ID
42230
Beskrivning
AMC-045 Type III Adverse Event Reporting Form (TAE) 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=1C146B28-823F-583B-E044-0003BA3F9857
Länk
Nyckelord
Versioner (4)
- 2012-08-26 2012-08-26 -
- 2014-11-26 2014-11-26 - Martin Dugas
- 2021-04-13 2021-04-13 - Dr. rer. medic Philipp Neuhaus
- 2021-04-13 2021-04-13 - Ahmed Rafee, MD
Rättsinnehavare
foglt
Uppladdad den
13 april 2021
DOI
För en begäran logga in.
Licens
Creative Commons BY 4.0
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
Anal Cancer NCT00324415 Toxicity - AMC-045 Type III Adverse Event Reporting Form (TAE) - 2516535v1.0
This form should be completed at week 18 for Type III Adverse Events. Type III Adverse Event - (1) any interruption in radiation therapy lasting more that 7 days, (2) failure to complete at least 6 courses of cetuximab and 2 cycles of cisplatin and 5-FU due to toxicity, (3) failure to complete the prescribed course of irradiation due to toxicity
- StudyEvent: AMC-045 Type III Adverse Event Reporting Form (TAE)
Beskrivning
Type III Adverse Events
Alias
- UMLS CUI-1
- C1519275
- UMLS CUI-2
Beskrivning
ProtocolSpecifiedAdverseEventOccurrenceInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C25320
- NCI Thesaurus ObjectClass
- C41331
- NCI Thesaurus ObjectClass
- C38024
- NCI Metathesaurus Property
- CL209504
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C1507394
- UMLS CUI-2
- C0877248
- UMLS CUI-3
- C0205369
- UMLS CUI-4
- C1512698
Beskrivning
RadiationTherapyInterruptionInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- NCI Thesaurus ObjectClass
- C15313
- NCI Thesaurus Property
- C25542
- UMLS CUI-1
- C1512698
- UMLS CUI-2
- C1522449
- UMLS CUI-3
- C1512900
Beskrivning
TreatmentInterruptionDayDuration
Datatyp
integer
Alias
- NCI Thesaurus ValueDomain
- C25301
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ValueDomain
- C25330
- NCI Thesaurus Property
- C25542
- UMLS CUI-1
- C0439228
- UMLS CUI-2
- C0449238
- UMLS CUI-3
- C1512900
Beskrivning
CetuximabCisplatinFluorouracilChemotherapyRegimenInterruptedToxicityInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C15632
- NCI Thesaurus ObjectClass
- C376
- NCI Thesaurus ObjectClass
- C1723
- NCI Thesaurus ObjectClass
- C505
- NCI Thesaurus Property
- C27990
- NCI Thesaurus Property
- C15697
- NCI Metathesaurus Property
- CL212531
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C0392920
- UMLS CUI-2
- C0008838
- UMLS CUI-3
- C0879636
- UMLS CUI-4
- C0016360
- UMLS CUI-5
- C0600688
- UMLS CUI-6
- C0040808
- UMLS CUI-7
- C1512698
Beskrivning
RadiationTherapyRegimenInterruptedToxicityInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C15313
- NCI Thesaurus Property
- C27990
- NCI Thesaurus Property
- C15697
- NCI Metathesaurus Property
- CL212531
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C1522449
- UMLS CUI-2
- C0600688
- UMLS CUI-3
- C0040808
- UMLS CUI-4
- C1512698
Beskrivning
Comments
Alias
- UMLS CUI-1
- C0947611
Similar models
This form should be completed at week 18 for Type III Adverse Events. Type III Adverse Event - (1) any interruption in radiation therapy lasting more that 7 days, (2) failure to complete at least 6 courses of cetuximab and 2 cycles of cisplatin and 5-FU due to toxicity, (3) failure to complete the prescribed course of irradiation due to toxicity
- StudyEvent: AMC-045 Type III Adverse Event Reporting Form (TAE)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C1549755 (UMLS CUI-1)
(UMLS CUI-2)
C41331 (NCI Thesaurus ObjectClass)
C38024 (NCI Thesaurus ObjectClass)
CL209504 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1507394 (UMLS CUI-1)
C0877248 (UMLS CUI-2)
C0205369 (UMLS CUI-3)
C1512698 (UMLS CUI-4)
C15313 (NCI Thesaurus ObjectClass)
C25542 (NCI Thesaurus Property)
C1512698 (UMLS CUI-1)
C1522449 (UMLS CUI-2)
C1512900 (UMLS CUI-3)
C15368 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
C25542 (NCI Thesaurus Property)
C0439228 (UMLS CUI-1)
C0449238 (UMLS CUI-2)
C1512900 (UMLS CUI-3)
C376 (NCI Thesaurus ObjectClass)
C1723 (NCI Thesaurus ObjectClass)
C505 (NCI Thesaurus ObjectClass)
C27990 (NCI Thesaurus Property)
C15697 (NCI Thesaurus Property)
CL212531 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C0392920 (UMLS CUI-1)
C0008838 (UMLS CUI-2)
C0879636 (UMLS CUI-3)
C0016360 (UMLS CUI-4)
C0600688 (UMLS CUI-5)
C0040808 (UMLS CUI-6)
C1512698 (UMLS CUI-7)
C27990 (NCI Thesaurus Property)
C15697 (NCI Thesaurus Property)
CL212531 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C0600688 (UMLS CUI-2)
C0040808 (UMLS CUI-3)
C1512698 (UMLS CUI-4)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI-1)