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A Randomized Phase III Trial of Concurrent Accelerated Radiation and Cisplatin Versus Concurrent Accelerated Radiation, Cisplatin, and Cetuximab (C225) [Followed by Surgery for Selected Patients] for Stage III and IV Head and Neck Carcinomas

Phase 3
18 Years
Open (Enrolling)
Head and Neck Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Concurrent Accelerated Radiation and Cisplatin Versus Concurrent Accelerated Radiation, Cisplatin, and Cetuximab (C225) [Followed by Surgery for Selected Patients] for Stage III and IV Head and Neck Carcinomas



- Evaluate whether the addition of cetuximab to a concurrent radiation-cisplatin regimen
will improve disease-free survival in patients with stage III or IV squamous cell
carcinoma of the oropharynx, hypopharynx, or larynx.


- Determine the impact of the addition of cetuximab to a concurrent radiation-cisplatin
regimen on overall survival, local-regional control, acute and late toxic effects,
quality of life, and health utilities in these patients.

- Correlate the expression of epidermal growth factor receptor (EGFR) and its down-stream
molecules with outcome in patients participating in this component of the trial.

- Correlate pre-treatment PET scan findings with disease-free survival, overall survival,
and local-regional control in patients participating in this component of the trial.

- Correlate post-treatment PET scan findings with nodal response and nodal relapse in
patients participating in this component of the trial.

OUTLINE: This is a randomized, controlled, multicenter study. Patients are stratified
according to primary site (larynx vs non-larynx), nodal stage (N0 vs N1, N2a, N2b vs N2c,
N3), Zubrod performance status (0 vs 1), use of intensity modulated radiotherapy (IMRT) (no
vs yes), and pre-treatment PET/CT scan (no vs yes). Patients are randomized to 1 of 2
treatment arms.

- Arm I: Patients undergo either 3D-conformal radiotherapy or IMRT once or twice a day, 5
or 6 days a week, for 6 weeks. Patients also receive cisplatin IV over 1 hour on days 1
and 22 (weeks 1 and 4) during radiotherapy.

- Arm II: Patients receive cetuximab IV over 1-2 hours once in weeks 0-7. Beginning in
week 1, patients also undergo radiotherapy and receive cisplatin as in arm I.

In both arms, patients with persistent nodal disease (any stage) (i.e., a residual palpable
or radiographic abnormality) undergo neck dissection* approximately 9-10 weeks after
completion of treatment.

NOTE: *A neck dissection is optional for patients with multiple lymph nodes or lymph nodes >
3 cm in diameter who achieve a complete clinical and radiographic response in the neck.

Quality of life is assessed at baseline, once during the last 2 weeks of treatment, at 3 and
12 months from the start of treatment, and then annually for 4 years.

After completion of study treatment, patients are followed periodically for 5 years and then
annually thereafter.

PROJECTED ACCRUAL: Approximately 720 patients will be accrued for this study.

Inclusion Criteria


- Histologically proven (from primary lesion and/or lymph nodes) squamous cell
carcinoma of the oropharynx, hypopharynx, or larynx

- Stage III or IV disease (T2, N2-3, M0; T3-4, any N, M0)

- No distant metastases

- The following primary tumor sites are excluded:

- Oral cavity

- Nasopharynx

- Sinuses

- Salivary glands


- Zubrod performance status 0-1

- Absolute neutrophil count (ANC) ≥ 1,800/mm^3

- Platelets ≥ 100,000/mm^3

- Hemoglobin ≥ 8.0 g/dL (transfusion or other intervention to achieve Hgb ≥ 8.0 g/dL is

- Bilirubin ≤ 1.5 mg/dL (Gilbert's disease as the sole cause of elevated bilirubin may
be allowed at the discretion of the principal investigator)

- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 2 times the
upper limit of normal

- Serum creatinine ≤ 1.5 mg/dL

- Creatinine clearance ≥ 50 mL/min

- Not pregnant or nursing

- Negative pregnancy test

- Women of childbearing potential and male participants must agree to use a medically
effective means of birth control throughout their participation in the treatment
phase of the study (until at least 60 days following the last study treatment)

- No prior invasive malignancy (except non-melanomatous skin cancer) unless disease
free for a minimum of 3 years

- No unstable angina and/or congestive heart failure requiring hospitalization in past
6 months

- Left ventricular ejection fraction ≥ 45%

- No transmural myocardial infarction within the last 6 months

- No acute bacterial or fungal infection requiring intravenous antibiotics

- No chronic obstructive pulmonary disease exacerbation or other respiratory illness
requiring hospitalization or precluding study therapy

- No acquired immune deficiency syndrome (AIDS)

