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A Phase III Randomized Study of 5-Fluorouracil, Mitomycin-C, and Radiotherapy Versus 5-Fluorouracil, Cisplatin, and Radiotherapy in Carcinoma of the Anal Canal


Phase 3
18 Years
N/A
Not Enrolling
Both
Anal Cancer

Thank you

Trial Information

A Phase III Randomized Study of 5-Fluorouracil, Mitomycin-C, and Radiotherapy Versus 5-Fluorouracil, Cisplatin, and Radiotherapy in Carcinoma of the Anal Canal


OBJECTIVES:

- Compare the initial and total local and distant failure rates in patients with anal
canal cancer treated with either fluorouracil (5-FU) plus mitomycin concurrently with
radiotherapy or 5-FU plus cisplatin followed by 5-FU plus cisplatin concurrently with
radiotherapy.

- Identify any differences in local control and colostomy rates at 2 years in patients
treated with these regimens.

- Determine any difference in colostomy free, disease free, or overall survival in
patients treated with these regimens.

- Compare the toxic effects of these regimens in these patients.

- Evaluate the prognostic effects of tumor markers P53 overexpression, human papilloma
virus status, and enzyme HAP1 in patients treated with these regimens.

OUTLINE: This is a randomized study. Patients are stratified according to gender, nodal
status (positive vs negative), and primary tumor size (greater than 2 cm to 5 cm vs greater
than 5 cm). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive fluorouracil (5-FU) IV continuously over 96 hours beginning on
days 1 and 29 and mitomycin IV on days 1 and 29 with concurrent radiotherapy.

- Arm II: Patients receive induction chemotherapy comprising 5-FU IV continuously over 96
hours beginning on days 1, 29, 57, and 85 and cisplatin IV over 1 hour on days 1, 29,
57, and 85. Beginning on day 57, patients receive concurrent radiotherapy.

In both arms, radiotherapy is administered daily, 5 days a week, for 5-6.5 weeks. Patients
with T3, T4, or N+ lesions or T2 lesions with residual disease receive additional
radiotherapy to a reduced field.

Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then
annually thereafter.

PROJECTED ACCRUAL: A total of 650 patients will be accrued for this study within 5 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed primary squamous, basaloid, or cloacogenic carcinoma of the
anal canal, other than carcinoma in situ

- T2-4, Any N, M0 (stage II or III)

- No local or regional recurrence after local excision or abdominal peritoneal
resection

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Performance status:

- Karnofsky 60-100%

Life expectancy:

- Not specified

Hematopoietic:

- WBC at least 4,000/mm^3

- Absolute neutrophil count at least 1,800/mm^3

- Platelet count at least 100,000/mm^3

- Hemoglobin at least 10 g/dL

Hepatic:

- Bilirubin less than 1.4 mg/dL

Renal:

- Creatinine no greater than 1.5 mg/dL OR

- Creatinine clearance at least 80 mL/min

Cardiovascular:

- No uncompensated heart disease

- No uncontrolled high blood pressure

Other:

- No AIDS

- No active systemic infection

- No uncontrolled diabetes

- No other prior malignancy within the past 5 years except nonmelanoma skin cancer

- No mental condition that would preclude study participation

- Not pregnant or nursing

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Prior epoetin alfa allowed in lieu of blood transfusions

Chemotherapy:

- At least 5 years since prior chemotherapy

Endocrine therapy:

- Not specified

Radiotherapy:

- At least 5 years since prior radiotherapy

Surgery:

- No prior surgery of anal canal except for biopsy of study site

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Principal Investigator

Jaffer A. Ajani, MD

Investigator Role:

Study Chair

Investigator Affiliation:

M.D. Anderson Cancer Center

Authority:

United States: Federal Government

Study ID:

CDR0000066667

NCT ID:

NCT00003596

Start Date:

October 1998

Completion Date:

Related Keywords:

  • Anal Cancer
  • stage II anal cancer
  • stage III anal cancer
  • squamous cell carcinoma of the anus
  • cloacogenic carcinoma of the anus
  • basaloid carcinoma of the anus
  • Anus Neoplasms

