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A Double-Blind Study Of Nutritional Intervention For The Treatment Of Cancer Cachexia Using Juven® Nutritional Supplement


Phase 3
17 Years
N/A
Not Enrolling
Both
Cachexia, Lymphoma, Lymphoproliferative Disorder, Unspecified Adult Solid Tumor, Protocol Specific

Thank you

Trial Information

A Double-Blind Study Of Nutritional Intervention For The Treatment Of Cancer Cachexia Using Juven® Nutritional Supplement


OBJECTIVES:

- Compare the change in lean body mass of patients treated with Juven® vs a non-Juven®
supplement.

- Compare the change in fatigue and quality of life of patients treated with these
supplements.

- Compare the results of plethysmography, bioimpedance, and skinfold measurement in
patients treated with these supplements.

- Compare the weight change in patients treated with these supplements.

OUTLINE: This is a randomized, double-blind, multicenter study. Patients are stratified
according to primary disease site (lung vs others), concurrent chemotherapy (yes vs no),
evidence of metastases (yes vs no), and degree of weight loss (2-5% vs 6-10%). Patients are
randomized to 1 of 2 treatment arms.

- Arm I: Patients receive oral Juven® supplement twice daily for 8 weeks.

- Arm II: Patients receive oral non-Juven® supplement twice daily for 8 weeks. All
patients undergo lean body mass measurement (to include multiple body composition and
weight change) and fatigue and quality of life assessments at baseline and then at 4
and 8 weeks.

PROJECTED ACCRUAL: A total of 468 patients (234 per treatment arm) will be accrued for this
study within 16 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed solid tumor or lymphoma with no leukemic
aspect

- Stage III or IV or any other stage associated with current metastatic disease at
presentation

- No primary or metastatic brain tumors

- Weight loss of at least 2% but no more than 10% within the past 3 months

- No ascites

PATIENT CHARACTERISTICS:

Age

- 17 and over

Performance status

- Zubrod 0-2

Life expectancy

- At least 3 months

Hematopoietic

- Not specified

Hepatic

- Not specified

Renal

- No hypercalcemia

Cardiovascular

- No persistent moderate or severe peripheral edema

- No uncontrolled congestive heart failure

Gastrointestinal

- No enteric fistula

- No concurrent intestinal obstruction

- Prior intestinal obstruction allowed

Other

- Not pregnant or nursing

- Negative pregnancy test

- No uncontrolled infections

- No other serious medical illness

- No metabolic disorder

PRIOR CONCURRENT THERAPY:

Biologic therapy

- Not specified

Chemotherapy

- Concurrent chemotherapy allowed

Endocrine therapy

- No dexamethasone as an appetite stimulant

- Intermittent dexamethasone during concurrent chemotherapy allowed

Radiotherapy

- Concurrent radiotherapy allowed

Surgery

- At least 1 week since prior minor surgery

- At least 3 weeks since prior major surgery

Other

- At least 30 days since prior total parenteral nutrition

- No concurrent parenteral feedings

- No concurrent known appetite stimulants (e.g., megestrol or dronabinol)

- No concurrent omega 3 fatty acids or their congeners (e.g., ProSure™)

- No concurrent amino acid supplements

- Concurrent use of other dietary supplements (e.g., Ensure® or Boost) is allowed

- Concurrent enteral feedings via PEG or nasogastric tube are allowed

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Supportive Care

Principal Investigator

Lawrence B. Berk, MD, PhD

Investigator Role:

Study Chair

Investigator Affiliation:

CCOP - Columbus

Authority:

United States: Federal Government

Study ID:

CDR0000269100

NCT ID:

NCT00053053

Start Date:

December 2002

Completion Date:

Related Keywords:

  • Cachexia
  • Lymphoma
  • Lymphoproliferative Disorder
  • Unspecified Adult Solid Tumor, Protocol Specific
  • unspecified adult solid tumor, protocol specific
  • cachexia
  • recurrent adult diffuse large cell lymphoma
  • recurrent adult diffuse mixed cell lymphoma
  • recurrent adult diffuse small cleaved cell lymphoma
  • recurrent adult Hodgkin lymphoma
  • recurrent adult immunoblastic large cell lymphoma
  • recurrent adult lymphoblastic lymphoma
  • recurrent cutaneous T-cell non-Hodgkin lymphoma
  • recurrent grade 1 follicular lymphoma
  • recurrent grade 2 follicular lymphoma
  • recurrent grade 3 follicular lymphoma
  • recurrent mantle cell lymphoma
  • stage III adult diffuse large cell lymphoma
  • stage III adult diffuse mixed cell lymphoma
  • stage III adult diffuse small cleaved cell lymphoma
  • stage III adult Burkitt lymphoma
  • stage III adult Hodgkin lymphoma
  • stage III adult immunoblastic large cell lymphoma
  • stage III adult lymphoblastic lymphoma
  • stage III cutaneous T-cell non-Hodgkin lymphoma
  • stage III grade 1 follicular lymphoma
  • stage III grade 2 follicular lymphoma
  • stage III grade 3 follicular lymphoma
  • stage III mantle cell lymphoma
  • stage IV adult diffuse large cell lymphoma
  • stage IV adult diffuse mixed cell lymphoma
  • stage IV adult diffuse small cleaved cell lymphoma
  • stage IV adult Burkitt lymphoma
  • stage IV adult Hodgkin lymphoma
  • stage IV adult immunoblastic large cell lymphoma
  • stage IV adult lymphoblastic lymphoma
  • stage IV cutaneous T-cell non-Hodgkin lymphoma
  • stage IV grade 1 follicular lymphoma
  • stage IV grade 2 follicular lymphoma
  • stage IV grade 3 follicular lymphoma
  • stage IV mantle cell lymphoma
  • intraocular lymphoma
  • AIDS-related peripheral/systemic lymphoma
  • recurrent adult Burkitt lymphoma
  • anaplastic large cell lymphoma
  • post-transplant lymphoproliferative disorder
  • recurrent marginal zone lymphoma
  • recurrent small lymphocytic lymphoma
  • stage III small lymphocytic lymphoma
  • stage III marginal zone lymphoma
  • stage IV small lymphocytic lymphoma
  • stage IV marginal zone lymphoma
  • extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
  • nodal marginal zone B-cell lymphoma
  • splenic marginal zone lymphoma
  • Cachexia
  • Lymphoma
  • Lymphoma, Non-Hodgkin
  • Lymphoproliferative Disorders
  • Lymphoma, Large-Cell, Immunoblastic

