Southwest Oncology Group Treatment Form (S0230) Goserelin in Preventing Ovarian Failure in Women Receiving Chemotherapy for Breast Cancer Source Form: NCI FormBuilder:

  1. 8/26/12 8/26/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
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January 9, 2015

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Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00068601 Treatment - Southwest Oncology Group Treatment Form (S0230) - 2170362v3.0

Instructions: All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section.

Vital Status
Has the patient progressed per the definition in Section 10.0 of the protocol?
Goserelin-for Arm 2 Patients Only
Were there any dose modifications or additions/omissions to goserelin?
Ccrr Module For Southwest Oncology Group Treatment Form (s0230)

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