (c71._) (Atypical teratoid/rhabdoid tumor)
CL Item
Schwannoma (neurilemmoma, Neurinoma) (Schwannoma)
CL Item
High Grade Astrocytoma, Nos (High grade astrocytoma NOS)
CL Item
9064-3 Germinoma (Germinoma)
CL Item
Embryonal Carcinoma (Embryonal carcinoma)
C3752 (NCI Thesaurus)
C0026705 (UMLS 2011AA)
CL Item
Yolk Sac Tumor (Yolk sac tumor)
C3011 (NCI Thesaurus)
C0014145 (UMLS 2011AA)
CL Item
Choriocarcinoma (Choriocarcinoma)
C2948 (NCI Thesaurus)
C0008497 (UMLS 2011AA)
CL Item
Teratoma (Teratoma)
C3403 (NCI Thesaurus)
C0039538 (UMLS 2011AA)
CL Item
Mixed Germ Cell Tumor (Mixed germ cell tumors)
C4285 (NCI Thesaurus)
CL Item
9350-1 Craniopharyngioma (c75.2) (Craniopharyngioma)
CL Item
9351-1 Craniopharyngioma, Adamantinomatous (c75.2) (Adamantinomatous)
CL Item
9352-1 Craniopharyngioma, Papillary (c75.2) (Papillary)
CL Item
9580-0 Granular Cell Tumor, Nos (Granular cell tumor)
CL Item
9531-0 Meningothelial Meningioma (Meningothelial meningioma)
CL Item
9532-0 Fibrous Meningioma (Fibrous meningioma)
CL Item
9537-0 Transitional Meningioma (Transitional meningioma)
CL Item
9533-0 Psammomatous Meningioma (Psammomatous meningioma)
CL Item
9534-0 Angiomatous Meningioma (Angiomatous meningioma)
CL Item
Microcystic Meningioma (Microcystic meningioma)
CL Item
Secretory Meningioma (Secretory meningioma)
CL Item
Lymphoplasmacyte-rich Meningioma (Lymphoplasmacyte-rich meningioma)
CL Item
Metaplastic Meningioma (Metaplastic meningioma)
CL Item
9539-1 Atypical Meningioma (Atypical meningioma)
CL Item
9538-1 Clear Cell Meningioma (Clear cell meningioma)
CL Item
Chordoid Meningioma (Chordoid meningioma)
CL Item
Rhabdoid Meningioma (Rhabdoid meningioma)
CL Item
9538-3 Papillary Meningioma (Papillary meningioma)
CL Item
Anaplastic Meningioma (Anaplastic meningioma)
CL Item
Other, Specify (Other specify)
Item
Advanced Disease Status at Registration
text
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25411 (NCI Thesaurus ObjectClass)
C0205179 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.4
Code List
Advanced Disease Status at Registration
CL Item
Residual (Residual)
C37895 (NCI Thesaurus)
C1609982 (UMLS 2011AA)
CL Item
Recurrent/progressive (Recurrent/Progressive)
CL Item
No Visible Disease (No visible disease)
DiseaseProgressionDate
Item
Date of Progression (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C25331 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
PathologicDiagnosisAssessedMostRecentDate
Item
Date of Most Recent Pathologic Diagnosis (MM DD YYYY)
date
C25610 (NCI Thesaurus ObjectClass)
C1521733 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus ObjectClass-2)
C0011900 (UMLS 2011AA ObjectClass-2)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25577 (NCI Thesaurus ValueDomain-2)
C1513491 (UMLS 2011AA ValueDomain-2)
Histologic Type, other
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1299220 (UMLS CUI-1)
C3262 (NCI Thesaurus ObjectClass)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
Histologic Type, other
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1299220 (UMLS CUI-1)
C3262 (NCI Thesaurus ObjectClass)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