Name

Location

Fred Hutchinson Cancer Research CenterSeattle, Washington  98109
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Mayo Clinic - JacksonvilleJacksonville, Florida  32224
Mayo Clinic Cancer CenterRochester, Minnesota  55905
Emory University Hospital - AtlantaAtlanta, Georgia  30322
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
Fox Chase Cancer CenterPhiladelphia, Pennsylvania  19111
CCOP - WichitaWichita, Kansas  67214-3882
Hurley Medical CenterFlint, Michigan  48503
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
CCOP - Kansas CityKansas City, Missouri  64131
CCOP - Missouri Valley Cancer ConsortiumOmaha, Nebraska  68131
CCOP - Southern Nevada Cancer Research FoundationLas Vegas, Nevada  89106
CCOP - Christiana Care Health ServicesWilmington, Delaware  19899
CCOP - Mount Sinai Medical CenterMiami Beach, Florida  33140
CCOP - North Shore University HospitalManhasset, New York  11030
CCOP - Illinois Oncology Research AssociationPeoria, Illinois  61602
CCOP - Carle Cancer CenterUrbana, Illinois  61801
CCOP - Iowa Oncology Research AssociationDes Moines, Iowa  50309-1016
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
CCOP - Northern New JerseyHackensack, New Jersey  07601
Bloomington HospitalBloomington, Indiana  47402
Bergan Mercy Medical CenterOmaha, Nebraska  68124
St. Joseph Regional Cancer CenterBryan, Texas  77802
Aurora Presbyterian HospitalAurora, Colorado  80012
Boulder Community HospitalBoulder, Colorado  80301-9019
Penrose Cancer Center at Penrose HospitalColorado Springs, Colorado  80933
Porter Adventist HospitalDenver, Colorado  80210
Presbyterian - St. Luke's Medical CenterDenver, Colorado  80218
St. Joseph HospitalDenver, Colorado  80218
Rose Medical CenterDenver, Colorado  80220
Swedish Medical CenterEnglewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502
Sky Ridge Medical CenterLone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United HospitalLongmont, Colorado  80502
North Suburban Medical CenterThornton, Colorado  80229
Rush-Copley Cancer Care CenterAurora, Illinois  60507
Hinsdale Hematology Oncology AssociatesHinsdale, Illinois  60521
Carle Cancer Center at Carle Foundation HospitalUrbana, Illinois  61801
Saint Anthony Memorial Health CentersMichigan City, Indiana  46360
Cedar Rapids Oncology AssociatesCedar Rapids, Iowa  52403
Mercy Medical Center - Sioux CitySioux City, Iowa  51104
St. Luke's Regional Medical CenterSioux City, Iowa  51104
CCOP - Michigan Cancer Research ConsortiumAnn Arbor, Michigan  48106
Genesys Hurley Cancer InstituteFlint, Michigan  48503
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Seton Cancer Institute - SaginawSaginaw, Michigan  48601
St. John Macomb HospitalWarren, Michigan  48093
Fairview Ridges HospitalBurnsville, Minnesota  55337
CCOP - DuluthDuluth, Minnesota  55805
Fairview Southdale HospitalEdina, Minnesota  55435
Hutchinson Area Health CareHutchinson, Minnesota  55350
Meeker County Memorial HospitalLichfield, Minnesota  55355
Hennepin County Medical Center - MinneapolisMinneapolis, Minnesota  55415
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
CCOP - MeritCare HospitalFargo, North Dakota  58122
St. Rita's Medical CenterLima, Ohio  45801
Natalie Warren Bryant Cancer Center at St. Francis HospitalTulsa, Oklahoma  74136
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Penn State Cancer Institute at Milton S. Hershey Medical CenterHershey, Pennsylvania  17033-0850
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical CenterLa Crosse, Wisconsin  54601
Marshfield Clinic - Marshfield CenterMarshfield, Wisconsin  54449
Medical College of Wisconsin Cancer CenterMilwaukee, Wisconsin  53226
Massachusetts General Hospital Cancer CenterBoston, Massachusetts  02114
Rapid City Regional HospitalRapid City, South Dakota  57709
Providence Saint Joseph Medical Center - BurbankBurbank, California  91505
Sutter Health Western Division Cancer Research GroupGreenbrae, California  94904
CCOP - Bay Area Tumor InstituteOakland, California  94609-3305
CCOP - Santa Rosa Memorial HospitalSanta Rosa, California  95403
Memorial Hospital Cancer CenterColorado Springs, Colorado  80909
Gulf Coast Cancer Treatment CenterPanama City, Florida  32405-4587
Northwest Community HospitalArlington Heights, Illinois  60005
Lutheran General Cancer Care CenterPark Ridge, Illinois  60068
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Memorial Hospital of South BendSouth Bend, Indiana  46601
Cape Cod HospitalHyannis, Massachusetts  02601
