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Head and Neck Cancer Staging Diagrams Oral Cavity NCT00113399 RTOG-0421 I6 - Staging Diagrams Oral Cavity Head and Neck Cancer NCT00113399

- 30-03-15 - 1 Formulier, 2 Itemgroepen, 14 Data-elementen, 1 Taal
Itemgroepen: Header, Head and Neck cancer characteristics
RTOG-0421 I6: Radiation Therapy Oncology Group Phase III Recurrent Head and Neck Study Staging Diagrams / Oral Cavity Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery NCT00113399 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB499DEC-47D0-3F31-E034-0003BA3F9857

Head and Neck Cancer NCT00265941 Treatment - RTOG-0522 T1: Radiotherapy Form - 2222762v1.0 - RTOG-0522 T1: Radiotherapy Form

- 09-01-15 - 1 Formulier, 1 Itemgroep, 22 Data-elementen, 1 Taal
Itemgroep: MODULE 1
RTOG-0522 T1: RadiotherapyForm 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=F6206E4A-5744-3EFE-E034-0003BA3F9857

Head and Neck Cancer NCT00588770 Off Treatment - ECOG Off-Treatment Form - 2502331v1.0 - Off-Treatment Form Head and Neck Cancer ECOG (NCT00588770)

- 07-01-15 - 1 Formulier, 3 Itemgroepen, 24 Data-elementen, 1 Taal
Itemgroepen: Header, Vital Status, Treatment
ECOG Off-Treatment Form Chemotherapy With or Without Bevacizumab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer NCT00588770 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1A096316-A5E7-28A3-E044-0003BA3F9857

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

- 20-09-21 - 1 Formulier, 9 Itemgroepen, 79 Data-elementen, 1 Taal
Itemgroepen: 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

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

- 20-09-21 - 1 Formulier, 12 Itemgroepen, 102 Data-elementen, 1 Taal
Itemgroepen: 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

Head and Neck Cancer NCT00588770 On-Study - ECOG Baseline Disease Evaluation Form (RECIST) - 2500959v1.0 - ECOG Baseline Disease Evaluation Form (RECIST)

- 09-01-15 - 1 Formulier, 6 Itemgroepen, 30 Data-elementen, 1 Taal
Itemgroepen: Header, Unnamed3, Unnamed2, TARGET LESIONS, NONTARGET LESIONS, Comments
ECOG Baseline Disease Evaluation Form (RECIST) 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=19F70873-B8E3-2933-E044-0003BA3F9857

Head and Neck Cancer NCT00956007 Registration - RTOG 0920 OPEN Registration Worksheet - Step 2 - 3219537v1.0 - RTOG 0920 OPEN Registration Worksheet - Step 2

- 17-09-21 - 1 Formulier, 2 Itemgroepen, 17 Data-elementen, 1 Taal
Itemgroepen: Patient Information 1, Patient Information
RTOG 0920 OPEN Registration Worksheet - Step 2 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=A0190014-3FCB-4E42-E040-BB89AD43786E

NCT00956007 Treatment - RTOG 0920 Phase III Head and Neck Cancer Radiotherapy Form (T1) - 2807789v1.0 - RTOG 0920 Phase III Head and Neck Cancer Radiotherapy Form (T1)

- 09-01-15 - 1 Formulier, 1 Itemgroep, 23 Data-elementen, 1 Taal
Itemgroep: Radiotherapy Form
RTOG 0920 Phase III Head and Neck Cancer Radiotherapy Form (T1) 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=5D1164A3-C392-12C3-E044-0003BA3F9857

NCT00956007 Demographic - RTOG 0920 Phase III Head and Neck Cancer Demographic Data Form (A5) - 2807575v1.0 - RTOG 0920 Phase III Head and Neck Cancer Demographic Data Form (A5)

- 09-01-15 - 1 Formulier, 4 Itemgroepen, 40 Data-elementen, 1 Taal
Itemgroepen: Header Module, Demographic Data, Cigarette History, Family History
RTOG 0920 Phase III Head and Neck Cancer Demographic Data Form (A5) 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=5D112C65-152C-09B2-E044-0003BA3F9857

NCT00956007 Treatment - RTOG 0920 Phase III Head and Neck Cancer Treatment Summary Form (TF) - 2808140v1.0 - RTOG 0920 Phase III Head and Neck Cancer Treatment Summary Form (TF)

- 09-01-15 - 1 Formulier, 15 Itemgroepen, 114 Data-elementen, 1 Taal
Itemgroepen: Header Module, SUMMARY OF SYSTEMIC TREATMENT, WEEK 1-INITIAL DOSE, WEEK 2, WEEK 3, WEEK 4, WEEK 5, WEEK 6, WEEK 7, WEEK 8, WEEK 9, WEEK 10, WEEK 11, Header, Footer Module
RTOG 0920 Phase III Head and Neck Cancer Treatment Summary Form (TF) 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=5D3B4F31-8FDD-6B5A-E044-0003BA3F9857

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

- 20-09-21 - 1 Formulier, 4 Itemgroepen, 38 Data-elementen, 1 Taal
Itemgroepen: 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

NCT01302834 RTOG 1016 TF: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Treatment Summary Form

- 08-07-15 - 1 Formulier, 12 Itemgroepen, 67 Data-elementen, 1 Taal
Itemgroepen: RTOG clinical trial administrative data, Summary of Systemic Treatment, ARM 1 ONLY - DAY 1, DAY 22, Header, ARM 2 ONLY - WEEK 1 - INITIAL DOSE, WEEK 2-8, Non-Protocol Therapy, Tube feeding, Protocol Specific Adverse Event Evaluation: Use the CTC AE version 4 (MedDRA 12) to code all events., New or continuing adverse events, Comments
NCT01302834 RTOG 1016 TF: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Treatment Summary Form Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9418B248-C31D-807C-E040-BB89AD431782

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