Information:
Fel:
ID
9251
Beskrivning
S0205 Advanced GI Carcinoma Prestudy Form S0205 Gemcitabine With or Without Cetuximab as First-Line Therapy in Treating Patients With Locally Advanced Unresectable or Metastatic Adenocarcinoma of the Pancreas Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A11A5640-9768-6C93-E034-080020C9C0E0
Länk
Nyckelord
Versioner (2)
- 2012-09-19 2012-09-19 -
- 2015-01-09 2015-01-09 - Martin Dugas
Uppladdad den
9 januari 2015
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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Pancreatic Cancer NCT00075686 Pre-Study - S0205 Advanced GI Carcinoma Prestudy Form - 2035482v3.0
Instructions: All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: S0205 Advanced GI Carcinoma Prestudy Form
Similar models
Instructions: All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: S0205 Advanced GI Carcinoma Prestudy Form
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
Patient Initials
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
InstitutionName
Item
Institution
text
AffiliateName
Item
Affiliate
text
RegisteredInvestigator
Item
Physician
text
InitialDiagnosisDate
Item
Date of initial diagnosis of pancreatic cancer
date
CL Item
The Cancer Is No Bigger Than 2 Centimeters (about 1 Inch) And Has Not Spread Outside The Breast. (I)
CL Item
Iia (II)
CL Item
Defined By Either Of The Following: The Cancer Is Smaller Than 5 Centimeters And Has Spread To The Lymh Nodes Under The Arm, Which Have Grown Into Each Other Or Into Other Structures And Are Attached To Them. The Cancer Is Bigger Than 5 Cm And Has Spre* (III)
CL Item
The Cancer Has Spread To Other Organs Of The Body, Most Often The Bones, Lungs, Liver, Or Brain. Or, Tumor Has Spread Locally To The Skin And Lymph Nodes Inside The Neck, Near The Collarbone. (IVA)
CL Item
IVB (IVB)
CL Item
Iib (IIB)
CL Item
Defined By Either Of The Following.: The Cancer Has Spread To Tissues Near The Breast (skin, Chest Wall, Including The Ribs And The Muscles In The Chest). The Cancer Has Spread To Lymph Nodes Inside The Chest Wall Along The Breast Bone. (IIIB)
Item
Current Disease Status
text
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C0449438 (NCI Metathesaurus Property)
C0012634 (UMLS 2011AA ObjectClass)
C0449438 (NCI Metathesaurus Property)
CL Item
Locally Advanced Unresectable (Locally advanced unresectable)
CL Item
Metastatic (Metastatic)
C14174 (NCI Thesaurus)
C0036525 (UMLS 2011AA)
C0036525 (UMLS 2011AA)
PatientHeight
Item
Height (cm)
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25347 (NCI Thesaurus Property)
C0489786 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25347 (NCI Thesaurus Property)
C0489786 (UMLS 2011AA Property)
PerformanceStatus
Item
Performance Status
text
CL Item
Primary Site/Direct Extension (Primary Site/Direct Extension)
CL Item
Regional Lymph Nodes (Regional Nodes)
CL Item
Distant Lymph Nodes (Distant Nodes)
CL Item
Lung (Lung/Pleura)
C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)
C0024109 (UMLS 2011AA)
CL Item
Liver (Liver)
C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)
C0023884 (UMLS 2011AA)
CL Item
Bone (Bone)
C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)
C0262950 (UMLS 2011AA)
CL Item
Other abdominal (Other abdominal)
CL Item
Other, Specify (Other, specify)
DiseaseInvolvementSite,Other
Item
Other, specify
text
PriorChemotherapyInd
Item
Prior Systemic Therapy
boolean
PriorRTInd
Item
Prior Radiation Therapy
boolean
PriorSurgeryInd
Item
Prior Surgery
boolean
PriorImmunotherapyInd
Item
Prior Immunotherapy
boolean
Comments
Item
Comments
text