Name

Location

Memorial Sloan-Kettering Cancer Center New York, New York  10021
University of Michigan Comprehensive Cancer Center Ann Arbor, Michigan  48109-0752
Mayo Clinic Cancer Center Rochester, Minnesota  55905
Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
MBCCOP - Hawaii Honolulu, Hawaii  96813
Barbara Ann Karmanos Cancer Institute Detroit, Michigan  48201
Abington Memorial Hospital Abington, Pennsylvania  19001
Fox Chase Cancer Center Philadelphia, Pennsylvania  19111
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
CCOP - Atlanta Regional Atlanta, Georgia  30342-1701
CCOP - Kansas City Kansas City, Missouri  64131
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Southern Nevada Cancer Research Foundation Las Vegas, Nevada  89106
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
CCOP - North Shore University Hospital Manhasset, New York  11030
CCOP - Southeast Cancer Control Consortium Winston-Salem, North Carolina  27104-4241
Veterans Affairs Medical Center - Indianapolis (Roudebush) Indianapolis, Indiana  46202
CCOP - Kalamazoo Kalamazoo, Michigan  49007-3731
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Veterans Affairs Medical Center - East Orange East Orange, New Jersey  07018-1095
Bloomington Hospital Bloomington, Indiana  47402
Yale Comprehensive Cancer Center New Haven, Connecticut  06520-8028
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center Grand Junction, Colorado  81502
Methodist Cancer Center at Methodist Hospital Indianapolis, Indiana  46202
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Penn State Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center La Crosse, Wisconsin  54601
Marshfield Clinic - Marshfield Center Marshfield, Wisconsin  54449
CCOP - Ochsner New Orleans, Louisiana  70121
Rapid City Regional Hospital Rapid City, South Dakota  57709
Comprehensive Cancer Center at Wake Forest University Winston-Salem, North Carolina  27157-1082
Cancer Center at the University of Virginia Charlottesville, Virginia  22908
Providence Saint Joseph Medical Center - Burbank Burbank, California  91505
Saint Agnes Cancer Center Fresno, California  93720
Sutter Health Western Division Cancer Research Group Greenbrae, California  94904
Veterans Affairs Medical Center - Long Beach Long Beach, California  90822
CCOP - Bay Area Tumor Institute Oakland, California  94609-3305
O'Connor Hospital San Jose, California  95128
CCOP - Santa Rosa Memorial Hospital Santa Rosa, California  95403
Memorial Hospital Cancer Center Colorado Springs, Colorado  80909
Florida Radiation Oncology Group Orange Park, Florida  32073
Gulf Coast Cancer Treatment Center Panama City, Florida  32405-4587
Sarasota Radiation and Medical Oncology Center Sarasota, Florida  34233
Northwest Community Hospital Arlington Heights, Illinois  60005
Lutheran General Cancer Care Center Park Ridge, Illinois  60068
Methodist Medical Center of Illinois Peoria, Illinois  61636
CCOP - Central Illinois Springfield, Illinois  62526
Harbor Hospital Center Baltimore, Maryland  21225
Cape Cod Hospital Hyannis, Massachusetts  02601
Veterans Affairs Medical Center - Boston (Jamaica Plain) Jamaica Plain, Massachusetts  02130
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
Elliot Regional Cancer Center Manchester, New Hampshire  03103
John F. Kennedy Medical Center Edison, New Jersey  08818
Newark Beth Israel Medical Center Newark, New Jersey  07112
Community Medical Center Toms River, New Jersey  08755
New York Methodist Hospital Brooklyn, New York  11215-3609
CCOP - Columbus Columbus, Ohio  43206
CCOP - Dayton Kettering, Ohio  45429
Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
Mercy Hospital of Pittsburgh Pittsburgh, Pennsylvania  15219
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
Mercy Hospital Cancer Center - Scranton Scranton, Pennsylvania  18501
CCOP - MainLine Health Wynnewood, Pennsylvania  19096
CCOP - Greenville Greenville, South Carolina  29615
Harrington Cancer Center Amarillo, Texas  79106
University of Texas Medical Branch Galveston, Texas  77555-1329
Joe Arrington Cancer Research and Treatment Center Lubbock, Texas  79410-1894
Dixie Regional Medical Center Saint George, Utah  84770
LDS Hospital Salt Lake City, Utah  84143
Deaconess Medical Center Spokane, Washington  99210-0248
Yakima Valley Memorial Hospital Yakima, Washington  98902
St. Vincent Hospital Green Bay, Wisconsin  54307-3508
University of Wisconsin Comprehensive Cancer Center Madison, Wisconsin  53792
Community Memorial Hospital Menomonee Falls, Wisconsin  53051
Veterans Affairs Medical Center - Milwaukee (Zablocki) Milwaukee, Wisconsin  53295
University of Colorado Cancer Center at University of Colorado Health Sciences Center Denver, Colorado  80010
University of Miami Sylvester Comprehensive Cancer Center Miami, Florida  33136
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Ellis Fischel Cancer Center at University of Missouri - Columbia Columbia, Missouri  65203
Siteman Cancer Center at Barnes-Jewish Hospital Saint Louis, Missouri  63110
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
Charles M. Barrett Cancer Center at University Hospital Cincinnati, Ohio  45267-0526
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Columbus, Ohio  43210-1240
CCOP - Columbia River Oncology Program Portland, Oregon  97225
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
Vanderbilt-Ingram Cancer Center at Vanderbilt Medical Center Nashville, Tennessee  37232-2516
CCOP - Scott and White Hospital Temple, Texas  76508
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, Maryland  21231-2410
CCOP - St. Vincent Hospital Cancer Center, Green Bay Green Bay, Wisconsin  54301
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
MBCCOP - Gulf Coast Mobile, Alabama  36688
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
Naval Medical Center - San Diego San Diego, California  92134-3202
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C. Syracuse, New York  13217
CCOP - Oklahoma Tulsa, Oklahoma  74136
Utah Valley Regional Medical Center - Provo Provo, Utah  84604
Foundation for Cancer Research and Education Phoenix, Arizona  85013
Bay Medical Center Panama City, Florida  32401
Peninsula Regional Medical Center Salisbury, Maryland  21801
MidMichigan Medical Center - Midland Midland, Michigan  48670
Monmouth Medical Center Long Branch, New Jersey  07740-6395
University of Utah Health Sciences Center Salt Lake City, Utah  84132
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute Boston, Massachusetts  02115
City of Hope Comprehensive Cancer Center Duarte, California  91010
UCSF Comprehensive Cancer Center San Francisco, California  94115
CCOP - Beaumont Royal Oak, Michigan  48073-6769
Hillman Cancer Center at University of Pittsburgh Cancer Institute Pittsburgh, Pennsylvania  15236
Markey Cancer Center at University of Kentucky Chandler Medical Center Lexington, Kentucky  40536-0084
Tulane Cancer Center at Tulane University Hospital and Clinic New Orleans, Louisiana  70112
Cancer Research Center at Boston Medical Center Boston, Massachusetts  02118
Herbert Irving Comprehensive Cancer Center at Columbia University New York, New York  10032
James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Roger Williams Medical Center Providence, Rhode Island  02908-4735
Fairview University Medical Center - University Campus Minneapolis, Minnesota  55455
SUNY Downstate Medical Center Brooklyn, New York  11203
McDowell Cancer Center at Akron General Medical Center Akron, Ohio  44307
Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve University Cleveland, Ohio  44106
Oklahoma University Medical Center Oklahoma City, Oklahoma  73104
M.D. Anderson Cancer Center at University of Texas Houston, Texas  77030
DCH Cancer Treatment Center Tuscaloosa, Alabama  35401
Radiation Medical Group, Incorporated San Diego, California  92101
Holmes Regional Medical Center Melbourne, Florida  32901-3276
Regional Radiation Oncology Center at Rome Rome, Georgia  30165
Central Baptist Hospital Lexington, Kentucky  40503
Riverhill Radiation Oncology Yonkers, New York  10701
Trinity Cancer Care Center Minot, North Dakota  58701
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
St. Luke's Hospital Cancer Center Bethlehem, Pennsylvania  18015
Mercy Fitzgerald Hospital Darby, Pennsylvania  19023
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
RMH Regional Cancer Center Harrisonburg, Virginia  22801
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
Comprehensive Cancer Center at University of Alabama at Birmingham Birmingham, Alabama  35294
Loma Linda University Cancer Institute at Loma Linda University Medical Center Loma Linda, California  92354
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Baptist-South Miami Regional Cancer Program Miami, Florida  33176
Winship Cancer Institute of Emory University Atlanta, Georgia  30322
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital Baltimore, Maryland  21215
SUNY Upstate Medical University Hospital Syracuse, New York  13210
Naval Medical Center - Portsmouth Portsmouth, Virginia  23708-2197
Massey Cancer Center at Virginia Commonwealth University Richmond, Virginia  23298-0037
Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha Omaha, Nebraska  68114-4199
CCOP - Marshfield Clinic Research Foundation Marshfield, Wisconsin  54449
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
Comprehensive Cancer Institute Huntsville, Alabama  35801
Torrance Memorial Medical Center Torrance, California  90505
Sibley Memorial Hospital Washington, District of Columbia  20016
21st Century Oncology - Fort Myers Fort Myers, Florida  33901-8082
Tallahassee Memorial Hospital Tallahassee, Florida  32308
Oncology Institute of Greater Lafayette Lafayette, Indiana  47904
Cancer Center at Lexington Clinic Lexington, Kentucky  40504
St. Agnes Cancer Center Baltimore, Maryland  21229
Lourdes Regional Cancer Center Binghamton, New York  13905
North Shore Radiation Oncology Setauket, New York  11733
Batte Cancer Center at Northeast Medical Center Concord, North Carolina  28025
Cancer Center at Christ Hospital Cincinnati, Ohio  45219
Parma Community General Hospital Parma, Ohio  44129
Vermont Cancer Center at University of Vermont Burlington, Vermont  05405-0075
Cancer Institute at Virginia Mason Medical Center Seattle, Washington  98111
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
Fox Chase Virtua Health Cancer Program - Marlton Marlton, New Jersey  08053
Greenebaum Cancer Center at University of Maryland Medical Center Baltimore, Maryland  21201
Josephine Ford Cancer Center at Henry Ford Health System Detroit, Michigan  48202
UNMC Eppley Cancer Center at the University of Nebraska Medical Center Omaha, Nebraska  68198-7680
Jonsson Comprehensive Cancer Center at UCLA Los Angeles, California  90095-1781
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School New Brunswick, New Jersey  08903
General Robert Huyser Cancer Center at David Grant Medical Center Travis Air Force Base, California  94535
Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital Greenville, North Carolina  27858-4354
Robert H. Lurie Comprehensive Cancer Center at Northwestern University Chicago, Illinois  60611
Maine Medical Center - Bramhall Campus Portland, Maine  04102
Mount Diablo Regional Cancer Center Concord, California  94524-4110
Ingalls Cancer Care Center at Ingalls Memorial Hospital Harvey, Illinois  60426
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Upper Michigan Cancer Center at Marquette General Hospital Marquette, Michigan  49855
Fox Chase Cancer Center at St. Francis Medical Center Trenton, New Jersey  08629
Delaware County Regional Cancer Center at Delaware County Memorial Hospital Drexel Hill, Pennsylvania  19026
DeCesaris Cancer Institute at Anne Arundel Medical Center Annapolis, Maryland  21401
California Cancer Center - Woodward Park Office Fresno, California  93720
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida Tampa, Florida  33612
Cancer Center at Ball Memorial Hospital Muncie, Indiana  47303
Wendt Regional Cancer Center at Finley Hospital Dubuque, Iowa  52001
Merle M. Mahr Cancer Center at Regional Medical Center of Hopkins County Madisonville, Kentucky  42431
Great Lakes Cancer Institute at McLaren Regional Medical Center Flint, Michigan  48532
South Jersey Healthcare Regional Cancer Center Millville, New Jersey  08332
Atlantic City Medical Center - Mainland Division Pomona, New Jersey  08240
Akron City Hospital at Summa Health System Akron, Ohio  44304
LaFortune Cancer Center at St. John Health System Tulsa, Oklahoma  74104
John and Dorothy Morgan Cancer Center at Lehigh Valley Hospital Allentown, Pennsylvania  18105
Allegheny Cancer Center at Allegheny General Hospital Pittsburgh, Pennsylvania  15212
Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital Pittsburgh, Pennsylvania  15224-1791
Bon Secours Cancer Care at St. Mary's Hospital Richmond, Virginia  23226
Vince Lombardi Cancer Clinic at St. Luke's Medical Center Milwaukee, Wisconsin  53215
All Saints Cancer Center at All Saints Healthcare Racine, Wisconsin  53405
Schiffler Cancer Center at Wheeling Hospital Wheeling, West Virginia  26003
Saint Louis University Cancer Center Saint Louis, Missouri  63110
Huntington Cancer Center at Huntington Hospital Pasadena, California  91105
St. Joseph's Regional Cancer Center Stockton, California  95204
Robert and Beverly Lewis Family Cancer Care Center at Pomona Valley Hospital Medical Center Pomona, California  91767
Hospital of Saint Raphael New Haven, Connecticut  06511
St. John's Cancer Center at St. John's Medical Center Anderson, Indiana  46016
York Cancer Center at Wellspan Health York, Pennsylvania  17403
Community Cancer Center at Rutland Regional Medical Center Rutland, Vermont  05701
Frank C. Love Cancer Institute at St. Anthony Hospital Oklahoma City, Oklahoma  73101
Montgomery Cancer Center Montgomery, Alabama  36106-3657
Radiation Oncology Centers - Sacramento Sacramento, California  95816
Louisville Radiation Oncology Center at Caritas Regional Cancer Center Louisville, Kentucky  40215
Beth Israel Medical Center - Philipps Ambulatory Care Center New York, New York  10003
Wilkes-Barre General Hospital Wilkes-Barre, Pennsylvania  18764-0001
West Tennessee Cancer Center at Jackson-Madison County General Hospital Jackson, Tennessee  38301
Cancer Center at Greater Baltimore Medical Center Baltimore, Maryland  21204
Valley Hospital - Ridgewood Ridgewood, New Jersey  07450
Esther Marie Hatton Cancer Care Center at St. Elizabeth Medical Center Edgewood, Kentucky  41017
Dale and Frances Hughes Cancer Center at Pocono Medical Center East Stroudsburg, Pennsylvania  18301
John B. Amos Community Cancer Center Columbus, Georgia  31902
NSMC Cancer Center - Peabody Peabody, Massachusetts  01960
Fitzpatrick Cancer Center at Champlain Valley Physicians Hospital Medical Center Plattsburgh, New York  12901
William Beaumont Hospital - Troy Campus Troy, Michigan  48085
University Medical Center at Princeton Princeton, New Jersey  08540
Associated Radiologists, P.A. at Warren Radiation Therapy Center Warren, New Jersey  07059
Radiation Oncology Associates, PA Albuquerque, New Mexico  87109
Finger Lakes Radiation Oncology Center at Clifton Springs Hospital and clinic Clifton Springs, New York  14432
Arlington Cancer Center - Arlington Arlington, Texas  76012
Columbia St. Mary's - Columbia Campus Milwaukee, Wisconsin  53211