Item
Site of Lesion (current lesion; check all that apply)
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
CL.7
Code List
Site of Lesion (current lesion; check all that apply)
CL Item
Frontal Lobe (Frontal)
C12352 (NCI Thesaurus)
C0016733 (UMLS 2011AA)
CL Item
Temporal Lobe (Temporal)
C12353 (NCI Thesaurus)
C0039485 (UMLS 2011AA)
CL Item
Parietal Lobe (Parietal)
C12354 (NCI Thesaurus)
C0030560 (UMLS 2011AA)
CL Item
Occipital Lobe (Occipital)
C12355 (NCI Thesaurus)
C0028785 (UMLS 2011AA)
CL Item
Cerebellum (Cerebellum)
C12445 (NCI Thesaurus)
C0007765 (UMLS 2011AA)
CL Item
Cerebellar Peduncle (Cerebellar peduncle)
C0228515 (NCI Metathesaurus)
CL Item
Cerebellar Hemisphere (Cerebellar hemisphere)
C0228465 (NCI Metathesaurus)
CL Item
Cerebellar Vermis (Cerebellar vermis)
CL Item
Brainstem (Brainstem)
CL Item
Midbrain (Midbrain)
C0025462 (NCI Metathesaurus)
CL Item
Pons (Pons)
C0032639 (NCI Metathesaurus)
CL Item
Medulla (Medulla)
CL Item
Dorsal Exophytic Brainstem (Dorsal exophytic brainstem)
CL Item
Spinal Cord (c1 And Below) (Spinal cord)
CL Item
Corpus Callosum (Corpus callosum)
C12446 (NCI Thesaurus)
C0010090 (UMLS 2011AA)
CL Item
Optic Chiasm (Optic chiasm)
C0029126 (NCI Metathesaurus)
CL Item
Hypothalamus (Hypothalamus)
C12458 (NCI Thesaurus)
C0020663 (UMLS 2011AA)
CL Item
Cavernous Sinus (Cavernous sinus)
C12690 (NCI Thesaurus)
C0007473 (UMLS 2011AA)
CL Item
Lateral Ventricle (Lateral ventricle)
C12834 (NCI Thesaurus)
C0152279 (UMLS 2011AA)
CL Item
Third Ventricle (Third ventricle)
C12827 (NCI Thesaurus)
C0149555 (UMLS 2011AA)
CL Item
Fourth Ventricle (Fourth ventricle)
C12828 (NCI Thesaurus)
C0149556 (UMLS 2011AA)
CL Item
Cisterna Magna (Cisterna magna)
C32324 (NCI Thesaurus)
C0008841 (UMLS 2011AA)
CL Item
Basal Ganglia (Basal ganglia)
C12447 (NCI Thesaurus)
C0004781 (UMLS 2011AA)
CL Item
Thalamus (Thalamus)
C12459 (NCI Thesaurus)
C0039729 (UMLS 2011AA)
CL Item
Optic Nerve (Optic nerve)
C12761 (NCI Thesaurus)
C0029130 (UMLS 2011AA)
CL Item
Pineal (Pineal)
CL Item
Aqueduct Of Sylvius (Aqueduct of sylvius)
C32135 (NCI Thesaurus)
C0007769 (UMLS 2011AA)
CL Item
Leptomeningeal (Leptomeningeal)
CL Item
Cervical (Cervical)
C12844 (NCI Thesaurus)
C0205064 (UMLS 2011AA)
CL Item
Thoracic (Thoracic)
C13360 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Lumbar (Lumbar)
CL Item
Conus (Conus)
C0598489 (NCI Metathesaurus)
CL Item
Cauda Equina (Cauda equina)
C12689 (NCI Thesaurus)
C0007458 (UMLS 2011AA)
CL Item
Other, Specify (Other specify)
Primary Disease Site
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C0449695 (UMLS CUI-1)
C25341 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
Item
Side
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
C25306 (NCI Thesaurus Property)
C0441987 (UMLS 2011AA Property)
CL.8
Code List
Side
CL Item
Left (Left)
C25229 (NCI Thesaurus)
C0205091 (UMLS 2011AA)
CL Item
Right (Right)
C25228 (NCI Thesaurus)
C0205090 (UMLS 2011AA)
CL Item
Both (Both)
C49636 (NCI Thesaurus)
C1706086 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does analysis of tissue show evidence of therapeutic effects?