CCOP - Montana Cancer ConsortiumBillings, Montana  59101
Newark Beth Israel Medical CenterNewark, New Jersey  07112
Community Medical CenterToms River, New Jersey  08755
New York Methodist HospitalBrooklyn, New York  11215-3609
CCOP - ColumbusColumbus, Ohio  43206
Veterans Affairs Medical Center - DaytonDayton, Ohio  45428
CCOP - DaytonKettering, Ohio  45429
Albert Einstein Cancer CenterPhiladelphia, Pennsylvania  19141
Mercy Hospital of PittsburghPittsburgh, Pennsylvania  15219
Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
Mercy Hospital Cancer Center - ScrantonScranton, Pennsylvania  18501
CCOP - MainLine HealthWynnewood, Pennsylvania  19096
CCOP - GreenvilleGreenville, South Carolina  29615
Harrington Cancer CenterAmarillo, Texas  79106
Joe Arrington Cancer Research and Treatment CenterLubbock, Texas  79410-1894
Dixie Regional Medical CenterSaint George, Utah  84770
LDS HospitalSalt Lake City, Utah  84143
St. Vincent HospitalGreen Bay, Wisconsin  54307-3508
University of Wisconsin Comprehensive Cancer CenterMadison, Wisconsin  53792
Community Memorial HospitalMenomonee Falls, Wisconsin  53051
Veterans Affairs Medical Center - Milwaukee (Zablocki)Milwaukee, Wisconsin  53295
University of Miami Sylvester Comprehensive Cancer CenterMiami, Florida  33136
CCOP - Northern Indiana CR ConsortiumSouth Bend, Indiana  46601
Holden Comprehensive Cancer Center at University of IowaIowa City, Iowa  52242-1002
CCOP - Grand RapidsGrand Rapids, Michigan  49503
Ellis Fischel Cancer Center at University of Missouri - ColumbiaColumbia, Missouri  65203
Siteman Cancer Center at Barnes-Jewish HospitalSaint Louis, Missouri  63110
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical CenterLebanon, New Hampshire  03756-0002
Cancer Institute of New Jersey at the Cooper University HospitalCamden, New Jersey  08103-1489
MetroHealth's Cancer Care Center at MetroHealth Medical CenterCleveland, Ohio  44106
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State UniversityColumbus, Ohio  43210-1240
CCOP - Columbia River Oncology ProgramPortland, Oregon  97225
Kimmel Cancer Center at Thomas Jefferson University - PhiladelphiaPhiladelphia, Pennsylvania  19107
Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsBaltimore, Maryland  21231-2410
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
USC/Norris Comprehensive Cancer Center and HospitalLos Angeles, California  90033-0804
Veterans Affairs Medical Center - ShreveportShreveport, Louisiana  71130
Veterans Affairs Medical Center - JacksonJackson, Mississippi  39216
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
Brooke Army Medical CenterFort Sam Houston, Texas  78234-6200
Veterans Affairs Medical Center - San Antonio (Murphy)San Antonio, Texas  78284
CCOP - Virginia Mason Research CenterSeattle, Washington  98101
Madigan Army Medical CenterTacoma, Washington  98431-5048
Naval Medical Center - San DiegoSan Diego, California  92134-3202
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.Syracuse, New York  13217
Utah Valley Regional Medical Center - ProvoProvo, Utah  84604
Camden-Clark Memorial HospitalParkersburg, West Virginia  26102
Providence Alaska Medical CenterAnchorage, Alaska  99508
Foundation for Cancer Research and EducationPhoenix, Arizona  85013
Monmouth Medical CenterLong Branch, New Jersey  07740-6395
Veterans Affairs Medical Center - SyracuseSyracuse, New York  13210
University of California Davis Cancer CenterSacramento, California  95817
Wesley Medical CenterWichita, Kansas  67214
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer InstituteBoston, Massachusetts  02115
University of New Mexico Cancer Research and Treatment CenterAlbuquerque, New Mexico  87131
City of Hope Comprehensive Cancer CenterDuarte, California  91010
Fletcher Allen Health Care - University Health Center CampusBurlington, Vermont  05401
Mobile Infirmary Medical CenterMobile, Alabama  36640-0460
John Stoddard Cancer Center at Iowa Methodist Medical CenterDes Moines, Iowa  50309
Midlands Cancer Center at Midlands Community HospitalPapillion, Nebraska  68128-4157
Sunrise Hospital and Medical CenterLas Vegas, Nevada  89109-2306
St. Vincent Mercy Medical CenterToledo, Ohio  43608
CCOP - Colorado Cancer Research Program, IncorporatedDenver, Colorado  80224
Great Falls ClinicGreat Falls, Montana  59405
Kansas Masonic Cancer Research Institute at the University of Kansas Medical CenterKansas City, Kansas  66160-7353
