Description:

RTOG-1010 A2 Registration Worksheet Form Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=903C5206-194A-6ECF-E040-BB89AD435F63

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=903C5206-194A-6ECF-E040-BB89AD435F63

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Versions (2) ▾
  1. 12/18/14
  2. 1/9/15
Uploaded on:

January 9, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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Adenocarcinoma of the Gastroesophageal Junction NCT01196390 Demographic - RTOG-1010 A2 Registration Worksheet Form - 3137821v1.0

No Instruction available.

  1. StudyEvent: RTOG-1010 A2 Registration Worksheet Form
    1. No Instruction available.
Module 1
Is the patient going to receive protocol treatment
If no, provide reason
Has the Step 2 eligibility checklist been completed
In the opinion of the investigator, is the patient eligible?
Patient has consented to take part in the Quality of Life Study
If no, provide reason
Presence of adenopathy
Is the patient HER2 positive