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Cervical Cancer NCT01101451 Quality of Life - GOG-0263: Quality of Life Questionnaire - 2933853v1.0 - GOG-0263: Quality of Life Questionnaire

- 09-01-15 - 1 Formulier, 7 Itemgroepen, 59 Data-elementen, 1 Taal
Itemgroepen: Header Module, PHYSICAL WELLBEING, SOCIAL/FAMILY WELL-BEING, EMOTIONAL WELL-BEING, FUNCTIONAL WELL-BEING, Additional Concerns, To be Completed by Clinical Staff
GOG-0263: Quality of Life Questionnaire Radiation Therapy With or Without Chemotherapy in Patients With Stage I or Stage II Cervical Cancer Who Previously Underwent Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7170934C-5F81-20E2-E040-BB89AD434964

Lung Cancer NCT01336894 Quality of Life - ACOSOG-Z4099 Patient Questionnaire Form - 3180120v1.0 - ACOSOG-Z4099 Patient Questionnaire Form

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 12 Data-elementen, 1 Taal
Itemgroepen: Header Module, Visit, Quality of Life Information
ACOSOG-Z4099 Patient Questionnaire Form Surgery With or Without Internal Radiation Therapy Compared With Stereotactic Body Radiation Therapy in Treating Patients With High-Risk Stage I Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=98F70399-A5F3-0EAF-E040-BB89AD430DD7

Lung Cancer NCT00107172 Quality of Life - Z4032 UCSD - Shortness of Breath Questionnaire - 2306605v3.0 - Z4032 UCSD - Shortness of Breath Questionnaire

- 09-01-15 - 1 Formulier, 4 Itemgroepen, 30 Data-elementen, 1 Taal
Itemgroepen: Header Module, How short of breath do you get, How much do these limit your daily life, Footer Module
Z4032 UCSD - Shortness of Breath Questionnaire 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=F21FBFC2-16CA-105F-E034-0003BA3F9857

Cervical Cancer NCT00064077 Quality of Life - Quality of Life Questionnaire, GOG-0204 - 2079887v3.0 - Quality of Life Questionnaire, GOG-0204

- 09-01-15 - 1 Formulier, 9 Itemgroepen, 54 Data-elementen, 1 Taal
Itemgroepen: Header, Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, Functional Well-Being, Overall Quality of Life, Additional Concerns, BRIEF PAIN INVENTORY, CCRR MODULE
Quality of Life Questionnaire, GOG-0204 Comparison of Four Combination Chemotherapy Regimens Using Cisplatin in Treating Patients With Stage IVB, Recurrent, or Persistent Cancer of the Cervix Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B58D04F2-7ACB-11E8-E034-0003BA12F5E7

Breast Cancer NCT00914043 Quality of Life - NSABP B-45 Quality of Life Questionnaire Form - 2847215v1.0 - NSABP B-45 Quality of Life Questionnaire Form

- 17-09-21 - 1 Formulier, 9 Itemgroepen, 96 Data-elementen, 1 Taal
Itemgroepen: Header Module, Time Point, QOL, QOL1, QOL2, QOL3, QOL4, QOL5, QOL7
NSABP B-45 Quality of Life Questionnaire Form Studying Biological Markers of Fatigue in Women With Residual Invasive Breast Cancer Enrolled on Clinical Trial NSABP-B-45 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=64B2569C-B533-2D46-E040-BB89AD432515

Breast Cancer NCT00659373 Quality of Life - Quality of Life Core Questionnaire (Form 24-QLC) - 2073639v3.0 - Quality of Life Core Questionnaire (Form 24-QLC)

- 09-01-15 - 1 Formulier, 2 Itemgroepen, 15 Data-elementen, 1 Taal
Itemgroepen: How have you been within the last two weeks?, CCRR MODULE
Quality of Life Core Questionnaire (Form 24-QLC) Brain Function in Premenopausal Women Receiving Tamoxifen With or Without Ovarian Function Suppression for Early-Stage Breast Cancer on Clinical Trial IBCSG-2402 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B0EA521D-9A9B-6310-E034-0003BA12F5E7

