Résultats de recherche - Portail des modèles médicaux de données (portail MDM)

RTOG-0525 F1: Follow-Up Form NCT00304031

- 16/06/2015 - 1 Formulaire, 6 Groupes Item, 45 Eléments de données, 1 Langue

Groupes Item: Clinical trial administrative data, Assessment, Disease Progression, Non-Protocol Therapy, Non-Protocol Therapy To Brain, Footer

RTOG-0525 F1: Follow-Up Form NCT00304031 Radiation Therapy and Temozolomide in Treating Patients With Newly Diagnosed Glioblastoma or Gliosarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FD9AAA90-325E-6D58-E034-0003BA3F9857

E3F05 Brain On-Study Form NCT00978458

- 16/06/2015 - 1 Formulaire, 8 Groupes Item, 43 Eléments de données, 1 Langue

Groupes Item: Header Module, Patient demographics, Data amendment, Patient Description Pre-Registration Hematology/Chemistry, Prior Brain Surgery, Motivation for Study Entry, Adverse Events present at time of registration (pre-treatment), Comments

E3F05 Brain On-Study Form NCT00978458 Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6C76FF0A-A556-4EDB-E040-BB89AD4325FA

AMC-061 Adverse Events Form (ADV) NCT00890747

- 16/06/2015 - 1 Formulaire, 2 Groupes Item, 19 Eléments de données, 1 Langue

Groupes Item: Adverse Event Information, Comments

AMC-061 Adverse Events Form (ADV) NCT00890747 Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=71988CF7-F8CE-68F0-E040-BB89AD4358A1

E3F05 Radiation Therapy Form NCT00978458

- 16/06/2015 - 1 Formulaire, 6 Groupes Item, 24 Eléments de données, 1 Langue

Groupes Item: Header Module, Patient demographics, Vital Status, Therapy Administered, Non-Protocol Therapy, Comments

E3F05 Radiation Therapy Form NCT00978458 Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6C1889F9-D047-5474-E040-BB89AD431A23

ACNS0122 Follow-up Worksheet NCT00047320

- 16/06/2015 - 1 Formulaire, 6 Groupes Item, 29 Eléments de données, 1 Langue

Groupes Item: Header, FOLLOW-UP STUDIES, DISEASE STATUS, EVALUATIONS, SIGNIFICANT EVENTS DURING THIS REPORTING PERIOD, CCRR MODULE

ACNS0122 Follow-up 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=BD7AAA29-31DD-2A8B-E034-0003BA12F5E7

ACNS0122: Relapse/Progression Worksheet NCT00047320

- 16/06/2015 - 1 Formulaire, 6 Groupes Item, 29 Eléments de données, 1 Langue

Groupes Item: Header, Date of relapse or progression, TYPE OF RECURRENCE/PROGRESSION, SITES OF INVOLVEMENT, Comments, CCRR MODULE

ACNS0122: Relapse/Progression 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=C3107FBD-6347-26E8-E034-0003BA12F5E7

ADVL0212: Eligibility Worksheet (Leukemia) NCT00053963

- 16/06/2015 - 1 Formulaire, 5 Groupes Item, 33 Eléments de données, 1 Langue

Groupes Item: Header, Eligibility Assessment, Comments, Treatment Assignment, CCRR MODULE

ADVL0212: Eligibility Worksheet (Leukemia) NCT00053963 FR901228 in Treating Children With Refractory or Recurrent Solid Tumors or Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C0F2D219-E599-53B9-E034-0003BA12F5E7

E3F05 Non-Protocol Therapy Form

- 12/06/2015 - 1 Formulaire, 6 Groupes Item, 27 Eléments de données, 1 Langue

Groupes Item: Header Module, Patient demographics, Data amendment, Non-Protocol Therapy Date, Type(s) of first non-protocol therapy, Comments

E3F05 Non-Protocol Therapy Form Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7004AA2A-D8EB-35F3-E040-BB89AD435DD6

E3F05 Off-Treatment Form NCT00978458

- 12/06/2015 - 1 Formulaire, 8 Groupes Item, 26 Eléments de données, 1 Langue

Groupes Item: Header Module, Patient demographics, Data amendment, Vital Status, Protocol treatment, Section I, Section II, Comments

E3F05 Off-Treatment Form NCT00978458 Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6C1889F9-CF7D-5474-E040-BB89AD431A23

North Central Cancer Treatment Group N0577 Notification Form NCT00887146

- 08/06/2015 - 1 Formulaire, 2 Groupes Item, 21 Eléments de données, 1 Langue

Groupes Item: Header Module, Patient status assessment

North Central Cancer Treatment Group N0577 Notification Form NCT00887146 Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C07CD25-652F-2417-E044-0003BA3F9857

North Central Cancer Treatment Group N0577 End Of Active Treatment/Cancel Notification Form NCT00887146

- 08/06/2015 - 1 Formulaire, 2 Groupes Item, 16 Eléments de données, 1 Langue

Groupes Item: Header Module, Preregistration Screening Failure

North Central Cancer Treatment Group N0577 End Of Active Treatment/Cancel Notification Form (Submit Once Per Patient) NCT00887146 Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C090D31-BAA2-2FAA-E044-0003BA3F9857

North Central Cancer Treatment Group N0577 Arm B & C Evaluation/Treatment Form NCT00887146

- 08/06/2015 - 1 Formulaire, 2 Groupes Item, 19 Eléments de données, 1 Langue

Groupes Item: Header Module, Assessment of Chemotherapy

North Central Cancer Treatment Group N0577 Arm B & C Evaluation/Treatment Form NCT00887146 Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C094A66-1244-40DD-E044-0003BA3F9857

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