ID

8709

Description

Z4032 Brachytherapy Report Surgery With or Without Internal Radiation Therapy in Treating Patients With Stage I Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F21E5540-6368-6874-E034-0003BA3F9857

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F21E5540-6368-6874-E034-0003BA3F9857

Mots-clés

Versions (2)
  1. 18/12/2014 18/12/2014 - Martin Dugas
  2. 09/01/2015 09/01/2015 - Martin Dugas
Téléchargé le

9 janvier 2015

DOI

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Licence

Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00107172 Treatment - Z4032 Brachytherapy Report - 2306538v3.0

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: Z4032 Brachytherapy Report
    1. No Instruction available.
Header Module
Description

Header Module

Visit
Description

AmericanCollegeofSurgeonsOncologyGroupVisitPeriodAmericanCollegeofSurgeonsOncologyGroupVisitPeriodType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C19712
UMLS 2011AA ObjectClass
C1515944
NCI Thesaurus ObjectClass-2
C25716
UMLS 2011AA ObjectClass-2
C0545082
Patient ID
Description

Patient Study ID

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Patient Initials
Description

Patient Initials

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution No.
Description

Institution Number

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Institution Name
Description

Institution Name

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Header
Description

Header

Date of Procedure (OR)
Description

BrachtherapyApplicationDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C25397
UMLS 2011AA Property
C0185125
Not Done
Description

RadiationTherapyNotPerformedText

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15313
UMLS 2011AA ObjectClass
C1522449
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus Property-2
C38000
UMLS 2011AA Property-2
C0884358
Staple line length (CM)
Description

LungLobeExcisionSurgicalMarginMeasurement

Type de données

float

Unités de mesure
  • cm
Alias
NCI Thesaurus ObjectClass
C12468
UMLS 2011AA ObjectClass
C0024109
NCI Thesaurus ObjectClass-2
C13393
UMLS 2011AA ObjectClass-2
C0796494
NCI Thesaurus Property
C15232
UMLS 2011AA Property
C0728940
NCI Thesaurus Property-2
C41227
UMLS 2011AA Property-2
C0229985
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
cm
Brachytherapy technique (check only one box)
Description

BrachytherapyDeliveryTechniqueType

Type de données

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 Property-2
C61560
Mesh Width (Mesh only)
Description

BrachytherapyImplantWidthMeasurement

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C41075
UMLS 2011AA Property
C0021102
NCI Thesaurus Property-2
C25345
UMLS 2011AA Property-2
C0487742
Mesh Length (cm)
Description

BrachytherapyImplantLengthMeasurement

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C41075
UMLS 2011AA Property
C0021102
NCI Thesaurus Property-2
C25334
UMLS 2011AA Property-2
C1444754
Mesh type used
Description

BrachytherapyImplantType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C17948
UMLS 2011AA Property
C0013183
Strand distance from resection margin (double strand only)
Description

BrachytherapySeedImplantationExcisionSurgicalMarginMeasurement

Type de données

float

Unités de mesure
  • cm
Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C15232
UMLS 2011AA Property
C0728940
NCI Thesaurus Property-2
C41227
UMLS 2011AA Property-2
C0229985
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
cm
Total number of strands
Description

BrachytherapySeedImplantationAdministeredTotalNumber

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C25304
UMLS 2011AA ValueDomain-2
C0439810
Strand
Description

BrachytherapySeedImplantationSutureMaterialSequenceNumber

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C25673
UMLS 2011AA ValueDomain-2
C1519249
Length (double strand only)
Description

BrachytherapySeedImplantationMeasurement

Type de données

float

Unités de mesure
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus Property
C16219
UMLS 2011AA Property
C1519225
cm
Seeds per strand
Description

BrachytherapySeedImplantationSutureMaterialNumber

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Activity per strand
Description

BrachytherapySeedImplantationSuturedMaterialDose

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Total activity
Description

BrachytherapySeedImplantationSuturedMaterialTotalDose

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Total # Seeds
Description

BrachytherapySeedImplantationSutureMaterialTotalAdministrationNumber

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C25304
UMLS 2011AA ValueDomain-2
C0439810
NCI Thesaurus ValueDomain-3
C25409
UMLS 2011AA ValueDomain-3
C1533734
Total Activity (mCi)
Description

BrachytherapySeedImplantationSutureMaterialTotalAdministrationDose

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25488
UMLS 2011AA ValueDomain-2
C0178602
NCI Thesaurus ValueDomain-3
C25409
UMLS 2011AA ValueDomain-3
C1533734
Prescription (Gy)
Description

BrachytherapySeedImplantationSutureMaterialDose

Type de données

float

Alias
NCI Thesaurus ObjectClass
C15195
UMLS 2011AA ObjectClass
C0006098
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass-2
C16219
UMLS 2011AA ObjectClass-2
C1519225
NCI Thesaurus Property
C42858
UMLS 2011AA Property
C0038969
Date of post-implant CT (mm/dd/yyyy)
Description

CTPostBrachytherapyDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C17204
UMLS 2011AA ObjectClass
C0040405
NCI Thesaurus Property
C38008
UMLS 2011AA Property
C0687676
NCI Metathesaurus Property
CL054378
Have the 3D dosimetry images, the post implant planning CT, and Dose Volume Histograms for CTV, PTV-1 and PTV-2 been sent to Quality Assurance Review Center (copied or printed copy QARC)
Description

