Risultati di ricerca - Portale di modelli di dati medici (MDM-Portal)

Eligibility Brain Cancer NCT01065805

- 20/08/19 - 1 modulo, 2 itemgroups, 13 elementi, 1 linguaggio

Itemgroups: Inclusion Criteria, Exclusion Criteria

A Study to Demonstrate the Safety and Preliminary Efficacy of 18F-FLT in Patients With Solid Tumours or Lymphoma; ODM derived from: https://clinicaltrials.gov/show/NCT01065805

Toxicity - Brain Cancer - Adverse Event Form - 2263172v3.0 - Brain Cancer - Adverse Event Form

- 09/01/15 - 1 modulo, 4 itemgroups, 23 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Form Administration, Brain: Adverse Events, Comments

Brain Cancer - Adverse Event Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE93FBC6-0592-249A-E034-0003BA12F5E7

Treatment - Brain Cancer - Treatment by Cycle Form - 2287531v3.0 - Brain Cancer - Treatment by Cycle Form

- 09/01/15 - 1 modulo, 7 itemgroups, 48 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Treatment Reporting Interval, Brain: Treatment Cycle Information - Clinical Evaluation Follow-up, Brain: Treatment Cycle Information - Systemic Therapy, Brain: Treatment Cycle Information - Concomitant Therapy, Brain: Treatment Schedule - Non-Protocol Therapy, Comments

Brain Cancer - Treatment by Cycle Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51F0AB1-37FF-4133-E034-0003BA3F9857

Treatment - Brain Cancer - Definitive Surgery Form - 2286489v3.0 - Brain Cancer - Definitive Surgery Form

- 09/01/15 - 1 modulo, 5 itemgroups, 20 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Form Administration, Brain: Surgical Treatment for Primary Site, Brain: Most Recent Surgery, Comments

Brain Cancer - Definitive Surgery Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE9506AA-7EEF-2525-E034-0003BA12F5E7

On-Study - Metastatic Brain Cancer - On-Study Form - 2287553v3.0 - Metastatic Brain Cancer - On-Study Form

- 09/01/15 - 1 modulo, 10 itemgroups, 64 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Form Administration, Non-CNS: Initial Disease Description, Brain: Current Disease Description, Brain: Concomitant Medications, Metastatic Brain: Prior Health History, Metastatic Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Brain: Prior Treatment - CNS RT, Brain: Prior Treatment - CNS Surgery

Metastatic Brain Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF3A8ACE-5457-4C56-E034-0003BA3F9857

Treatment - Brain Cancer - Neurologic Evaluation Form - 2286577v3.0 - Brain Cancer - Neurologic Evaluation Form

- 09/01/15 - 1 modulo, 3 itemgroups, 32 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Form Administration, Brain: Neurologic Evaluation

Brain Cancer - Neurologic Evaluation Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE951920-1FCC-25F8-E034-0003BA12F5E7

Follow-Up - Brain Cancer - Event Monitoring Form - 2287724v3.0 - Brain Cancer - Event Monitoring Form

- 09/01/15 - 1 modulo, 7 itemgroups, 29 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Vital Status, Brain: Off Study Reason, Brain: Disease Follow-Up Status, Brain: Notice of Progression, Brain: Notice of New Primary, Brain: Long-Term Toxicity

Brain Cancer - Event Monitoring Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DD029-A8BB-3E76-E034-0003BA3F9857

Treatment - Brain Cancer - Radiation Therapy Treatment Form - 2286709v3.0 - Brain Cancer - Radiation Therapy Treatment Form

- 09/01/15 - 1 modulo, 3 itemgroups, 18 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Radiation Therapy, Comments

Brain Cancer - Radiation Therapy Treatment Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE952E13-775D-272C-E034-0003BA12F5E7

On-Study - Primary Brain Cancer - On-Study Form Recurrent Treatment - 2293986v3.0 - Primary Brain Cancer - On-Study Form Recurrent Treatment

- 09/01/15 - 1 modulo, 9 itemgroups, 62 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Form Administration, Brain: Recurrent Disease Description, Brain: Neurologic Function, Brain: Concomitant Medications, Brain: Prior Health History, Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Comments

Primary Brain Cancer - On-Study Form Recurrent Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DA7FB-264B-3B94-E034-0003BA3F9857

On-Study - Primary Brain Cancer - On-Study Form Newly Diagnosed Patients - 2293729v3.0 - Primary Brain Cancer - On-Study Form Newly Diagnosed Patients

- 09/01/15 - 1 modulo, 7 itemgroups, 45 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Form Administration, Brain: Disease Description, Brain: Neurologic Function, Brain: Prior Health History, Brain: Concomitant Medications, Brain: Prior Surgical Treatment for Primary Site

Primary Brain Cancer - On-Study Form Newly Diagnosed Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51E77B9-7E48-3A03-E034-0003BA3F9857

PBSC Harvest Worksheet Germ Cell Tumors ACNS0122 NCT00047320

- 31/07/15 - 1 modulo, 5 itemgroups, 19 elementi, 2 lingue

Itemgroups: Header, Height / Weight, Peripheral stem cell transplantation, Organ function, Comments

ACNS0122 PBSC Harvest Worksheet NCT00047320 Neoadjuvant Chemotherapy With or Without Second-Look Surgery Followed by Radiation Therapy With or Without Peripheral Stem Cell Transplantation in Treating Patients With Intracranial Germ Cell Tumors Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BD8E5AF7-9FAF-0089-E034-0003BA12F5E7

Response - Baseline Brain Tumor Evaluation Form - 2291059v3.0 - Baseline Brain Tumor Evaluation Form

- 09/01/15 - 1 modulo, 5 itemgroups, 28 elementi, 1 linguaggio

Itemgroups: CRF Header, Brain: Disease at Baseline, Brain: Measurable Lesion(s) Baseline Evaluation, Brain: Non-measurable/evaluable Lesion(s) Baseline Evaluation, Comments

Baseline Brain Tumor Evaluation Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E12EBFF4-9ABA-55D4-E034-0003BA12F5E7

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