Markey Cancer Center at University of Kentucky Chandler Medical CenterLexington, Kentucky  40536-0084
Cancer Research Center at Boston Medical CenterBoston, Massachusetts  02118
Cancer Institute at Oregon Health and Science UniversityPortland, Oregon  97201-3098
Swedish Cancer Institute at Swedish Medical Center - First Hill CampusSeattle, Washington  98104
Blumenthal Cancer Center at Carolinas Medical CenterCharlotte, North Carolina  28232-2861
Evanston Northwestern Health Care - Evanston HospitalEvanston, Illinois  60201
Fairview University Medical Center - University CampusMinneapolis, Minnesota  55455
Hulston Cancer Center at Cox Medical Center SouthSpringfield, Missouri  65807
St. John's Regional Health CenterSpringfield, Missouri  65804
SUNY Downstate Medical CenterBrooklyn, New York  11203
McDowell Cancer Center at Akron General Medical CenterAkron, Ohio  44307
Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve UniversityCleveland, Ohio  44106
Sioux Valley Hospital and University of South Dakota Medical CenterSioux Falls, South Dakota  57117-5134
M.D. Anderson Cancer Center at University of TexasHouston, Texas  77030
Central Baptist HospitalLexington, Kentucky  40503
Trinity Cancer Care CenterMinot, North Dakota  58701
CCOP - Toledo Community HospitalToledo, Ohio  43623-3456
St. Luke's Hospital Cancer CenterBethlehem, Pennsylvania  18015
Wilford Hall Medical CenterLackland Air Force Base, Texas  78236-5300
Comprehensive Cancer Center at University of Alabama at BirminghamBirmingham, Alabama  35294
Loma Linda University Cancer Institute at Loma Linda University Medical CenterLoma Linda, California  92354
Baptist-South Miami Regional Cancer ProgramMiami, Florida  33176
Via Christi Cancer Center at Via Christi Regional Medical CenterWichita, Kansas  67214
CancerCare of Maine at Eastern Maine Medial CenterBangor, Maine  04401
Spectrum Health Cancer Care - Butterworth CampusGrand Rapids, Michigan  49503-2560
Presbyterian Cancer Center at Presbyterian HospitalCharlotte, North Carolina  28233-3549
Toledo HospitalToledo, Ohio  43606
Greenville Hospital System Cancer CenterGreenville, South Carolina  29605
Mary Babb Randolph Cancer Center at West Virginia University HospitalsMorgantown, West Virginia  26506
Methodist Hospital Cancer Center at Nebraska Methodist Hospital - OmahaOmaha, Nebraska  68114-4199
St. Mary's - Duluth Clinic Cancer CenterDuluth, Minnesota  55805
James P. Wilmot Cancer Center at University of Rochester Medical CenterRochester, New York  14642
Lewistown HospitalLewistown, Pennsylvania  17044
Mount Nittany Medical CenterState College, Pennsylvania  16803
Green Bay Oncology, Limited at St. Mary's HospitalGreen Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical CenterMarinette, Wisconsin  54143
Torrance Memorial Medical CenterTorrance, California  90505
21st Century Oncology - Fort MyersFort Myers, Florida  33901-8082
Tallahassee Memorial HospitalTallahassee, Florida  32308
Baptist Cancer Institute - JacksonvilleJacksonville, Florida  32207
Saint Anthony's Hospital at Saint Anthony's Health CenterAlton, Illinois  62002
Siouxland Hematology-Oncology AssociatesSioux City, Iowa  51101
Cancer Center of Kansas - ChanuteChanute, Kansas  66720
Cancer Center of Kansas - Dodge CityDodge City, Kansas  67801
Cancer Center of Kansas, P.A. - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas - KingmanKingman, Kansas  67068
Southwest Medical CenterLiberal, Kansas  67901
Cancer Center of Kansas - NewtonNewton, Kansas  67114
Cancer Center of Kansas, P.A. - ParsonsParsons, Kansas  67357
Pratt Cancer Center of KansasPratt, Kansas  67124
Cancer Center of Kansas - SalinaSalina, Kansas  67042
Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Cancer Center of Kansas, P.A.Wichita, Kansas  67208
Associates in Womens HealthWichita, Kansas  67203
Cancer Center of Kansas, P.A. - WichitaWichita, Kansas  67214
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Mecosta County General HospitalBig Rapids, Michigan  49307
Metropolitan HospitalGrand Rapids, Michigan  49506
Lacks Cancer Center at Saint Mary's Mercy Medical CenterGrand Rapids, Michigan  49503
Holland Community HospitalHolland, Michigan  49423
Hackley HospitalMuskegon, Michigan  49443
Northern Michigan HospitalPetoskey, Michigan  49770
Munson Medical CenterTraverse City, Michigan  49684
St. Francis Medical CenterCape Girardeau, Missouri  63701
Southeast Missouri Regional Cancer Center at Southeast Missouri HospitalGape Girardeau, Missouri  63701
