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Brain and Central Nervous System Tumors NCT00978458 On-Study - E3F05 Neurologic Function Status and KPS Form - 2901661v1.0 - E3F05 Neurologic Function Status and KPS Form

- 08/01/2015 - 1 Formulaire, 7 Groupes Item, 22 Eléments de données, 1 Langue
Groupes Item: Header Module, ON TREATMENT, OFF TREATMENT, Amendment, Vital Status, Patient Characteristics, Footer Module
E3F05 Neurologic Function Status and KPS 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=6C76FF0A-A486-4EDB-E040-BB89AD4325FA

Brain and Central Nervous System Tumors NCT00887146 Treatment - North Central Cancer Treatment Group N0577 CTEP Report Variables Prior Therapy - 2745128v1.0 - North Central Cancer Treatment Group N0577 CTEP Report Variables Prior Therapy

- 08/01/2015 - 1 Formulaire, 2 Groupes Item, 8 Eléments de données, 1 Langue
Groupes Item: Header, Prior Therapy
North Central Cancer Treatment Group N0577 CTEP Report Variables Prior Therapy 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=4C07CD25-64D7-2417-E044-0003BA3F9857

Brain and Central Nervous System Tumors NCT00887146 On-Study - North Central Cancer Treatment Group CD Submission Form - 2804515v1.0 - North Central Cancer Treatment Group CD Submission Form

- 08/01/2015 - 1 Formulaire, 3 Groupes Item, 15 Eléments de données, 1 Langue
Groupes Item: Header Module, Header, Completed by VIEW Personnel:
North Central Cancer Treatment Group CD Submission Form 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=5C3973FB-A21F-4ECE-E044-0003BA3F9857

Brain and Central Nervous System Tumors NCT00887146 Treatment - North Central Cancer Treatment Group N0577 Concurrent Steroid and Anticonvulsant Treatment Form - Baseline - 2745270v1.0 - North Central Cancer Treatment Group N0577 Concurrent Steroid and Anticonvulsant Treatment Form - Baseline

- 08/01/2015 - 1 Formulaire, 3 Groupes Item, 28 Eléments de données, 1 Langue
Groupes Item: Header, Header, Concomitant Treatmet
North Central Cancer Treatment Group N0577 Concurrent Steroid and Anticonvulsant Treatment Form - Baseline 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=4C07E8C3-3306-293D-E044-0003BA3F9857

Radiation Therapy Reporting Form N0577

- 08/01/2015 - 1 Formulaire, 5 Groupes Item, 26 Eléments de données, 1 Langue
Groupes Item: Header Module, Brain, Technique, Treatment Areas, Dose and Time, Footer Module
North Central Cancer Treatment Group N0577 Radiation Therapy Reporting Form 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=4C094A4D-BDDC-3997-E044-0003BA3F9857

Brain and Central Nervous System Tumors NCT00978458 Follow-Up - E3F05 Long-Term Follow-up Form - 2900961v1.0 - E3F05 Long-Term Follow-up Form

- 08/01/2015 - 1 Formulaire, 9 Groupes Item, 34 Eléments de données, 1 Langue
Groupes Item: Header Module, Header, Section I - Vital Status, Section II - Reporting Period, Section III - Notice of New Primary, Section IV - Disease Follow-up Status, Section V - Adverse Events, Section VI - Non-Protocol Therapy Prior To (CNS) Progression, Footer Module
E3F05 Long-Term Follow-up 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=6C1889F9-D142-5474-E040-BB89AD431A23

Brain and Central Nervous System Tumors NCT00890747 Off Treatment - AMC-061 Off Protocol Treatment Summary Form (F05) - 2934968v1.0 - AMC-061 Off Protocol Treatment Summary Form (F05)

- 08/01/2015 - 1 Formulaire, 1 Groupe Item, 4 Eléments de données, 1 Langue
Groupe Item: Off-Protocol Treatment Summary
AMC-061 Off Protocol Treatment Summary Form (F05) 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-F855-68F0-E040-BB89AD4358A1

Death Form (F04) Brain and Central Nervous System Tumors (NCT00890747)

- 08/01/2015 - 1 Formulaire, 1 Groupe Item, 10 Eléments de données, 1 Langue
Groupe Item: Death Information
AMC-061 Death Form (F04) Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy NCT00890747 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=71988CF7-F80D-68F0-E040-BB89AD4358A1

Radiology Review Form (SR) Glioblastoma (NCT00884741)

- 08/01/2015 - 1 Formulaire, 2 Groupes Item, 20 Eléments de données, 1 Langue
Groupes Item: Header Module, Progression/Radiology Review
RTOG 0825 Phase III GBM Radiology Review Form (SR) Temozolomide and Radiation Therapy With or Without Bevacizumab in Treating Patients With Newly Diagnosed Glioblastoma NCT00884741 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5A7BE879-E0E2-3571-E044-0003BA3F9857

Brain and Central Nervous System Tumors NCT00978458 Treatment - E3F05 Chemotherapy Form - Arm B Only - 2904374v1.0 - Chemotherapy Form Glioma (Arm B, E3F05)

- 01/01/2015 - 1 Formulaire, 5 Groupes Item, 31 Eléments de données, 1 Langue
Groupes Item: Header Module, Vital Status, Patient Characteristics, Therapy Administered, Non-Protocol Therapy
E3F05 Chemotherapy Form - Arm B Only Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma NCT00978458 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6D055B43-63F1-A6F7-E040-BB89AD436A92

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