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Brain and Central Nervous System Tumors NCT00978458 Follow-Up - E3F05 Primary Brain Tumor Follow-Up Disease Evaluation Form - 2902962v1.0 - E3F05 Primary Brain Tumor Follow-Up Disease Evaluation Form

- 08-01-15 - 1 Formulier, 16 Itemgroepen, 94 Data-elementen, 1 Taal
Itemgroepen: Header Module, Header, ON TREATMENT, OFF TREATMENT, Section I, Section II MEASURABLE LESIONS, T2/FLAIR, T1/Contrast, Section III - Lesions Reported as Non-Measurable at Baseline, T2/FLAIR , T1/Contrast, Section IV New CNS Lesions/New Enhancement of Previously Reported Lesions, T2/FLAIR, T1/Contrast, Section V Progression, Comments
E3F05 Primary Brain Tumor Follow-Up Disease Evaluation 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=6CB91C46-8BDC-9A0D-E040-BB89AD433170

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

- 08-01-15 - 1 Formulier, 2 Itemgroepen, 8 Data-elementen, 1 Taal
Itemgroepen: 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

- 08-01-15 - 1 Formulier, 3 Itemgroepen, 15 Data-elementen, 1 Taal
Itemgroepen: 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

- 08-01-15 - 1 Formulier, 3 Itemgroepen, 28 Data-elementen, 1 Taal
Itemgroepen: 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

- 08-01-15 - 1 Formulier, 5 Itemgroepen, 26 Data-elementen, 1 Taal
Itemgroepen: 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

- 08-01-15 - 1 Formulier, 9 Itemgroepen, 34 Data-elementen, 1 Taal
Itemgroepen: 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)

- 08-01-15 - 1 Formulier, 1 Itemgroep, 4 Data-elementen, 1 Taal
Itemgroep: 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)

- 08-01-15 - 1 Formulier, 1 Itemgroep, 10 Data-elementen, 1 Taal
Itemgroep: 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)

- 08-01-15 - 1 Formulier, 2 Itemgroepen, 20 Data-elementen, 1 Taal
Itemgroepen: 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)

- 01-01-15 - 1 Formulier, 5 Itemgroepen, 31 Data-elementen, 1 Taal
Itemgroepen: 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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