David C. Pratt Cancer Center at St. John's MercySt. Louis, Missouri  63141
Sletten Regional Cancer InstituteGreat Falls, Montana  59405
Fox Chase Virtua Health Cancer Program - MarltonMarlton, New Jersey  08053
Wayne Memorial Hospital, IncorporatedGoldsboro, North Carolina  27534
Adena Regional Medical CenterChillicothe, Ohio  54601
Doctors Hospital at Ohio HealthColumbus, Ohio  43228
Riverside Methodist Hospital Cancer CareColumbus, Ohio  43214
Grant Riverside Cancer ServicesColumbus, Ohio  43215
Mount Carmel West HospitalColumbus, Ohio  43222
Grady Memorial HospitalDelaware, Ohio  43015
Fairfield Medical CenterLancaster, Ohio  43130
Strecker Cancer Center at Marietta Memorial HospitalMarietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial HospitalNewark, Ohio  43055
Community Hospital of Springfield and Clark CountySpringfield, Ohio  45505
Mercy Medical Center Oncology UnitSpringfield, Ohio  45504
Mount Carmel Cancer Services at Mount Carmel St. Ann's HospitalWesterville, Ohio  43081
Genesis - Good Samaritan HospitalZanesville, Ohio  43701
Avera McKennan Hospital and University Health CenterSioux Falls, South Dakota  57105
Medical X-Ray CenterSioux Falls, South Dakota  57105
Cottonwood Hospital Medical CenterMurray, Utah  84107
McKay-Dee Hospital CenterOgden, Utah  84403
Utah Cancer Specialists at UCS Cancer CenterSalt Lake City, Utah  84106
St. Joseph Hospital Community Cancer CenterBellingham, Washington  98225
Olympic Hematology and OncologyBremerton, Washington  98310
University Cancer Center at University of Washington Medical CenterSeattle, Washington  98195
Harborview Medical CenterSeattle, Washington  98104
Group Health Central HospitalSeattle, Washington  98104
Cancer Care Northwest - Spokane SouthSpokane, Washington  99202
Central Washington HospitalWenatchee, Washington  98801
Wenatchee Valley ClinicWenatchee, Washington  98801
Lombardi Cancer Center at Georgetown University Medical CenterWashington, District of Columbia  20007
Josephine Ford Cancer Center at Henry Ford Health SystemDetroit, Michigan  48202
Memorial Cancer Institute at Memorial Regional HospitalHollywood, Florida  33021
New York Weill Cornell Cancer Center at Cornell UniversityNew York, New York  10021
Lenoir Memorial Cancer CenterKinston, North Carolina  28503-1678
Zimmer Cancer Center at New Hanover Regional Medical CenterWilmington, North Carolina  28402-9025
Crouse HospitalSyracuse, New York  13210
Mountain States Tumor Institute - BoiseBoise, Idaho  83712
Brigham and Women's HospitalBoston, Massachusetts  02115
Medcenter One Health SystemBismarck, North Dakota  58501
Oncology/Hematology Associates of Central Illinois, P.C.Peoria, Illinois  61602
Huntsman Cancer Institute at University of UtahSalt Lake City, Utah  84112
Summit Medical CenterOakland, California  94609
Robert H. Lurie Comprehensive Cancer Center at Northwestern UniversityChicago, Illinois  60611
Elkhart General HospitalElkhart, Indiana  46515
Hillcrest Cancer Center at Hillcrest HospitalMayfield Heights, Ohio  44124
Baptist Centers for Cancer CareMemphis, Tennessee  38120
Front Range Cancer SpecialistsFort Collins, Colorado  80528
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
Finger Lakes Hematology and OncologyClifton Springs, New York  14432
Joan Karnell Cancer Center at Pennsylvania HospitalPhiladelphia, Pennsylvania  19107
Alta Bates Comprehensive Cancer CenterBerkeley, California  94704
Mount Diablo Regional Cancer CenterConcord, California  94524-4110
Marin Cancer Institute at Marin General HospitalGreenbrae, California  94904
Saint Rose HospitalHayward, California  94545
Memorial Medical Center Cancer ServicesModesto, California  95355
California Pacific Medical Center - California CampusSan Francisco, California  94118
J.C. Robinson, M.D. Regional Cancer CenterSan Pablo, California  94806
Sutter Solano Medical CenterVallejo, California  94589
St. Mary-Corwin Regional Medical CenterPueblo, Colorado  81004
Beebe Medical CenterLewes, Delaware  19958
St. Francis HospitalWilmington, Delaware  19805
Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross HospitalFort Lauderdale, Florida  33308
Ella Milbank Foshay Cancer Center at Jupiter Medical CenterJupiter, Florida  33458
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
St. Joseph Medical CenterBloomington, Illinois  61701
Graham HospitalCanton, Illinois  61520
Memorial HospitalCarthage, Illinois  62321
Galesburg Cottage HospitalGalesburg, Illinois  61401
Galesburg ClinicGalesburg, Illinois  61401
InterCommunity Cancer Center of Western IllinoisGalesburg, Illinois  61401
Mason District HospitalHavana, Illinois  62644
Hopedale Medical ComplexHopedale, Illinois  61747
Kewanee HospitalKewanee, Illinois  61443
McDonough District HospitalMacomb, Illinois  61455
Edward Hospital Cancer CenterNaperville, Illinois  60540
BroMenn Regional Medical CenterNormal, Illinois  61761
Community Cancer CenterNormal, Illinois  61761
Community Hospital of OttawaOttawa, Illinois  61350
Cancer Treatment Center at Pekin HospitalPekin, Illinois  61554
OSF St. Francis Medical CenterPeoria, Illinois  61637
Proctor HospitalPeoria, Illinois  61614
Illinois Valley Community HospitalPeru, Illinois  61354
Perry Memorial HospitalPrinceton, Illinois  61356
St. Margaret's HospitalSpring Valley, Illinois  61362
Valley Cancer CenterSpring Valley, Illinois  61362
Center for Cancer Therapy at LaPorte Hospital and Health ServicesLa Porte, Indiana  46350
St. Luke's HospitalCedar Rapids, Iowa  52402
Genesis Medical Center - West CampusDavenport, Iowa  52804
Genesis Regional Cancer Center at Genesis Medical CenterDavenport, Iowa  52803
John Stoddard Cancer Center at Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Mercy Capitol HospitalDes Moines, Iowa  50307
Medical Oncology and Hematology Associates at John Stoddard Cancer CenterDes Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer CenterDes Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Burgess Health CenterOnawa, Iowa  51040
Medical Oncology and Hematology Associates - West Des MoinesWest Des Moines, Iowa  50266
Louisiana State University Health Sciences Center - MonroeMonroe, Louisiana  71210
Feist-Weiller Cancer Center at Louisiana State University Health SciencesShreveport, Louisiana  71130-3932
Union Hospital Cancer Center at Union HospitalElkton MD, Maryland  21921
Hickman Cancer Center at Bixby Medical CenterAdrian, Michigan  49221
St. Joseph Mercy Cancer Center at St. Joseph Mercy HospitalAnn Arbor, Michigan  48106-0995
Upper Michigan Cancer Center at Marquette General HospitalMarquette, Michigan  49855
Providence Cancer Institute at Providence Hospital - Southfield CampusSouthfield, Michigan  48075
MeritCare Clinic - BemidjiBemidji, Minnesota  56601
Brainerd Medical CenterBrainerd, Minnesota  56401
Virginia Piper Cancer Institute at Abbott-Northwestern HospitalMinneapolis, Minnesota  55407
Chippewa County - Montevideo HospitalMontevideo, Minnesota  56265
Hubert H. Humphrey Cancer Center at North Memorial Medical CenterRobbinsdale, Minnesota  55422-2900
CentraCare Clinic - River CampusSt. Cloud, Minnesota  56303
Bryan LGH Medical Center WestLincoln, Nebraska  68502
St. Elizabeth Regional Medical CenterLincoln, Nebraska  68510
Booker Cancer Center at Riverview Medical CenterRed Bank, New Jersey  07701
Fox Chase Cancer Center at St. Francis Medical CenterTrenton, New Jersey  08629
Highland Hospital of RochesterRochester, New York  14620
Community General Hospital of Greater SyracuseSyracuse, New York  13215
Wayne Radiation OncologyGoldsboro, North Carolina  27534
Wilson Medical CenterWilson, North Carolina  27893-3428
Forsyth Regional Cancer Center at Forsyth Medical CenterWinston-Salem, North Carolina  27103
Bismarck Cancer CenterBismarck, North Dakota  58501
St. Alexius Medical CenterBismarck, North Dakota  58502
MeritCare Medical GroupFargo, North Dakota  58122
Samaritan North Cancer Care CenterDayton, Ohio  45415
Grandview HospitalDayton, Ohio  45405
Good Samaritan HospitalDayton, Ohio  45406
Charles F. Kettering Memorial HospitalKettering, Ohio  45429
Lima Memorial HospitalLima, Ohio  45804
St. Luke's HospitalMaumee, Ohio  43537
Middletown Regional HospitalMiddletown, Ohio  45044
St. Charles Mercy HospitalOregon, Ohio  43616
Firelands Regional Medical CenterSandusky, Ohio  44870
Promedica Cancer Center at Flower HospitalSylvania, Ohio  43560
Mercy Hospital of TiffinTiffin, Ohio  44883
UVMC Cancer Care Center at Upper Valley Medical CenterTroy, Ohio  45373-1300
Ruth G. McMillan Cancer Center at Greene Memorial HospitalXenia, Ohio  45385
Legacy Mount Hood Medical CenterGresham, Oregon  97030
Providence Milwaukie HospitalMilwaukie, Oregon  97222
Kaiser Permanente Health Care - PortlandPortland, Oregon  97232
Providence Cancer Center at Providence Portland Medical CenterPortland, Oregon  97213-2967
Providence St. Vincent Medical CenterPortland, Oregon  97225
Legacy Meridian Park HospitalTualatin, Oregon  97062
Bryn Mawr HospitalBryn Mawr, Pennsylvania  19010
