ID
9666
Beschrijving
RTOG 0848: Phase III Pancreas-Resected + Adjuvant Treatment Systemic Treatment Summary Form (SF) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=690785CE-F693-0044-E040-BB89AD432A23
Link
Trefwoorden
Versies (4)
- 20-09-12 20-09-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 09-01-15 09-01-15 - Martin Dugas
- 09-01-15 09-01-15 - Martin Dugas
Geüploaded op
9 januari 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Pancreatic Cancer NCT01013649 Treatment - RTOG 0848: Phase III Pancreas-Resected + Adjuvant Treatment Systemic Treatment Summary Form (SF) - 2867004v1.0
INSTRUCTIONS: Form is submitted 1 week after completion or termination of adjuvant systemic treatment. All 4 pages of the form must be submitted. Dates are mm-dd-yyyy unless otherwise specified.
- StudyEvent: RTOG 0848: Phase III Pancreas-Resected + Adjuvant Treatment Systemic Treatment Summary Form (SF)
Beschrijving
Header
Beschrijving
ProtocolTreatmentArmFirstRandomizationAssignmentType
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C42651
- UMLS 2011AA ObjectClass
- C0442711
- NCI Thesaurus Property
- C25196
- UMLS 2011AA Property
- C0034656
- NCI Thesaurus Property-2
- C32141
- UMLS 2011AA Property-2
- C1140618
- NCI Thesaurus Property-3
- C25509
- UMLS 2011AA Property-3
- C1279901
- NCI Thesaurus Property-4
- C25426
- UMLS 2011AA Property-4
- C1516050
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beschrijving
Assessment
Beschrijving
Patient Height
Datatype
float
Maateenheden
- cm
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0489786
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25347
Beschrijving
Patient Weight
Datatype
float
Maateenheden
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Beschrijving
Body Surface Area
Datatype
float
Maateenheden
- m2
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS CUI-1
- C0005902
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property
- C25157
Beschrijving
AgentAdministeredType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Beschrijving
Unnamed 3
Beschrijving
Agent
Datatype
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
Beschrijving
Medication Start Date
Datatype
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
Beschrijving
Medication End Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-2
- C0806020
- NCI Thesaurus Property
- C25275
Beschrijving
Number of Doses, Total
Datatype
float
Alias
- NCI Thesaurus Property
- C25304
- UMLS CUI-1
- C0178602
- NCI Thesaurus ValueDomain
- C25463
- UMLS CUI-2
- C0750480
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property-2
- C25256
Beschrijving
Cumulative Dose Agent
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C2986497
- NCI Thesaurus ObjectClass-2
- C25470
- UMLS CUI-2
- C1521826
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25488
Beschrijving
Dose Modification
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25256
- NCI Thesaurus Property
- C25572
- NCI Thesaurus ValueDomain-2
- C25572
Beschrijving
Off Treatment Reason
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
Beschrijving
Alternative therapy, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0949216
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25415
- NCI Thesaurus Property
- C25382
Beschrijving
Off Treatment Reason, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
- UMLS CUI-3
- C1521902
- NCI Thesaurus Property-2
- C25455
Beschrijving
Off Treatment Reason, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
- UMLS CUI-3
- C1521902
Beschrijving
TherapyModificationText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25572
Beschrijving
Protocol Specific Adverse Event Evaluation
Beschrijving
Adverse Event
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25648
- UMLS CUI-1
- C0877248
- NCI Thesaurus ObjectClass-2
- C41331
- NCI Thesaurus ObjectClass-3
- C15368
- NCI Metathesaurus Property
- C0684224
- NCI Thesaurus ValueDomain
- C38148
Beschrijving
MedDRACode
Datatype
float
Alias
- NCI Thesaurus ValueDomain
- C25162
- UMLS 2011AA ValueDomain
- C0805701
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Metathesaurus ObjectClass
- CL104089
Beschrijving
CTC Adverse Event Term
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C1516728
- NCI Thesaurus ObjectClass
- C49704
- UMLS CUI-2
- C2826934
- NCI Thesaurus Property
- C45559
Beschrijving
CTC Adverse Event Grade
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C49704
- UMLS CUI-1
- C2985911
- NCI Thesaurus ValueDomain
- C18000
- NCI Thesaurus Property
- C25365
Beschrijving
Adverse Event Start Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2697888
- NCI Thesaurus Property
- C25375
- NCI Thesaurus ValueDomain-2
- C25431
- NCI Thesaurus ObjectClass
- C49704
Beschrijving
CTC Adverse Event Attribution Category
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1706735
- NCI Thesaurus ObjectClass
- C49704
- NCI Thesaurus Property
- C25358
Beschrijving
SAE report
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C1519255
- NCI Thesaurus ObjectClass
- C41331
- UMLS CUI-2
- C0684224
- NCI Thesaurus Property
- C25375
- NCI Thesaurus ObjectClass-2
- C54035
Beschrijving
Unnamed Module 4
Beschrijving
Research Comments
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Beschrijving
Investigator Signature
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Beschrijving
Investigator Signature Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
Similar models
INSTRUCTIONS: Form is submitted 1 week after completion or termination of adjuvant systemic treatment. All 4 pages of the form must be submitted. Dates are mm-dd-yyyy unless otherwise specified.
