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Colorectal Cancer Toxicity NCT00303628 E5204 - Adverse Event Form (CTCAE v3.0) Colorectal Cancer NCT00303628

- 20-09-21 - 1 Formulier, 5 Itemgroepen, 24 Data-elementen, 1 Taal
Itemgroepen: Header, Adverse event, Adverse event blood, bone marrow lab, Adverse event infections, Other Adverse Events
E5204 Adverse Event Form (CTCAE v3.0) Combination Chemotherapy With or Without Bevacizumab in Treating Patients Who Have Had Surgery for Stage II or Stage III Rectal Cancer NCT00303628 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=089B4062-6B32-38B1-E044-0003BA3F9857

Metastatic Colorectal Cancer Fluorouracil Leucovorin Irinotecan Oxaliplatin NCT00077233 CALGB 80203 - FACT/GOG NEUROTOXICITY SUBSCALE

- 14-07-17 - 1 Formulier, 1 Itemgroep, 11 Data-elementen, 1 Taal
Itemgroep: Fact/GOG Neurotoxicity Subscale
Colorectal Cancer NCT00077233 Toxicity - CALGB: FACT/GOG NEUROTOXICITY SUBSCALE - 2170915v3.0 CALGB: FACT/GOG NEUROTOXICITY SUBSCALE 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 https://clinicaltrials.gov/ct2/show/NCT00077233

Metastatic Colorectal Cancer Fluorouracil Leucovorin Irinotecan Oxaliplatin NCT00077233 CALGB 80203 - Skin Toxicity Cetuximab

- 14-07-17 - 1 Formulier, 2 Itemgroepen, 20 Data-elementen, 1 Taal
Itemgroepen: Administrative Data, Cetuximab SKIN TOXICITIES
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 https://clinicaltrials.gov/ct2/show/NCT00077233

NCT00070122 SOUTHWEST ONCOLOGY GROUP S0303 ADVERSE EVENT FORM

- 08-07-15 - 1 Formulier, 5 Itemgroepen, 18 Data-elementen, 1 Taal
Itemgroepen: Header, TOXICITY, Adverse event assessment, Comments, CCRR MODULE
NCT00070122 SOUTHWEST ONCOLOGY GROUP S0303 ADVERSE EVENT FORM 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=BC630A33-AF74-10CA-E034-0003BA12F5E7

E5202 Adverse Event Form (CTCAE v3.0) NCT00217737

- 08-07-15 - 1 Formulier, 8 Itemgroepen, 28 Data-elementen, 1 Taal
Itemgroepen: ECOG clinical trial administrative data, Patient demographics, ON TREATMENT, OFF TREATMENT, Adverse event assessment, III. INFECTIONS, Other Adverse Events, Comments
E5202 Adverse Event Form (CTCAE v3.0) NCT00217737 Oxaliplatin, Leucovorin, and Fluorouracil With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF36966F-AF72-06D9-E034-0003BA3F9857

CALGB: 80203 ADVERSE EVENT FORM NCT00077233

- 08-07-15 - 1 Formulier, 5 Itemgroepen, 19 Data-elementen, 1 Taal
Itemgroepen: Header, Patient demographics, AER/ADR filed?, EXPECTED ADVERSE EVENTS, CCRR MODULE
CALGB: 80203 ADVERSE EVENT 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=B4C3B499-D669-0736-E034-0003BA12F5E7

USMCI 8214/Z6091: Adverse Event - Medical Form NCT01167725

- 08-07-15 - 1 Formulier, 2 Itemgroepen, 16 Data-elementen, 1 Taal
Itemgroepen: Header Module, Adverse event report
USMCI 8214/Z6091: Adverse Event - Medical Form NCT01167725 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=625EA23A-C584-1163-E040-BB89AD4327CD

E3201 Adverse Event Form NCT00068692

- 08-07-15 - 1 Formulier, 5 Itemgroepen, 19 Data-elementen, 1 Taal
Itemgroepen: Header, Data amendment, Adverse event assessment, Comments, CCRR MODULE
E3201 Adverse Event 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=B5521EAE-B379-6D90-E034-0003BA12F5E7

CALGB: 80405 ADVERSE EVENT (AE) FORM NCT00265850

- 21-06-15 - 1 Formulier, 3 Itemgroepen, 20 Data-elementen, 1 Taal
Itemgroepen: Header, Patient demographics, EXPECTED ADVERSE EVENTS
CALGB: 80405 ADVERSE EVENT (AE) 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=F39BC806-6212-58D3-E034-0003BA3F9857

Colorectal Cancer (NSABP NCT00096278) - ADVERSE EVENT FORM Colorectal Cancer (NSABP C-08 NCT00096278)

- 23-03-15 - 1 Formulier, 2 Itemgroepen, 18 Data-elementen, 1 Taal
Itemgroepen: Header, Adverse event
NSABP PROTOCOL C-08 ADVERSE EVENT FORM Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer NCT00096278 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF511EA4-0C5D-199B-E034-0003BA3F9857

FORM ALERT Colorectal Cancer (NCT00096278)

- 10-01-15 - 1 Formulier, 2 Itemgroepen, 23 Data-elementen, 1 Taal
Itemgroepen: Header, Adverse event
NSABP PROTOCOL C-08: FORM ALERT Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer NCT00096278 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D7FA5174-1580-6420-E034-0003BA12F5E7

Colorectal Cancer NCT00499369 Toxicity - Southwest Oncology Group S0600 Adverse Event Form - 2813352v1.0 - Southwest Oncology Group S0600 Adverse Event Form

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 19 Data-elementen, 1 Taal
Itemgroepen: Header, Adverse Events, Comments
Southwest Oncology Group S0600 Adverse Event Form 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=5DA30D89-6264-0FC6-E040-BB89A643170F

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