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Colorectal Cancer NCT01167725 Follow-Up - USMCI 8214/Z6091: Follow Up Form - 2832822v1.0 - USMCI 8214/Z6091: Follow Up Form

- 20-09-21 - 1 Formulier, 9 Itemgroepen, 39 Data-elementen, 1 Taal
Itemgroepen: Header Module, Vital Status, Cancer Follow-Up Status, First Peritoneal Surface Recurrence, First Distant Recurrence, Notice of First Subsequent Treatment, Notice of New Primary, Late Adverse Event, Late Adverse Event Reporting
USMCI 8214/Z6091: Follow Up Form 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=620B3C7C-4FFC-9435-E040-BB89AD430464

SOUTHWEST ONCOLOGY GROUP S0303 FOLLOW UP FORM NCT00070122

- 05-07-15 - 1 Formulier, 9 Itemgroepen, 25 Data-elementen, 1 Taal
Itemgroepen: Header, VITAL STATUS, DISEASE FOLLOW UP STATUS, NOTICE OF FIRST RELAPSE OR PROGRESSION, NOTICE OF NEW PRIMARY, NON-PROTOCOL TREATMENT, LONG TERM TOXICITY, Comments, CCRR MODULE
SOUTHWEST ONCOLOGY GROUP S0303 FOLLOW UP FORM NCT00070122 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=BC72229E-9073-416E-E034-0003BA12F5E7

CALGB: 80203 Follow-up and Response Form NCT00077233

- 05-07-15 - 1 Formulier, 4 Itemgroepen, 28 Data-elementen, 1 Taal
Itemgroepen: Header, Patient demographics, Miscellaneous Patient Assessment, CCRR MODULE
CALGB: 80203 Follow-up and Response Form NCT00077233 Fluorouracil and Leucovorin Plus Either Irinotecan or Oxaliplatin With or Without Cetuximab in Treating Patients With Previously Untreated Metastatic Adenocarcinoma of the Colon or Rectum Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B4C3AFD5-EA93-071F-E034-0003BA12F5E7

SOUTHWEST ONCOLOGY GROUP NOTICE OF DEATH (S0303) NCT00070122

- 03-07-15 - 1 Formulier, 5 Itemgroepen, 22 Data-elementen, 1 Taal
Itemgroepen: Header, Date of death, CAUSES OF DEATH, Comments, CCRR MODULE
SOUTHWEST ONCOLOGY GROUP NOTICE OF DEATH (S0303) NCT00070122 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=BC722876-4198-4172-E034-0003BA12F5E7

NCT00096278 NSABP PROTOCOL C-08: LIVER FUNCTION TEST FOLLOW-UP FORM

- 03-07-15 - 1 Formulier, 2 Itemgroepen, 17 Data-elementen, 1 Taal
Itemgroepen: Header, Liver function
NCT00096278 NSABP PROTOCOL C-08: LIVER FUNCTION TEST FOLLOW-UP FORM Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF5136E1-073F-1BFA-E034-0003BA3F9857

Southwest Oncology Group Notice of Death NCT00499369

- 03-07-15 - 1 Formulier, 4 Itemgroepen, 22 Data-elementen, 1 Taal
Itemgroepen: SWOG clinical trial administrative data, Date of death, CAUSES OF DEATH, Comments
Southwest Oncology Group Notice of Death NCT00499369 Irinotecan and Cetuximab With or Without Bevacizumab in Treating Patients With Metastatic Colorectal Cancer That Progressed During First-Line Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1540B71E-561F-704F-E044-0003BA3F9857

NSABP PROTOCOL C-08: MENSTRUAL STATUS FORM NCT00096278

- 03-07-15 - 1 Formulier, 2 Itemgroepen, 11 Data-elementen, 1 Taal
Itemgroepen: Header, MENSTRUAL STATUS
NSABP PROTOCOL C-08: MENSTRUAL STATUS FORM NCT00096278 Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D7F6C655-DE00-4623-E034-0003BA12F5E7

CALGB: SOLID TUMOR EVALUATION FORM NCT00265850

- 18-06-15 - 1 Formulier, 5 Itemgroepen, 27 Data-elementen, 1 Taal
Itemgroepen: Header, Patient demographics, TARGET LESION(S), NON-TARGET LESION(S), Footer module
CALGB: SOLID TUMOR EVALUATION FORM NCT00265850 Cetuximab and/or Bevacizumab Combined With Combination Chemotherapy in Treating Patients With Metastatic Colorectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F8798A2C-BB78-089F-E034-0003BA3F9857

E3201 Second Primary Form NCT00068692

- 16-06-15 - 1 Formulier, 4 Itemgroepen, 18 Data-elementen, 1 Taal
Itemgroepen: Header, Second primary cancer assessment, Comments, CCRR MODULE
E3201 Second Primary Form NCT00068692 Comparison of Adjuvant Chemotherapy Regimens in Treating Patients With Stage II or Stage III Rectal Cancer Who Are Receiving Radiation Therapy and Fluorouracil Before or After Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B5523D6D-210C-6DCB-E034-0003BA12F5E7

NSABP PROTOCOL C-08: HYPERTENSION STATUS FORM NCT00096278

- 09-06-15 - 1 Formulier, 2 Itemgroepen, 20 Data-elementen, 1 Taal
Itemgroepen: Header, Blood pressure assessment
NSABP PROTOCOL C-08: HYPERTENSION STATUS FORM NCT00096278 Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D7FA15D7-81B4-61AD-E034-0003BA12F5E7

SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0303) NCT00070122

- 09-06-15 - 1 Formulier, 5 Itemgroepen, 20 Data-elementen, 1 Taal
Itemgroepen: Header, Target lesion, Non-target disease, New lesions, Comments
SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0303) NCT00070122 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=D9879314-F0D0-1EFA-E034-0003BA12F5E7

SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM (S0303) NCT00070122

- 09-06-15 - 1 Formulier, 3 Itemgroepen, 17 Data-elementen, 1 Taal
Itemgroepen: Header, Evaluation of lesions, Comments
SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM (S0303) NCT00070122 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=D987428E-4DF8-08E0-E034-0003BA12F5E7

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