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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 Formular, 2 Itemgruppen, 8 Datenelemente, 1 Sprache
Itemgruppen: 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 Formular, 3 Itemgruppen, 15 Datenelemente, 1 Sprache
Itemgruppen: 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 NCT00978458 Treatment - E3F05 Chemotherapy Form - Arm B Only - 2904374v1.0 - Chemotherapy Form Glioma (Arm B, E3F05)

- 01.01.15 - 1 Formular, 5 Itemgruppen, 31 Datenelemente, 1 Sprache
Itemgruppen: 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

Treatment - Colorectal Cancer - Surgery Form - 2020211v2.31 - Colorectal Cancer - Surgery Form

- 19.09.12 - 1 Formular, 2 Itemgruppen, 23 Datenelemente, 1 Sprache
Itemgruppen: COLORECTAL: SURGICAL PROCEDURE, Comments
Colorectal Cancer - Surgery Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A9B6-3FA4-E034-080020C9C0E0

ICHOM Lung Cancer - At time of treatment decision - Clinical Form

- 30.04.20 - 1 Formular, 2 Itemgruppen, 2 Datenelemente, 1 Sprache
Itemgruppen: Administrative data, Treatment Factors
ICHOM Lung cancer data collection Version 2.3.1 Revised: April 10th, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ Notice: This work was conducted using resources from ICHOM, the International Consortium for Health Outcomes Measurement (www.ICHOM.org). The content is solely the responsibility of the authors and does not necessarily represent the official views of ICHOM. For Lung Cancer, the following conditions and treatment approaches (or interventions) are covered by our Standard Set. Conditions: Small Cell and Non-Small Cell Lung Cancer Treatment Approaches: Surgery | Radiotherapy | Chemotherapy | Targeted Therapy | Immunotherapy | Other This document contains At time of treatment decision - Clinical Form. Collecting Patient-Reported Outcome Measures: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). European Organization for Research and Treatment of Cancer Quality of Life Lung Cancer-Specific Questionnaire (EORTC QLQ-LC13). Both are free for all health care organizations, but a license is needed for use. http:// groups.eortc.be/qol/eortc-qlq-c30 is the official distribution site for EORTC QLQ-C30 and EORTC QLQ-LC13 questionnaires. Therefore only the total score will be included in this version of the standard set. Publication: Mak KS, van Bommel AC, Stowell C, et al. Defining a standard set of patient-centred outcomes for lung cancer. Eur Respir J. 2016;48(3):852–860. doi:10.1183/13993003.02049-2015 For this standard set ICHOM was supported by the Alliance of Dedicated Cancer Centers. For this version of the standard set, semantic annotation with UMLS CUIs has been added.

Intravenous Topotecan and Gemcitabine as Second-line Treatment in Patients With Ovarian Cancer NCT00061308 - Screening - Prior Ovarian Cancer Treatment; Laboratory Tests; Lesion Assessment Record

- 23.08.19 - 1 Formular, 13 Itemgruppen, 48 Datenelemente, 1 Sprache
Itemgruppen: Administrative, Prior Ovarian Cancer Treatment - Chemotherapy, Has the patient received radiotherapy?, Prior Ovarian Cancer Treatment - Radiotherapy , Has the patient received prior cancer-related surgery?, Prior Ovarian Cancer Treatment - Surgical Treatment , Has the patient received other cancer-related treatments?, Other Cancer Related Treatments, Laboratory Tests (within 7 days prior to Day 1) - Haematology, Laboratory Tests (within 7 days prior to Day 1) - Haematology , Laboratory Tests (within 7 days prior to Day 1) - Chemistry, Laboratory Tests (within 7 days prior to Day 1) - Chemistry , Lesion Assessment Record
Study ID: 104864/627 Clinical Study ID: 104864/627 Study Title: An Open-label, Multicenter, Non-Comparative Phase II Study of the Combination of Intravenous Topotecan and Gemcitabine Administered Once Weekly for Three Weeks Every 28 Days as Second-line Treatment in Patients With Recurrent Platinum Sensitive Ovarian Cancer Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00061308 Sponsor: GlaxoSmithKline Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Topotecan, Gemcitabine Study Indication: Peritoneal Cancer, Ovarian Cancer, Neoplasms, Ovarian, Fallopian Tube Cancer

Brain and Central Nervous System Tumors NCT00053963 Treatment - ADVL0212: Reporting Period Worksheet (Leukemia) - 2172521v3.0 - Reporting Period Worksheet (Leukemia ADVL0212)

- 12.03.15 - 1 Formular, 7 Itemgruppen, 66 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient characteristics, Treatment, Concomitant Medication, New Cancer, Follow-Up, Adverse event
ADVL0212: Reporting Period Worksheet (Leukemia) FR901228 in Treating Children With Refractory or Recurrent Solid Tumors or Leukemia NCT00053963 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C0F387DC-C9D3-5664-E034-0003BA12F5E7

Brain and Central Nervous System Tumors NCT00884741 Treatment - RTOG 0825 Phase III GBM Salvage Treatment Guideline Questionnaire (SX) - 2797409v1.0 - RTOG 0825 Phase III GBM Salvage Treatment Guideline Questionnaire (SX)

- 09.01.15 - 1 Formular, 3 Itemgruppen, 13 Datenelemente, 1 Sprache
Itemgruppen: Header Module, Inclusion Criteria, Footer Module
RTOG 0825 Phase III GBM Salvage Treatment Guideline Questionnaire (SX) Temozolomide and Radiation Therapy With or Without Bevacizumab in Treating Patients With Newly Diagnosed Glioblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5AE28686-9246-64D7-E044-0003BA3F9857

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