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Eligibility Carcinoma, Squamous Cell NCT00671437

- 9/27/21 - 1 form, 2 itemgroups, 12 items, 1 language
Itemgroups: Inclusion Criteria, Exclusion Criteria
Determine Tumor Response Using Fluorodeoxyglucose (FDG)- Positron Emission Tomography (PET)/Computed Tomography (CT) Before and After Cetuximab in Patients With Head and Neck Cancer; ODM derived from: https://clinicaltrials.gov/show/NCT00671437

Eligibility Carcinoma, Squamous Cell of the Head and Neck NCT00753038

- 9/27/21 - 1 form, 2 itemgroups, 16 items, 1 language
Itemgroups: Inclusion Criteria, Exclusion Criteria
Phase 2 Study of REOLYSIN® in Combination With Paclitaxel and Carboplatin in Patients With Head and Neck Carcinoma; ODM derived from: https://clinicaltrials.gov/show/NCT00753038

NCT00113399 RTOG-0421 HP: Radiation Therapy Oncology Group Health Utility Measurement Euro (EQ-5D) Miscellaneous Patient Assessment Form

- 9/20/21 - 1 form, 2 itemgroups, 23 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment
NCT00113399 RTOG-0421 HP: Radiation Therapy Oncology Group Health Utility Measurement Euro (EQ-5D) Miscellaneous Patient Assessment Form Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EBAEDD99-A13F-1374-E034-0003BA3F9857

RTOG 0920 Phase III Head and Neck Cancer Health Utility Measurement Euro QOL (EQ-5D) Form (HP)

- 9/20/21 - 1 form, 4 itemgroups, 38 items, 1 language
Itemgroups: Header Module, QOL Cover Sheet, Health Utility Measurement, Header
RTOG 0920 Phase III Head and Neck Cancer Health Utility Measurement Euro QOL (EQ-5D) Form (HP) Radiation Therapy With or Without Cetuximab in Treating Patients Who Have Undergone Surgery for Locally Advanced Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5D3C3F4A-8C30-21E8-E044-0003BA3F9857

RTOG-0522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941

- 9/20/21 - 1 form, 2 itemgroups, 28 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Miscellaneous Patient Assessment
RTOG-00522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F5E8260F-4AEB-157F-E034-0003BA3F9857

E1305 On-Study Form NCT00588770

- 9/20/21 - 1 form, 9 itemgroups, 71 items, 1 language
Itemgroups: Header, Data amendment, Patient Information, Cardiac History, Prior Treatment for Disease, Disease Status at Initial Diagnosis, Disease Status at Time of Study Entry, Baseline Abnormalities, Footer Module
E1305 On-Study Form NCT00588770 Chemotherapy With or Without Bevacizumab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1A0A6D56-A371-47E3-E044-0003BA3F9857

Initial Evaluation Head and Neck Cancer Stage III or IV RTOG-0522 I1 NCT00265941

- 9/20/21 - 1 form, 9 itemgroups, 79 items, 1 language
Itemgroups: Header, Patient demographics, PRIOR TREATMENT, COMORBIDITY, DIAGNOSTIC WORK-UP, LABORATORY TESTS, TUMOR MEASUREMENTS AT PRESENTATION, Protocol Specific Adverse Event Evaluation, COMMENTS
RTOG-0522 I1: Initial Evaluation Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F64A912E-BA2D-250A-E034-0003BA3F9857

Initial Evaluation recurrent Head and Neck Cancer RTOG NCT00113399

- 9/20/21 - 1 form, 2 itemgroups, 69 items, 1 language
Itemgroups: Header, COMMENTS
Radiation Therapy Oncology Group Follow-up Form Phase III Recurrent Head and Neck Study Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EC4F6FCB-F88D-02BE-E034-0003BA3F9857

Pre-Study Form Head and Neck Cancer Phase III RTOG 0920 I1 NCT00956007

- 9/20/21 - 1 form, 12 itemgroups, 102 items, 1 language
Itemgroups: Header Module, Patient demographics, Swallowing problems/Smoking history, DIAGNOSTIC WORK-UP, Laboratory Values, Primary Site, Staging, Surgery and Pathologic Risk Factors, PRIOR TREATMENT, SEVERE ACTIVE COMORBIDITIES, Protocol Specific Adverse Event Evaluation, Footer Module
NCT00956007 RTOG 0920 Phase III Head and Neck Cancer Initial Evaluation Form (I1) Radiation Therapy With or Without Cetuximab in Treating Patients Who Have Undergone Surgery for Locally Advanced Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5D3AD2F7-ECBD-0ECD-E044-0003BA3F9857

On-Study - Curative Treatment for Head and Neck Cancer - On-Study Form - 2268312v3.0 - Curative Treatment for Head and Neck Cancer - On-Study Form

- 9/20/21 - 1 form, 5 itemgroups, 48 items, 1 language
Itemgroups: CRF Header, Head & Neck: Form Administration, Head & Neck: Patient Assessment, Head & Neck: Disease Description, Head & Neck: Prior Health History - Curative
Curative Treatment for Head and Neck Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D4976276-569A-5CEB-E034-0003BA12F5E7

On-Study - Palliative Treatment for Head and Neck Cancer - On-Study Form - 2267713v3.0 - Palliative Treatment for Head and Neck Cancer - On-Study Form

- 9/20/21 - 1 form, 9 itemgroups, 85 items, 1 language
Itemgroups: CRF Header, Head & Neck: Form Administration, Head & Neck: Patient Assessment, Head & Neck: Disease Description - Initial Diagnosis of Disease, Head & Neck: Disease Description - Current Diagnosis, Head & Neck: Prior Health History - Palliative, Head & Neck: Prior Treatment - Systemic Therapy, Head & Neck: Prior Treatment - Radiation Therapy, Head & Neck: Prior Treatment - Surgery
Palliative Treatment for Head and Neck Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=20B9E4F5-9DD3-2343-E044-0003BA3F9857

Head and Neck Cancer NCT00588770 Eligibility - E1305 Registration Worksheet (step 1) - 2750715v1.0 - E1305 Registration Worksheet (step 1)

- 9/17/21 - 1 form, 1 itemgroup, 14 items, 1 language
Itemgroup: Eligibility
E1305 Registration Worksheet (step 1) Chemotherapy With or Without Bevacizumab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4D9A0B72-1D0D-5E28-E044-0003BA3F9857

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