No Instruction available.

  1. StudyEvent: North Central Cancer Treatment Group N0577 Radiation Therapy Reporting Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
Protocol ID NCCTG
Item
Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1518419 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25581 (NCI Thesaurus Property-2)
PatientNorthCentralCancerTreatmentGroupIdentifierNumber
Item
Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25581 (NCI Thesaurus Property-2)
C1518419 (UMLS 2011AA Property-2)
Patient Initials
Item
Patient Initials (L F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Number
Item
Institution Number
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Institution Name
Item
Institution
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended (If yes, highlight amended areas)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Brain
C0006104 (UMLS CUI-1)
Radiation Therapy Start Date
Item
Radiation Therapy Start Date
date
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS CUI-1)
C25431 (NCI Thesaurus Property)
C0808070 (UMLS CUI-2)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Radiation Therapy End Date
Item
Radiation Therapy End Date
date
C25164 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C0806020 (UMLS CUI-2)
C25275 (NCI Thesaurus Property)
C25496 (NCI Thesaurus Property-2)
Item Group
Technique
Item
Modality (Primary)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C41147 (NCI Thesaurus Property-2)
C0695347 (UMLS 2011AA Property-2)
Code List
Modality (Primary)
CL Item
Cobalt Radioisotopes (Cobalt)
C0009153 (NCI Metathesaurus)
CL Item
Linear Accelerator (Linear Accelerator)
C28169 (NCI Thesaurus)
C0023730 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Whole-BrainRadiotherapyAdministrationMegaVoltDose
Item
Dose
float
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C54653 (NCI Thesaurus ValueDomain-2)
C1553028 (UMLS 2011AA ValueDomain-2)
C42551 (NCI Thesaurus ValueDomain-3)
C0439502 (UMLS 2011AA ValueDomain-3)
Whole-BrainRadiotherapyRadiationFieldAdministrationSite
Item
Field
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C54648 (NCI Thesaurus Property)
C1882536 (UMLS 2011AA Property)
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
Whole-BrainRadiotherapyRadiationFieldAdministrationAxisMeasurement
Item
Field size
float
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C54648 (NCI Thesaurus Property)
C1882536 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25154 (NCI Thesaurus ValueDomain-2)
C1522496 (UMLS 2011AA ValueDomain-2)
Whole-BrainRadiotherapyRadiationFieldAdministrationPerpendicularAxisMeasurement
Item
Field size
float
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C54648 (NCI Thesaurus Property)
C1882536 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C54649 (NCI Thesaurus ValueDomain-2)
C1295725 (UMLS 2011AA ValueDomain-2)
Whole-BrainRadiotherapyRadiationFieldAdministrationSourceDistanceMeasure
Item
Treatment distance
float
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C54648 (NCI Thesaurus Property)
C1882536 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25683 (NCI Thesaurus ValueDomain-2)
C0449416 (UMLS 2011AA ValueDomain-2)
C25167 (NCI Thesaurus ValueDomain-3)
C0012751 (UMLS 2011AA ValueDomain-3)
Item
Target
text
C16187 (NCI Thesaurus ObjectClass)
C1520143 (UMLS 2011AA ObjectClass)
C54648 (NCI Thesaurus Property)
C1882536 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25702 (NCI Thesaurus ValueDomain-2)
C1521840 (UMLS 2011AA ValueDomain-2)
Code List
Target
CL Item
Source To Surface Distance (SSD)
CL Item
Source To Axis Distance (SAD)
Item Group
Treatment Areas, Dose and Time
Radiation Therapy Body Site
Item
RT Site
text
C25191 (NCI Thesaurus ValueDomain)
C1997599 (UMLS CUI-1)
C25341 (NCI Thesaurus Property)
C15313 (NCI Thesaurus ObjectClass)
Radiation Therapy Total Dose
Item
RT Total Dose (cGy)
float
C25304 (NCI Thesaurus ValueDomain)
C2169193 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C25488 (NCI Thesaurus ValueDomain-2)
C25382 (NCI Thesaurus Property)
Total Number of Fractions
Item
Total Number of Fractions
integer
C25304 (NCI Thesaurus Property)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C1264633 (UMLS CUI-2)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS CUI-3)
C25514 (NCI Thesaurus Property-2)
RadiationTherapyTotalDayCount
Item
Elapsed days
float
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25304 (NCI Thesaurus Property)
C0439810 (UMLS 2011AA Property)
C25301 (NCI Thesaurus Property-2)
C0439228 (UMLS 2011AA Property-2)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
Unscheduled Interruptions in Radiation Therapy
Item
Were there any unscheduled interruptions in radiation therapy?
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C1512900 (UMLS CUI-2)
C25542 (NCI Thesaurus Property)
TreatmentInterruptionDayDuration
Item
Days Treatment Was Interrupted
float
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain-2)
C0449238 (UMLS 2011AA ValueDomain-2)
C25542 (NCI Thesaurus Property)
C1512900 (UMLS 2011AA Property)
Item
Reasons
text
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25542 (NCI Thesaurus Property)
C1512900 (UMLS 2011AA Property)
Code List
Reasons
CL Item
Social (Social)
CL Item
Local Reaction (Local reaction)
CL Item
Systemic Reaction (Systemic reaction)
CL Item
Machine Down (Machine down)
CL Item
Other Specify (other)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
RadiationTherapyInterruptionSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25542 (NCI Thesaurus Property)
C1512900 (UMLS 2011AA Property)
Item Group
Unnamed2
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
RadiationOncologyPhysicianSignatureText
Item
Radiation Oncologist's Signature
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C17833 (NCI Thesaurus ObjectClass-2)
C1514693 (UMLS 2011AA ObjectClass-2)
Investigator Signature Date
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial