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NCT01302834 Quality of Life - RTOG 1016 QN: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Hearing Handicap Inventory for Adults (HHIA-S) - 3183758v1.0 - RTOG 1016 QN: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Hearing Handicap Inventory for Adults (HHIA-S)

- 1/9/15 - 1 form, 2 itemgroups, 18 items, 1 language
Itemgroups: Header Module, HEARING HANDICAP INVENTORY FOR ADULTS SCREENING QUESTIONNAIRE (NEWMAENT AL., 1990; NEWMAENT AL., 1991)
RTOG 1016 QN: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Hearing Handicap Inventory for Adults (HHIA-S) Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9A132BA5-9085-FFE2-E040-BB89AD43727A

NCT00113399 RTOG-0421 HP: Radiation Therapy Oncology Group Health Utility Measurement Euro (EQ-5D) Miscellaneous Patient Assessment Form

- 9/20/21 - 1 form, 2 itemgroups, 23 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment
NCT00113399 RTOG-0421 HP: Radiation Therapy Oncology Group Health Utility Measurement Euro (EQ-5D) Miscellaneous Patient Assessment Form Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EBAEDD99-A13F-1374-E034-0003BA3F9857

RTOG 0920 Phase III Head and Neck Cancer Health Utility Measurement Euro QOL (EQ-5D) Form (HP)

- 9/20/21 - 1 form, 4 itemgroups, 38 items, 1 language
Itemgroups: Header Module, QOL Cover Sheet, Health Utility Measurement, Header
RTOG 0920 Phase III Head and Neck Cancer Health Utility Measurement Euro QOL (EQ-5D) Form (HP) Radiation Therapy With or Without Cetuximab in Treating Patients Who Have Undergone Surgery for Locally Advanced Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5D3C3F4A-8C30-21E8-E044-0003BA3F9857

RTOG-0522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941

- 9/20/21 - 1 form, 2 itemgroups, 28 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment
RTOG-00522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F5E8260F-4AEB-157F-E034-0003BA3F9857

NCT01302834 Quality of Life - RTOG 1016 QL35: Radiation Therapy Oncology Group Phase III Head and Neck Cancer EORTC-QLQ-H&N35 - 3159340v1.0 - RTOG 1016 QL35: Radiation Therapy Oncology Group Phase III Head and Neck Cancer EORTC-QLQ-H&N35

- 9/17/21 - 1 form, 5 itemgroups, 42 items, 1 language
Itemgroups: Header Module, EORTC QLQ-H&N35, EORTC QLQ-H&N35 (cont), EORTC QLQ-H&N35 (cont2), EORTC QLQ-H&N35 (cont3)
RTOG 1016 QL35: Radiation Therapy Oncology Group Phase III Head and Neck Cancer EORTC-QLQ-H&N35 Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=95322CC4-A66C-8D67-E040-BB89AD431C52

NCT01302834 Quality of Life - RTOG 1016 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire - 3160066v1.0 - RTOG 1016 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire

- 9/17/21 - 1 form, 2 itemgroups, 29 items, 1 language
Itemgroups: Header Module, Work Status Questionnaire
RTOG 1016 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=953353B4-562C-83C2-E040-BB89AD433EAB

RTOG 1016 HP: Radiation Therapy Oncology Group Phase III Head and Neck Cancer The Health Utility Measurement Euro (EQ-5D)

- 7/2/17 - 1 form, 3 itemgroups, 9 items, 1 language
Itemgroups: Header Module, EQ-5D Health Questionnaire, Health State
RTOG 1016 HP: Radiation Therapy Oncology Group Phase III Head and Neck Cancer The Health Utility Measurement Euro (EQ-5D) Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=95334267-A54C-00F8-E040-BB89AD43108C

RTOG-0522 QP: Miscellaneous Patient Assessment Form NCT00265941

- 6/21/15 - 1 form, 3 itemgroups, 22 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment, COMMENTS
RTOG-0522 QP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F6217E11-C5E7-5543-E034-0003BA3F9857

RTOG-0421 SS: Radiation Therapy Oncology Group Head & Neck Symptom Index-10 (FHNSI-10) Miscellaneous Patient Assessment Form NCT00113399

- 6/21/15 - 1 form, 3 itemgroups, 24 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment, COMMENTS
RTOG-0421 SS: Radiation Therapy Oncology Group Head & Neck Symptom Index-10 (FHNSI-10) Miscellaneous Patient Assessment Form NCT00113399 Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB3734B1-A6F3-725D-E034-0003BA3F9857

RTOG-0421 QP: Radiation Therapy Oncology Group Performance Status Scale Miscellaneous Patient Assessment Form NCT00113399

- 6/21/15 - 1 form, 3 itemgroups, 22 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment, COMMENTS
RTOG-0421 QP: Radiation Therapy Oncology Group Performance Status Scale Miscellaneous Patient Assessment Form NCT00113399 Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB3722D1-7299-70BB-E034-0003BA3F9857

RTOG-0522 FA: FACT (Function Assessment Cancer Therapy) NCT00265941

- 6/21/15 - 1 form, 6 itemgroups, 49 items, 1 language
Itemgroups: RTOG clinical trial administrative data, PHYSICAL WELL-BEING, SOCIAL/FAMILY WELL-BEING, EMOTIONAL WELL-BEING, FUNCTIONAL WELL-BEING, ADDITIONAL CONCERNS
RTOG-0522 FA: FACT (Function Assessment Cancer Therapy) NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F60B771F-164B-2C87-E034-0003BA3F9857

NCT00956007 Quality of Life - RTOG 0920 Phase III Head and Neck Cancer Therapy General Form FACT-H&N (FA) - 2810973v1.0 - RTOG 0920 Phase III Head and Neck Cancer Therapy General Form FACT-H&N (FA)

- 1/9/15 - 1 form, 8 itemgroups, 62 items, 1 language
Itemgroups: Header Module, Header, QOL Cover Sheet, PHYSICAL WELL-BEING, SOCIAL/FAMILY WELL-BEING, EMOTIONAL WELL-BEING, FUNCTIONAL WELL-BEING, ADDITIONAL CONCERNS
RTOG 0920 Phase III Head and Neck Cancer Therapy General Form FACT-H&N (FA) Radiation Therapy With or Without Cetuximab in Treating Patients Who Have Undergone Surgery for Locally Advanced Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5D3C2575-89D6-1D1F-E044-0003BA3F9857

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