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["②治療歴情報"]
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["カナ氏名："]
["患者氏名：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日："]
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["性別　　：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年齢　　：",null,null,null,null,null,null,"歳"]
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[]
["【これまでの治療】投与されたレジメン毎に記載"]
["項目",null,null,null,null,null,null,null,null,null,null,null,null,"内容"]
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["治療ライン",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ライン"]
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["治療目的",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"術前補助",null,null,null,null,"術後補助",null,null,null,null,"根治的",null,null,null,null,null,null,null,null,null,null,null,"レジメン内容変更情報","無",false]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緩和的（進行抑制目的）",null,null,null,null,null,null,null,null,null,"その他"]
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["実施施設",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"当院",null,null,null,"他院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"終了理由","無効中止",false]
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["レジメン名（治験の場合は「治験」）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"終了理由","副作用等で中止",false]
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["薬剤名（一般名）"]
[]
[]
["薬剤名（商品名）"]
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["レジメン内容変更情報"]
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["投与開始日"]
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["投与終了日"]
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["終了理由"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"副作用等で中止",null,null,null,null,"（",null,null,null,null,null,"）",null,"その他・不明"]
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["増悪確認日（終了理由が無効中止の場合）"]
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["最良効果"]
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["Grade3以上の有害事象"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"なし",null,null,"あり",null,null,"不明"]
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["有害事象①",null,null,null,null,null,null,null,null,null,null,null,null,null,"CTCAEv5.0名称："]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"最悪 Grade",null,null,null,null,"："]
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["有害事象②",null,null,null,null,null,null,null,null,null,null,null,null,null,"CTCAEv5.0名称："]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"最悪 Grade",null,null,null,null,"："]
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["有害事象③",null,null,null,null,null,null,null,null,null,null,null,null,null,"CTCAEv5.0名称："]
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