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C38032 (NCI Thesaurus Property)
C1527144 (UMLS 2011AA Property)
CL.9
Code List
Does analysis of tissue show evidence of therapeutic effects?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Type of Therapeutic Effect (If Yes,)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C38032 (NCI Thesaurus Property)
C1527144 (UMLS 2011AA Property)
CL.10
Code List
Type of Therapeutic Effect (If Yes,)
CL Item
Radiation Changes (Radiation changes)
CL Item
Surgical Changes (Surgical changes)
CL Item
Drug-related Changes (Drug-related changes)
CL Item
Other, Specify (Other specify)
TreatmentTherapeuticEffectSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C38032 (NCI Thesaurus Property)
C1527144 (UMLS 2011AA Property)
Item
Histologic Grade (WHO)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0043237 (NCI Metathesaurus Property)
C25526 (NCI Thesaurus ValueDomain)
C0205462 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain-2)
C0919553 (UMLS 2011AA ValueDomain-2)
CL.11
Code List
Histologic Grade (WHO)
CL Item
Well Differentiated (grade I) (Well differentiated (Grade I))
CL Item
Moderately Differentiated (grade Ii) (Moderately Differentiated (Grade II))
CL Item
Poorly Differentiated (grade Iii) (Poorly Differentiated (Grade III))
CL Item
Undifferentiated (grade Iv) (Undifferentiated (Grade IV))
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
CSF Cytology
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16491 (NCI Thesaurus ObjectClass)
C0010819 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C12692 (NCI Thesaurus ObjectClass-2)
C0007806 (UMLS 2011AA ObjectClass-2)
CL.12
Code List
CSF Cytology
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Undetermined (Undetermined)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
Item
CSF Involvement
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C12692 (NCI Thesaurus ObjectClass)
C0007806 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
CL.13
Code List
CSF Involvement
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item Group
Brain: Neurologic Function
Item
Neurologic Function Status
text
C25262 (NCI Thesaurus ObjectClass)
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)
CL.14
Code List
Neurologic Function Status
CL Item
No Neurologic Symptoms, Fully Active At Home/work Without Assistance (No neurologic symptoms, fully active at home/work without assistance)
CL Item
Minor Neurologic Symptoms, Fully Active At Home/work Without Assistance (Minor neurologic symptoms, fully active at home/work without assistance)
CL Item
Moderate Neurologic Symptoms, Fully Active At Home/work But Requires Assistance (Moderate neurologic symptoms, fully active at home/work but requires assistance)
CL Item
Moderate Neurologic Symptoms, Less Than Fully Active At Home/work And Requires Assitance (Moderate neurologic symptoms, less than fully active at home/work and requires assistance)
CL Item
Severe Neurologic Symptoms, Totally Inactive Requiring Complete Assistance At Home Or Institution, Unable To Work (Severe neurologic symptoms, totally inactive requiring complete assistance at home or institution, unable to work)
Item Group
Brain: Concomitant Medications
Item
Is the person receiving anti-convulsant medication?
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C264 (NCI Thesaurus ObjectClass-2)
C0003286 (UMLS 2011AA ObjectClass-2)
CL.15
Code List
Is the person receiving anti-convulsant medication?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Agent
Item
Agent Name (If Yes,)
text
C25364 (NCI Thesaurus Property)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
Agent
Item
Agent Name (If Yes,)
text
C25364 (NCI Thesaurus Property)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
Agent
Item
Agent Name (If Yes,)
text
C25364 (NCI Thesaurus Property)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
Medication Start Date
Item
Agent Start Date (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C1521826 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C0808070 (UMLS CUI-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Medication Start Date
Item
Agent Start Date (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C1521826 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C0808070 (UMLS CUI-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Medication Start Date
Item
Agent Start Date (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C1521826 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C0808070 (UMLS CUI-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Item
Is this anti-convulsant medication enzyme-inducing?
text
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C264 (NCI Thesaurus ObjectClass-2)
C0003286 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C16554 (NCI Thesaurus Property-2)
C0014442 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.16
Code List
Is this anti-convulsant medication enzyme-inducing?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Is the patient receiving corticosteroids?
text
C38148 (NCI Thesaurus ValueDomain)
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)
CL.17
Code List
Is the patient receiving corticosteroids?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Agent Total Dose
Item
Agent Total Dose (per day)
float
C25304 (NCI Thesaurus ValueDomain)
C2986497 (UMLS CUI-1)
C25379 (NCI Thesaurus Property)
C25488 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
Item
Is the patient receiving other medications?
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass-2)
C0013227 (UMLS 2011AA ObjectClass-2)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
CL.18
Code List
Is the patient receiving other medications?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item Group
Brain: Prior Health History
IntracranialBrainHemorrhageOccurrenceInd-3
Item
Has the patient experienced an intracranial hemorrhage?
boolean
C12439 (NCI Thesaurus ObjectClass)
C0006104 (UMLS 2011AA ObjectClass)
C38236 (NCI Thesaurus ObjectClass-2)
C1522213 (UMLS 2011AA ObjectClass-2)
C26791 (NCI Thesaurus Property)
C0019080 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property-2)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
BrainHemorrhageObservedMostRecentDate
Item
Date of Most Recent (MM DD YYYY)
date
C12439 (NCI Thesaurus ObjectClass)
C0006104 (UMLS 2011AA ObjectClass)
C26791 (NCI Thesaurus Property)
C0019080 (UMLS 2011AA Property)
C25599 (NCI Thesaurus Property-2)
C1441672 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25577 (NCI Thesaurus ValueDomain-2)
C1513491 (UMLS 2011AA ValueDomain-2)
EyeHemorrhageOccurrenceInd-3
Item
Has the patient experienced an intraocular hemorrhage?
