Zoekresultaten - Portaal voor medische datamodellen (MDM-portaal)

CALGB 140503 PRE-REGISTRATION WORKSHEET

- 20-09-21 - 1 Formulier, 3 Itemgroepen, 20 Data-elementen, 1 Taal

Itemgroepen: Protocol Administration, Patient Demographics/Pre-Treatment Characteristics, Notes:

CALGB 140503 PRE-REGISTRATION WORKSHEET Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E4AB7DA-A34F-776C-E040-BB89AD430B3B

E1505 Disease and Vital Status Form NCT00324805

- 20-09-21 - 1 Formulier, 12 Itemgroepen, 45 Data-elementen, 1 Taal

Itemgroepen: Header, Patient demographics, Data amendment, ON TREATMENT, VITAL STATUS, Section II - Reporting Period, Section III - Notice of New Primary, Disease Follow-Up Status, Biopsy, Section VI - Non-Protocol Therapy Prior To Recurrence, Section VII - Treatment for First Recurrence, Footer Module

E1505 Disease and Vital Status Form NCT00324805 Chemotherapy With or Without Bevacizumab in Treating Patients With Stage IB, Stage II, or Stage IIIA Non-Small Lung Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=07D0C4EF-5573-55B4-E044-0003BA3F9857

Registration Worksheet NSCLC Z4032 NCT00107172

- 20-09-21 - 1 Formulier, 8 Itemgroepen, 55 Data-elementen, 1 Taal

Itemgroepen: Header Module, Patient demographics, Pre-Operative Criteria, CT Scan of Chest/Upper Abdomen, Pregnancy Test, Clinical Stage, Pre-operative PFT's, Footer Module

Z4032 Registration Worksheet NCT00107172 Surgery With or Without Internal Radiation Therapy in Treating Patients With Stage I Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F20F53D3-C88B-6847-E034-0003BA3F9857

Intra-operative Registration/Randomization Lung Cancer CALGB 140503 NCT00499330

- 20-09-21 - 1 Formulier, 8 Itemgroepen, 26 Data-elementen, 1 Taal

Itemgroepen: Protocol Administration, Patient Demographics/Pre-Treatment Characteristics1, Patient Demographics/Pre-Treatment Characteristics2, Patient Demographics/Pre-Treatment Characteristics3, Certification Of Eligibility, Protocol Design, Companion Studies, Notes:

Lung Cancer NCT00499330 Registration - CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET - 2916823v1.0 CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E4AB7DA-A794-776C-E040-BB89AD430B3B

Lung Cancer NCT00113386 Quality of Life - RTOG-0412 FA: Funcation Assessment Cancer Therapy - Lung Trial Outcome Index (TOI) - 2288075v3.0 - RTOG-0412 FA: Funcation Assessment Cancer Therapy - Lung Trial Outcome Index (TOI)

- 20-09-21 - 1 Formulier, 4 Itemgroepen, 32 Data-elementen, 1 Taal

Itemgroepen: MODULE 1, PHYSICAL WELL-BEING, FUNCTIONAL WELL-BEING, ADDITIONAL CONCERNS

RTOG-0412 FA: Funcation Assessment Cancer Therapy - Lung Trial Outcome Index (TOI) Cisplatin and Docetaxel With or Without Radiation Therapy in Treating Patients Who Are Undergoing Surgery for Newly Diagnosed Stage III Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E48B0FD8-0824-0529-E034-0003BA3F9857

Prestudy form NSCLC Stage III NCT00020709

- 20-09-21 - 1 Formulier, 4 Itemgroepen, 25 Data-elementen, 1 Taal

Itemgroepen: SWOG clinical trial administrative data, PATIENT AND DISEASE DESCRIPTION, CURRENT LABORATORY VALUES (SI UNITS), Notes

NCT00020709 S0023: Combination Chemo Plus RT With or Without Gefitinib in Treating Patients With Unresectable Stage III NSCLC Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4AA8-361C-E034-080020C9C0E0

CALGB: 30607 Follow-Up and Response Form NCT00693992

- 20-09-21 - 1 Formulier, 6 Itemgroepen, 27 Data-elementen, 1 Taal

Itemgroepen: Header, Patient demographics, Patient status assessment, Response Data, Non-Protocol Treatment, New Primary Data

CALGB: 30607 Follow-Up and Response Form NCT00693992 Sunitinib as Maintenance Therapy in Treating Patients With Stage III or Stage IV Non-Small Cell Lung Cancer Previously Treated With Combination Chemotherapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=35A0F1D4-FCF7-1AF2-E044-0003BA3F9857

ECOG-E1505 Long-Term Follow-up Form NCT00324805

- 20-09-21 - 1 Formulier, 12 Itemgroepen, 46 Data-elementen, 1 Taal

Itemgroepen: Header, Patient demographics, Data amendment, Off protocol treatment period, 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 Recurrence, Treatment for First Recurrence, Footer module

ECOG-E1505 Long-Term Follow-up Form NCT00324805 Chemotherapy With or Without Bevacizumab in Treating Patients With Stage IB, Stage II, or Stage IIIA Non-Small Lung Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=076D113B-20F5-4CB7-E044-0003BA3F9857

Radiation Therapy Oncology Group Initial Follow-up Form Phase III Lung Prophylactic Cranial RT NCT00048997

- 20-09-21 - 1 Formulier, 3 Itemgroepen, 46 Data-elementen, 1 Taal

Itemgroepen: Header Module, Medical history, Comments

Radiation Therapy Oncology Group Initial Follow-up Form Phase III Lung Prophylactic Cranial RT Radiation Therapy in Preventing CNS Metastases in Patients With Non-Small Cell Lung Cancer NCT00048997 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9EC372A6-7094-05D5-E034-080020C9C0E0

Radiation Therapy Oncology Group Follow-up Form Phase III Lung Prophylactic Cranial RT 10363 NCT00048997

- 20-09-21 - 1 Formulier, 3 Itemgroepen, 44 Data-elementen, 1 Taal

Itemgroepen: Header Module, Patient medical history, Comments

Radiation Therapy Oncology Group Follow-up Form Phase III Lung Prophylactic Cranial RT 10363 Radiation Therapy in Preventing CNS Metastases in Patients With Non-Small Cell Lung Cancer NCT00048997 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9EC372A6-6F06-05D5-E034-080020C9C0E0

On-Study Form Lung Cancer - SCLC

- 20-09-21 - 1 Formulier, 8 Itemgroepen, 68 Data-elementen, 1 Taal

Itemgroepen: CRF Header, Pre-Treatment Characteristics , Disease Description SCLC, Prior Treatment SCLC, Prior Systemic Therapy, Prior Surgery, Prior Radiation Therapy, Comments

Phase II Consortium - Phase II Lung Cancer - SCLC On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=005B53D3-2C60-14E5-E044-0003BA3F9857

Lung Cancer NCT00045162 Pre-Study - SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM - 2402234v1.0 - SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM

- 20-09-21 - 1 Formulier, 5 Itemgroepen, 19 Data-elementen, 1 Taal

Itemgroepen: Header, Patient and Disease Description, Current Laboratory Values, Prior Treatment Related To This Cancer, Comments

SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM S0124: Cisplatin Combined With Either Irinotecan or Etoposide in Treating Patients With Extensive-Stage Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=001A8323-2611-48BE-E044-0003BA3F9857

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