Delaware County Regional Cancer Center at Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
St. Mary Regional Cancer CenterLanghorne, Pennsylvania  19047
Lankenau Cancer Center at Lankenau HospitalWynnewood, Pennsylvania  19096
Bon Secours St. Francis Health SystemGreenville, South Carolina  29601
Cancer Therapy and Research CenterSan Antonio, Texas  78229
University Hospital - San AntonioSan Antonio, Texas  78229
Mountainview MedicalBerlin, Vermont  05602
Danville Regional Medical CenterDanville, Virginia  24541
Virginia Oncology Associates - HamptonHampton, Virginia  23666
Green Bay Oncology, Limited at St. Vincent HospitalGreen Bay, Wisconsin  54301-3526
Eureka HospitalEureka, Illinois  61530
Joliet Oncology Hematology Associates, Limited - WestJoliet, Illinois  60435
Oncology Hematology Associates of Central Illinois - OttawaOttawa, Illinois  61350
Cancer Center of Kansas - OttawaOttawa, Kansas  66067
DeCesaris Cancer Institute at Anne Arundel Medical CenterAnnapolis, Maryland  21401
Mercy HospitalCoon Rapids, Minnesota  55433
Mercy and Unity Cancer Center at Mercy and Unity HospitalsFridley, Minnesota  55432-2799
Park Nicollet ClinicSt. Louis Park, Minnesota  55416
St. Anthony's Memorial HospitalEffingham, Illinois  62401
McFarland Clinic, P.C.Ames, Iowa  50010
Saint Anthony Regional HospitalCarroll, Iowa  51401
Miller-Dwan Medical CenterDuluth, Minnesota  55805
St. John's HospitalMaplewood, Minnesota  55109
Rice Memorial HospitalWillmar, Minnesota  56201
Fremont Area Medical CenterFremont, Nebraska  68025-2387
Alegent Health - Immanuel Medical CenterOmaha, Nebraska  68122
Mid Dakota Clinic, P.C.Bismarck, North Dakota  58501
Pottstown Memorial Regional Cancer CenterPottstown, Pennsylvania  19464
Geisinger Medical GroupState College, Pennsylvania  16801
Geisinger Wyoming Valley Medical CenterWilkes-Barre, Pennsylvania  18711
Alaska Regional HospitalAnchorage, Alaska  99508
CCOP - Mayo Clinic Scottsdale Oncology ProgramScottsdale, Arizona  85259
Hembree Mercy Cancer Center at St. Edward Mercy Medical CenterFt. Smith, Arkansas  72903
Mills-Peninsula Health ServicesBurlingame, California  94010
California Cancer Center - Woodward Park OfficeFresno, California  93720
Valley Memorial HospitalLivermore, California  94550
Providence Holy Cross Cancer CenterMission Hills, California  91346-9600
Leavey Cancer Center at Northridge Hospital Medical CenterNorthridge, California  91325
Highland General HospitalOakland, California  94602
Palo Alto Medical FoundationPalo Alto, California  94301
Pomona Valley Hospital Medical CenterPomona, California  91767
Radiological Associates of Sacramento Medical Group, Inc.Sacramento, California  95815
Middlesex Hospital Cancer CenterMiddletown, Connecticut  06457
H. Lee Moffitt Cancer Center and Research Institute at University of South FloridaTampa, Florida  33612
Northeast Georgia Medical CenterGainesville, Georgia  30501
Pearlman Comprehensive Cancer Center at South Georgia Medical CenterValdosta, Georgia  31603
Good Shepherd HospitalBarrington, Illinois  60010
Creticos Cancer Center at Advocate Illinois Masonic Medical CenterChicago, Illinois  60657
Cancer Care Center at Advocate Good Samaritan HospitalDowners Grove, Illinois  60515
Swedish American HospitalRockford, Illinois  61104
St. Francis Hospital and Health CentersBeech Grove, Indiana  46107
Cancer Center at Ball Memorial HospitalMuncie, Indiana  47303
Saint Joseph Regional Medical Center - Plymouth CampusPlymouth, Indiana  46544
Union HospitalTerre Haute, Indiana  47804
Mercy Cancer Center at Mercy Medical CenterCedar Rapids, Iowa  52403
Alegent Health Mercy HospitalCouncil Bluffs, Iowa  51503
Wendt Regional Cancer Center at Finley HospitalDubuque, Iowa  52001
Mercy Cancer Center at Mercy Medical Center - North IowaMason City, Iowa  50401
Alegent Health Community Memorial HospitalMissouri Valley, Iowa  51555
South Central Kansas Regional Medical CenterArkansas City, Kansas  67005
Cancer Treatment Center at the Medical Center - Bowling GreenBowling Green, Kentucky  42101
Merle M. Mahr Cancer Center at Regional Medical Center of Hopkins CountyMadisonville, Kentucky  42431
Tulane Cancer CenterNew Orleans, Louisiana  70112
Central Maine Medical CenterLewiston, Maine  04240
Maine General Medical Center - WatervilleWaterville, Maine  04901
Bethke Cancer Center at Emerson HospitalConcord, Massachusetts  01742
Hudner Oncology Center at Saint Anne's HospitalFall River, Massachusetts  02721
Newton - Wellesley HospitalNewton, Massachusetts  02162
