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Anal Cancer NCT00550589 On-Study - AMC-046 HPV On-Study Form (ONS) - 2989612v1.0 - On-Study Form (ONS) AMC-046 HPV

- 20-09-21 - 1 Formulier, 4 Itemgroepen, 25 Data-elementen, 1 Taal
Itemgroepen: Header Module, HIV History, Does the participant have a history of high grade dysplasia, Prior Therapy
Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus NCT00550589 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7D8985E5-2FE1-08A5-E040-BB89AD434A3B

Anal Cancer NCT00324415 Treatment - AMC-045 Concomitant Medication Form (MED) - 2936871v1.0 - AMC-045 Concomitant Medication Form (MED)

- 13-04-21 - 1 Formulier, 2 Itemgroepen, 12 Data-elementen, 1 Taal
Itemgroepen: Concomitant Medications, Comments
AMC-045 Concomitant Medication Form (MED) Cisplatin, Fluorouracil, Cetuximab, and Radiation Therapy in Treating Patients With HIV and Stage I, Stage II, or Stage III Anal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=72844558-61F6-0B0B-E040-BB89AD4314AD

Anal Cancer HIV Cisplatin, Fluorouracil, Cetuximab, and Radiation NCT00324415 AMC-045 - Anal Cancer Initial Evaluation Form

- 28-07-17 - 1 Formulier, 4 Itemgroepen, 31 Data-elementen, 1 Taal
Itemgroepen: Header Module, Tumor Characteristics, Procedures, TNM classification before treatment
AMC-045 Anal Cancer Initial Evaluation Form (IEF) NCT00324415 Pre-Study - AMC-045 Anal Cancer Initial Evaluation Form (IEF) - 2516530v1.0 Cisplatin, Fluorouracil, Cetuximab, and Radiation Therapy in Treating Patients With HIV and Stage I, Stage II, or Stage III Anal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1C146420-B4DA-57A0-E044-0003BA3F9857

HIV Cidofovir High-Grade Squamous Intraepithelial Lesions NCT00550589 AMC-046 - Perianal Response Form

- 11-06-17 - 1 Formulier, 6 Itemgroepen, 14 Data-elementen, 1 Taal
Itemgroepen: Header Module, Complete Response, Partial Response, Stable Disease, Progressive Disease, Comments
AMC-046 Perianal Response Form Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus https://clinicaltrials.gov/ct2/show/NCT00550589

HIV Cidofovir High-Grade Squamous Intraepithelial Lesions NCT00550589 AMC-046 - Perianal Exam and Disease Evaluation Form (PAE)

- 09-06-17 - 1 Formulier, 3 Itemgroepen, 19 Data-elementen, 1 Taal
Itemgroepen: Header Module, Disease Evaluation, Lesion Characteristics
AMC-046 Perianal Exam and Disease Evaluation Form (PAE) Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus https://clinicaltrials.gov/ct2/show/NCT00550589

AMC-076 HIV T-Cell Laboratory Values Form (F24)

- 24-05-17 - 1 Formulier, 2 Itemgroepen, 11 Data-elementen, 1 Taal
Itemgroepen: Header Module, T-Cell Laboratory Values
AMC-076 HIV T-Cell Laboratory Values Form (F24) Infrared Coagulator Ablation or Observation in Preventing Anal Cancer in HIV-Positive Patients With Anal Neoplasia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A80B56C5-5F38-DD40-E040-BB89AD43147B

AMC-076 HPV On-Study Form (ONS) NCT01164722

- 08-07-15 - 1 Formulier, 4 Itemgroepen, 10 Data-elementen, 1 Taal
Itemgroepen: Header Module, HIV Status, Condyloma Status, Comments
AMC-076 HPV On-Study Form (ONS) NCT01164722 Infrared Coagulator Ablation or Observation in Preventing Anal Cancer in HIV-Positive Patients With Anal Neoplasia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A80C062E-17BA-F42E-E040-BB89AD432F38

AMC-046 Screen Failure Form NCT00550589

- 03-06-15 - 1 Formulier, 3 Itemgroepen, 8 Data-elementen, 1 Taal
Itemgroepen: Biopsy/Cytology Status, Screen Failure, Comments
AMC-046 Screen Failure Form Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3BEAAEF0-A692-3FA8-E044-0003BA3F9857 NCT00550589

Anal Cancer NCT01164722 AMC-076 - On-Study Form (ONS) Anal Cancer NCT01164722

- 20-05-15 - 1 Formulier, 4 Itemgroepen, 12 Data-elementen, 1 Taal
Itemgroepen: Header Module, HIV, Condyloma, CD4
AMC-076 HPV On-Study Form (ONS) Infrared Coagulator Ablation or Observation in Preventing Anal Cancer in HIV-Positive Patients With Anal Neoplasia NCT01164722 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A80C062E-17BA-F42E-E040-BB89AD432F38

Anal Cancer NCT00550589 Toxicity - AMC-046 Adverse Events Form (ADV) - 2989394v1.0 - AMC-046 Adverse Events Form (ADV)

- 09-01-15 - 1 Formulier, 4 Itemgroepen, 19 Data-elementen, 1 Taal
Itemgroepen: Adverse Event Information, Adverse Event Information1, Adverse Event Information2, Comments
AMC-046 Adverse Events Form (ADV) Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7D8985E5-2E37-08A5-E040-BB89AD434A3B

Anal Cancer NCT00324415 Toxicity - AMC-045 Adverse Events Form (ADV) - 2936750v1.0 - AMC-045 Adverse Events Form (ADV)

- 09-01-15 - 1 Formulier, 4 Itemgroepen, 21 Data-elementen, 1 Taal
Itemgroepen: Adverse Event Information, Adverse Event Information1, Adverse Event Information2, Comments
AMC-045 Adverse Events Form (ADV) Cisplatin, Fluorouracil, Cetuximab, and Radiation Therapy in Treating Patients With HIV and Stage I, Stage II, or Stage III Anal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=72844558-6106-0B0B-E040-BB89AD4314AD

Anal Cancer NCT00324415 Toxicity - AMC-045 Delayed Toxicity Form (TOX) - 2514820v1.0 - AMC-045 Delayed Toxicity Form (TOX)

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 5 Data-elementen, 1 Taal
Itemgroepen: Header Module, Delayed Toxicity, Comments
AMC-045 Delayed Toxicity Form (TOX) Cisplatin, Fluorouracil, Cetuximab, and Radiation Therapy in Treating Patients With HIV and Stage I, Stage II, or Stage III Anal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1BB3598F-7655-640C-E044-0003BA3F9857

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