- StudyEvent: RTOG 0848: Phase III Pancreas-Resected + Adjuvant Treatment Systemic Treatment Summary Form (SF)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C42651 (NCI Thesaurus ObjectClass-2)
C0442711 (UMLS 2011AA ObjectClass)
C25196 (NCI Thesaurus Property)
C0034656 (UMLS 2011AA Property)
C32141 (NCI Thesaurus Property-2)
C1140618 (UMLS 2011AA Property-2)
C25509 (NCI Thesaurus Property-3)
C1279901 (UMLS 2011AA Property-3)
C25426 (NCI Thesaurus Property-4)
C1516050 (UMLS 2011AA Property-4)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0489786 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25347 (NCI Thesaurus Property)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
C0005902 (UMLS CUI-1)
C25712 (NCI Thesaurus ValueDomain)
C25157 (NCI Thesaurus Property)
C0332307 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0016360 (UMLS 2011AA)
C505 (NCI Thesaurus-3)
C0016360 (UMLS 2011AA-4)
C0671970 (UMLS 2011AA)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C1521826 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C0808070 (UMLS CUI-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C0806020 (UMLS CUI-2)
C25275 (NCI Thesaurus Property)
C0178602 (UMLS CUI-1)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS CUI-2)
C1708 (NCI Thesaurus ObjectClass)
C25256 (NCI Thesaurus Property-2)
C2986497 (UMLS CUI-1)
C25470 (NCI Thesaurus ObjectClass-2)
C1521826 (UMLS CUI-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25304 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1707811 (UMLS CUI-1)
C25256 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C25572 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA)
C0949216 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25415 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C1521902 (UMLS CUI-3)
C25455 (NCI Thesaurus Property-2)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C1521902 (UMLS CUI-3)
C1527021 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C0877248 (UMLS CUI-1)
C41331 (NCI Thesaurus ObjectClass-2)
C15368 (NCI Thesaurus ObjectClass-3)
C0684224 (NCI Metathesaurus Property)
C38148 (NCI Thesaurus ValueDomain)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0805701 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CL104089 (NCI Metathesaurus ObjectClass)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C45559 (NCI Thesaurus Property)
C2985911 (UMLS CUI-1)
C18000 (NCI Thesaurus ValueDomain)
C25365 (NCI Thesaurus Property)
C2697888 (UMLS CUI-1)
C25375 (NCI Thesaurus Property)
C25431 (NCI Thesaurus ValueDomain-2)
C49704 (NCI Thesaurus ObjectClass)
C1706735 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C25358 (NCI Thesaurus Property)
C0445356 (UMLS 2011AA)
C1519255 (UMLS CUI-1)
C41331 (NCI Thesaurus ObjectClass)
C0684224 (UMLS CUI-2)
C25375 (NCI Thesaurus Property)
C54035 (NCI Thesaurus ObjectClass-2)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)