QualityAssuranceCenterSubmissionInd-2

Type de données

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25445
UMLS 2011AA Property
C0205099
NCI Thesaurus Property-2
C25694
UMLS 2011AA Property-2
C1515022
NCI Metathesaurus ObjectClass
C0178932
Footer Module
Description

Footer Module

Completed by
Description

Person Completing Form

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Date Form Completed (mm/dd/yyyy)
Description

Date Form Completed

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1115437
NCI Thesaurus ObjectClass
C40988
NCI Thesaurus Property
C25250
NCI Thesaurus ValueDomain-2
C25367
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1 Formulaires
  1. StudyEvent: Z4032 Brachytherapy Report
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Header Module
Item
Visit
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass-2)
C0545082 (UMLS 2011AA ObjectClass-2)
CL.1
Code List
Visit
CL Item
Day 0 (Day 0)
Patient Study ID
Item
Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Item Group
Header
BrachtherapyApplicationDate
Item
Date of Procedure (OR)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25397 (NCI Thesaurus Property)
C0185125 (UMLS 2011AA Property)
RadiationTherapyNotPerformedText
Item
Not Done
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
LungLobeExcisionSurgicalMarginMeasurement
Item
Staple line length (CM)
float
C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C13393 (NCI Thesaurus ObjectClass-2)
C0796494 (UMLS 2011AA ObjectClass-2)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C41227 (NCI Thesaurus Property-2)
C0229985 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
Item
Brachytherapy technique (check only one box)
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)
C61560 (NCI Thesaurus Property-2)
CL.2
Code List
Brachytherapy technique (check only one box)
CL Item
Mesh (Mesh)
CL Item
Double Strand (Double strand)
BrachytherapyImplantWidthMeasurement
Item
Mesh Width (Mesh only)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C41075 (NCI Thesaurus Property)
C0021102 (UMLS 2011AA Property)
C25345 (NCI Thesaurus Property-2)
C0487742 (UMLS 2011AA Property-2)
BrachytherapyImplantLengthMeasurement
Item
Mesh Length (cm)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C41075 (NCI Thesaurus Property)
C0021102 (UMLS 2011AA Property)
C25334 (NCI Thesaurus Property-2)
C1444754 (UMLS 2011AA Property-2)
Item
Mesh type used
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C17948 (NCI Thesaurus Property)
C0013183 (UMLS 2011AA Property)
CL.3
Code List
Mesh type used
CL Item
Mesh Pre-fabricated By Manufacturer (Mesh pre-fabricated by manufacturer)
CL Item
Mesh Seeds Manually Threaded (Mesh seeds manually threaded)
BrachytherapySeedImplantationExcisionSurgicalMarginMeasurement
Item
Strand distance from resection margin (double strand only)
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C41227 (NCI Thesaurus Property-2)
C0229985 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
BrachytherapySeedImplantationAdministeredTotalNumber
Item
Total number of strands
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25304 (NCI Thesaurus ValueDomain-2)
C0439810 (UMLS 2011AA ValueDomain-2)
BrachytherapySeedImplantationSutureMaterialSequenceNumber
Item
Strand
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25673 (NCI Thesaurus ValueDomain-2)
C1519249 (UMLS 2011AA ValueDomain-2)
BrachytherapySeedImplantationMeasurement
Item
Length (double strand only)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus Property)
C1519225 (UMLS 2011AA Property)
BrachytherapySeedImplantationSutureMaterialNumber
Item
Seeds per strand
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
BrachytherapySeedImplantationSuturedMaterialDose
Item
Activity per strand
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
BrachytherapySeedImplantationSuturedMaterialTotalDose
Item
Total activity
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
BrachytherapySeedImplantationSutureMaterialTotalAdministrationNumber
Item
Total # Seeds
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25304 (NCI Thesaurus ValueDomain-2)
C0439810 (UMLS 2011AA ValueDomain-2)
C25409 (NCI Thesaurus ValueDomain-3)
C1533734 (UMLS 2011AA ValueDomain-3)
BrachytherapySeedImplantationSutureMaterialTotalAdministrationDose
Item
Total Activity (mCi)
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C0178602 (UMLS 2011AA ValueDomain-2)
C25409 (NCI Thesaurus ValueDomain-3)
C1533734 (UMLS 2011AA ValueDomain-3)
BrachytherapySeedImplantationSutureMaterialDose
Item
Prescription (Gy)
float
C15195 (NCI Thesaurus ObjectClass)
C0006098 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C16219 (NCI Thesaurus ObjectClass-2)
C1519225 (UMLS 2011AA ObjectClass-2)
C42858 (NCI Thesaurus Property)
C0038969 (UMLS 2011AA Property)
CTPostBrachytherapyDate
Item
Date of post-implant CT (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C38008 (NCI Thesaurus Property)
C0687676 (UMLS 2011AA Property)
CL054378 (NCI Metathesaurus Property)
QualityAssuranceCenterSubmissionInd-2
Item
Have the 3D dosimetry images, the post implant planning CT, and Dose Volume Histograms for CTV, PTV-1 and PTV-2 been sent to Quality Assurance Review Center (copied or printed copy QARC)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25445 (NCI Thesaurus Property)
C0205099 (UMLS 2011AA Property)
C25694 (NCI Thesaurus Property-2)
C1515022 (UMLS 2011AA Property-2)
C0178932 (NCI Metathesaurus ObjectClass)
Item Group
Footer Module
Person Completing Form
Item
Completed by
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Date Form Completed
Item
Date Form Completed (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
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