Description:

ACNS0122 Consolidation Worksheet Neoadjuvant Chemotherapy With or Without Second-Look Surgery Followed by Radiation Therapy With or Without Peripheral Stem Cell Transplantation in Treating Patients With Intracranial Germ Cell Tumors Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BD4225D7-47E1-0D12-E034-0003BA12F5E7

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https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BD4225D7-47E1-0D12-E034-0003BA12F5E7
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Versions (5)
  1. 8/26/12 8/26/12 -
  2. 1/8/15 1/8/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 1/9/15 1/9/15 - Martin Dugas
  5. 7/5/15 7/5/15 -
Uploaded on:

January 8, 2015

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Creative Commons BY-NC 3.0 Legacy
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Brain and Central Nervous System Tumors NCT00047320 Treatment - ACNS0122 Consolidation Worksheet - 2168511v3.0

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Details

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1 forms  
  1. StudyEvent: ACNS0122 Consolidation Worksheet
    1. No Instruction available.
Unnamed2
cm
Kg
Tumor Evaluation
Type [imaging studies]
Disease Status
Was the patient's disease status evaluated during this reporting interval?
Type of response
5 more items in the detailed view.
Evaluations
Was a Neurologic assessment done?
Was endocrinologic evaluation done?
Significant Events During This Reporting Period
Were there any dose modifications or additions/omissions to protocol treatment?
Has a new primary cancer or MDS been diagnosed that has not been previously reported?
Is patient off protocol therapy?
Reason treatment ended
12 more items in the detailed view.
Life status at the end of this reporting period
Was patient unable to be contacted for current scheduled follow-up?
Was the patient enrolled on another COG therapeutic study at the end of the reporting period?
Did the patient withdraw consent for follow-up at the end of the reporting period?
Did the patient receive non-protocol anti-cancer treatment during this reporting period?
Type [non-protocol treatment] (Types of Treatment)
4 more items in the detailed view.
Treatment Plan After This Treatment Period
What is the patient's treatment plan after chemotherapy?
Toxicities
Attribution
Adverse Drug Experience?
Unnamed3
Ccrr Module For Acns0122 Consolidation Worksheet
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