South Suburban Oncology CenterQuincy, Massachusetts  02169
Battle Creek Health SystemBattle Creek, Michigan  49017
Great Lakes Cancer Institute at McLaren Regional Medical CenterFlint, Michigan  48532
Spectrum Health Hospital - Blodgett CampusGrand Rapids, Michigan  49506
Mercy HospitalPort Huron, Michigan  48060
Oncology Care Associates, P.L.L.C.Saint Joseph, Michigan  49085
Cancer Care Center at St. Luke's HospitalDuluth, Minnesota  55805
Cancer Care Center at Regions HospitalSaint Paul, Minnesota  55101
Saint Francis Cancer CenterShakopee, Minnesota  55379
St. Joseph's HospitalSt Paul, Minnesota  55102
Adult and Pediatric Urology, P.L.L.P.St. Cloud, Minnesota  56303
Woodwinds HospitalWoodbury, Minnesota  55125
Regional Cancer Center at Singing River HospitalPascagoula, Mississippi  39581
Saint Luke's HospitalChesterfield, Missouri  63017
Missouri Cancer AssociatesColumbia, Missouri  65201
Missouri Baptist Cancer CenterSt. Louis, Missouri  63131
Center for Cancer Care and ResearchSt. Louis, Missouri  63141
Cancer Center at the Good Samaritan Health SystemsKearney, Nebraska  68847
Cancer Resource Center - LincolnLincoln, Nebraska  68510
Cancer Center at Creighton University Medical CenterOmaha, Nebraska  68131
Washoe Cancer Services at Washoe Medical Center - RenoReno, Nevada  89502
South Jersey Healthcare Regional Cancer CenterMillville, New Jersey  08332
Cancer Center at the Mountainside HospitalMontclair, New Jersey  07042
Atlantic City Medical Center - Mainland DivisionPomona, New Jersey  08240
Capital Health System Regional Cancer CenterTrenton, New Jersey  08618
Hematology-Oncology Associates, PCAlbuquerque, New Mexico  87106
Lovelace Medical Center at Lovelace Sandia Health SystemAlbuquerque, New Mexico  87108
Louis Busch Hager Cancer Center at Mary Imogene Bassett HospitalCooperstown, New York  13326
Catskill Regional Medical CenterHarris, New York  12742
Randolph HospitalAsheboro, North Carolina  27203
John Smith, Jr./Dalton McMichael Cancer Center at Morehead Memorial HospitalEden, North Carolina  27288
Moses Cone Regional Cancer Center at Wesley Long Community HospitalGreensboro, North Carolina  27401
Annie Penn Cancer CenterReidsville, North Carolina  27320
Altru Cancer Center at Altru HospitalGrand Forks, North Dakota  58201
Akron City Hospital at Summa Health SystemAkron, Ohio  44304
University Hospitals Ireland Cancer Center at Mercy Medical CenterCanton, Ohio  44708
Huron Hospital Cancer Care CenterCleveland, Ohio  44112
Euclid HospitalCleveland, Ohio  44119
Miami Valley HospitalDayton, Ohio  45409
Cancer Research UK Medical Oncology Unit at Churchill Hospital & Weatherall Institute of Molecular Medicine - OxfordSalem, Ohio  44460
Medical College of Ohio Cancer InstituteToledo, Ohio  43614
Toledo Clinic, IncorporatedToledo, Ohio  43623
South Pointe Hospital Cancer Care CenterWarrensville Heights, Ohio  44122
Cancer Treatment CenterWooster, Ohio  44691
LaFortune Cancer Center at St. John Health SystemTulsa, Oklahoma  74104
Comprehensive Cancer Center at Legacy Good Samaritan Hospital & Medical CenterPortland, Oregon  97210
Institute of Oncology at Vilnius UniversityPortland, Oregon  97227
Salem Hospital Regional Cancer CenterSalem, Oregon  97309
John and Dorothy Morgan Cancer Center at Lehigh Valley HospitalAllentown, Pennsylvania  18105
Cancer Center at Paoli Memorial HospitalPaoli, Pennsylvania  19301
Allegheny Cancer Center at Allegheny General HospitalPittsburgh, Pennsylvania  15212
Western Pennsylvania Cancer Institute at Western Pennsylvania HospitalPittsburgh, Pennsylvania  15224-1791
St. Joseph Medical CenterReading, Pennsylvania  19604
Guthrie Medical Center - SayreSayre, Pennsylvania  18840
Bon Secours Cancer Care at St. Mary's HospitalRichmond, Virginia  23226
Providence Cancer Institute at Providence Everett Medical Center - Pacific CampusEverett, Washington  98201
Cancer Care Center at Skagit Valley HospitalMt. Vernon, Washington  98273
Cancer Center at Southwest Washington Medical CenterVancouver, Washington  98668
Midelfort Clinic - LutherEau Claire, Wisconsin  54702
Luther Mildelfort HospitalEau Claire, Wisconsin  54702
Central Wisconsin Cancer Program at Agnesian Health CareFond Du Lac, Wisconsin  54935
St. Mary's Hospital Medical CenterGreen Bay, Wisconsin  54303
Vince Lombardi Cancer Clinic at St. Luke's Medical CenterMilwaukee, Wisconsin  53215
All Saints Cancer Center at All Saints HealthcareRacine, Wisconsin  53405
West Allis Memorial HospitalWest Allis, Wisconsin  53227