Colorectal Cancer NCT00726622 Quality of Life - Z6051 International Index of Erectile Function Questionnaire (IIEF) - 2740994v1.0 - Z6051 International Index of Erectile Function Questionnaire (IIEF)

- 09-01-15 - 1 Formulier, 2 Itemgroepen, 21 Data-elementen, 1 Taal
Itemgroepen: Header Module, IIEF
Z6051 International Index of Erectile Function Questionnaire (IIEF) Laparoscopic-Assisted Resection or Open Resection in Treating Patients With Stage IIA, Stage IIIA, or Stage IIIB Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4AE9A885-FEFA-574B-E044-0003BA3F9857

Cervical Cancer NCT01101451 Quality of Life - Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ) - 2785914v1.0 - Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ)

- 09-01-15 - 1 Formulier, 6 Itemgroepen, 21 Data-elementen, 1 Taal
Itemgroepen: HEADER MODULE, Smoking History Questionnaire, Personal Smoking Section, Household Smoking Section, Second Hand Smoking Section, COMMENTS
Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ) Radiation Therapy With or Without Chemotherapy in Patients With Stage I or Stage II Cervical Cancer Who Previously Underwent Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=572CCDFB-3AD6-1370-E044-0003BA3F9857

S0205 LASA QUALITY OF LIFE QUESTIONNAIRE NCT00075686

- 03-07-15 - 1 Formulier, 4 Itemgroepen, 16 Data-elementen, 1 Taal
Itemgroepen: SWOG clinical trial administrative data, Quality of life assessment, CCRR MODULE, CCRR MODULE
S0205 LASA QUALITY OF LIFE QUESTIONNAIRE NCT00075686 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=A66316F3-7D6E-48C9-E034-0003BA0B1A09

Colorectal Cancer NCT01167725 Quality of Life - USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire - 2858927v1.0 - USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire

- 09-01-15 - 1 Formulier, 11 Itemgroepen, 47 Data-elementen, 1 Taal
Itemgroepen: Header Module, Header Module, Header, Module Question 3, Module Question 4, Module Question 5, Module Question 9, Module Question 11, Header, Unnamed2, Footer Module
USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=665C50CD-E1EF-DFF5-E040-BB89AD43117E

Colorectal Cancer NCT00070122 Quality of Life - SOUTHWEST ONCOLOGY GROUP S0303 Chemotherapy Convenience and Satisfaction Questionnaire - Experience - 2167428v3.0 - SOUTHWEST ONCOLOGY GROUP S0303 Chemotherapy Convenience and Satisfaction Questionnaire - Experience

- 09-01-15 - 1 Formulier, 2 Itemgroepen, 26 Data-elementen, 1 Taal
Itemgroepen: Header, CCRR MODULE
SOUTHWEST ONCOLOGY GROUP S0303 Chemotherapy Convenience and Satisfaction Questionnaire - Experience Combination Chemotherapy and Bevacizumab in Treating Patients With Locally Advanced, Metastatic, or Recurrent Colorectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BC88C25D-EB2A-2B36-E034-0003BA12F5E7

Breast Cancer NCT00914043 Quality of Life - NSABP B-45 Missing Data Worksheet for Quality of Life Questionnaire Form - 2847103v1.0 - NSABP B-45 Missing Data Worksheet for Quality of Life Questionnaire Form

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 11 Data-elementen, 1 Taal
Itemgroepen: Header Module, Reason QOL not assessed, Comments
NSABP B-45 Missing Data Worksheet for Quality of Life Questionnaire Form Studying Biological Markers of Fatigue in Women With Residual Invasive Breast Cancer Enrolled on Clinical Trial NSABP-B-45 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=64AFECAB-BECC-0357-E040-BB89AD431986

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