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C26791 (NCI Thesaurus Property)
C0019080 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property-2)
C0015392 (NCI Metathesaurus ObjectClass)
EyeHemorrhageObservedMostRecentDate
Item
Date of Most Recent (MM DD YYYY)
date
C0015392 (NCI Metathesaurus ObjectClass)
C26791 (NCI Thesaurus Property)
C0019080 (UMLS 2011AA Property)
C25599 (NCI Thesaurus Property-2)
C1441672 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25577 (NCI Thesaurus ValueDomain-2)
C1513491 (UMLS 2011AA ValueDomain-2)
Item
Current Medical Conditions (currently symptomatic or on medications for)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
CL.21
Code List
Current Medical Conditions (currently symptomatic or on medications for)
CL Item
Cerebrovascular Disease (Cerebrovascular disease)
CL Item
Cardiac Disease (Cardiac disease)
CL Item
Deep Vein Thrombosis (Deep vein thrombosis)
CL Item
Hypertension (Hypertension)
C3117 (NCI Thesaurus)
C0020538 (UMLS 2011AA)
CL Item
Diabetes (Diabetes)
CL Item
Other Malignancies, Specify (Other malignancies specify)
CL Item
Other, Specify (Other specify)
MalignantDiseaseOtherPresentSpecify
Item
Other malignancies specify
text
C14143 (NCI Thesaurus ObjectClass)
C0205282 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25626 (NCI Thesaurus Property-2)
C0150312 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
PatientMedicalConditionCurrentSpecify
Item
Other specify
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus ValueDomain-2)
C0521116 (UMLS 2011AA ValueDomain-2)
Item Group
Brain: Prior Treatment
CancerPriorTreatmentInd-3
Item
Prior Treatment?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C15368 (NCI Thesaurus Property-2)
PriorChemotherapyAdministeredInd-3
Item
Prior Systemic Chemotherapy?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
PriorImmunotherapyAdministeredInd-3
Item
Prior Immunotherapy?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15262 (NCI Thesaurus ObjectClass)
C0021083 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Prior Radiation Therapy
Item
Prior Radiation Therapy?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C0332152 (UMLS CUI-2)
C25629 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
Prior Surgery
Item
Prior Surgery?
boolean
C38148 (NCI Thesaurus ValueDomain)
C0744961 (UMLS CUI-1)
C38000 (NCI Thesaurus Property)
C15329 (NCI Thesaurus ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
PriorRadiationSurgeryAdministeredInd-3
Item
Prior Radiosurgery?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15696 (NCI Thesaurus ObjectClass-2)
C0085203 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
PriorRadiosensitizerAdministeredInd-3
Item
Prior Radiosensitizer Therapy?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C798 (NCI Thesaurus ObjectClass-2)
C0034541 (UMLS 2011AA ObjectClass-2)
PriorTherapyOtherAdministeredInd-3
Item
Any Other Prior Therapy?
boolean
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
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)
PriorTherapyOtherName
Item
Name of other prior therapies (If yes,)
text
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property-2)
C0600091 (UMLS 2011AA Property-2)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
Item Group
Brain: Prior Treatment - Systemic Regimens
PriorTreatmentRegimenName
Item
Prior Treatment Regimen Name (Drug, Agent, Biologic)
text
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C15697 (NCI Thesaurus Property)
C0040808 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
PriorTreatmentRegimenBeginDate
Item
Prior Treatment Regimen Start Date (MM DD YYYY)
date
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C15697 (NCI Thesaurus Property)
C0040808 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
PriorTreatmentRegimenEndDate
Item
Prior Treatment Regimen End Date (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C15697 (NCI Thesaurus Property)
C0040808 (UMLS 2011AA Property)
PriorTreatmentRegimenText
Item
Prior Treatment Regimen Type (Adjuvant, High Dose)
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C15697 (NCI Thesaurus Property)
C0040808 (UMLS 2011AA Property)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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