- HIV testing is not required for entry into this protocol

- Protocol-specific requirements may also exclude immuno-compromised patients

- No prior allergic reaction to the study drug(s)

- No other uncontrolled condition, which in the opinion of the investigator, would
interfere in the safe and timely completion of study procedures

- No comorbidity of uncontrolled diabetes (i.e., symptomatic hyperglycemia)

- No other severe active comorbidity


- No prior systemic chemotherapy for the study cancer

- Prior chemotherapy for a different cancer is allowed

- No prior radiotherapy to the region of the study cancer that would result in overlap
of radiation therapy fields

- No initial surgical treatment (excluding diagnostic biopsy of the primary site or
nodal sampling of neck disease)

- No radical or modified neck dissection

- No prior therapy that specifically and directly targets the EGFR pathway

Type of Study:


Study Design:

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Disease-free survival (DFS)

Outcome Time Frame:

From randomization to date of failure (local, regional or distant progression or death) or last follow-up. Analysis occurs after 434 failures have been reported.

Safety Issue:


Principal Investigator

K. Kian Ang, MD, PhD

Investigator Role:

Principal Investigator

Investigator Affiliation:

M.D. Anderson Cancer Center


United States: Food and Drug Administration

Study ID:

RTOG 0522



Start Date:

November 2005

Completion Date:

Related Keywords:

  • Head and Neck Cancer
  • stage III squamous cell carcinoma of the hypopharynx
  • stage IV squamous cell carcinoma of the hypopharynx
  • stage III squamous cell carcinoma of the larynx
  • stage IV squamous cell carcinoma of the larynx
  • stage III squamous cell carcinoma of the oropharynx
  • stage IV squamous cell carcinoma of the oropharynx
  • Head and Neck Neoplasms



Roswell Park Cancer Institute Buffalo, New York  14263
Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic - Jacksonville Jacksonville, Florida  32224
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Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
Barbara Ann Karmanos Cancer Institute Detroit, Michigan  48201
Hurley Medical Center Flint, Michigan  48503
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CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
Veterans Affairs Medical Center - Atlanta (Decatur) Decatur, Georgia  30033
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Aurora Presbyterian Hospital Aurora, Colorado  80012
Boulder Community Hospital Boulder, Colorado  80301-9019
Penrose Cancer Center at Penrose Hospital Colorado Springs, Colorado  80933
Porter Adventist Hospital Denver, Colorado  80210
Presbyterian - St. Luke's Medical Center Denver, Colorado  80218
St. Joseph Hospital Denver, Colorado  80218
Swedish Medical Center Englewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center Grand Junction, Colorado  81502
Sky Ridge Medical Center Lone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United Hospital Longmont, Colorado  80502
St. Mary - Corwin Regional Medical Center Pueblo, Colorado  81004
North Suburban Medical Center Thornton, Colorado  80229
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Joliet Oncology-Hematology Associates, Limited - West Joliet, Illinois  60435
Carle Cancer Center at Carle Foundation Hospital Urbana, Illinois  61801
Methodist Cancer Center at Methodist Hospital Indianapolis, Indiana  46202
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
Siouxland Hematology-Oncology Associates, LLP Sioux City, Iowa  51101
Tufts-NEMC Cancer Center Boston, Massachusetts  02111
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
Saint Joseph Mercy Cancer Center Ann Arbor, Michigan  48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical Center Dearborn, Michigan  48123-2500
Genesys Hurley Cancer Institute Flint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical Center Grosse Pointe Woods, Michigan  48236
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Sparrow Regional Cancer Center Lansing, Michigan  48912-1811
St. John Macomb Hospital Warren, Michigan  48093
MeritCare Bemidji Bemidji, Minnesota  56601
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - Duluth Duluth, Minnesota  55805-1983
CCOP - Duluth Duluth, Minnesota  55805
Miller - Dwan Medical Center Duluth, Minnesota  55805
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Minnesota Oncology Hematology, PA - Maplewood Maplewood, Minnesota  55109
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
St. Francis Cancer Center at St. Francis Medical Center Shakopee, Minnesota  55379
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
St. Rita's Medical Center Lima, Ohio  45801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center Wilkes-Barre, Pennsylvania  18711
Sanford Cancer Center at Sanford USD Medical Center Sioux Falls, South Dakota  57117-5039
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Madison, Wisconsin  53792-6164
Medical College of Wisconsin Cancer Center Milwaukee, Wisconsin  53226
Rapid City Regional Hospital Rapid City, South Dakota  57709
CCOP - Bay Area Tumor Institute Oakland, California  94609-3305
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
CCOP - Columbus Columbus, Ohio  43206
Veterans Affairs Medical Center - Dayton Dayton, Ohio  45428
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Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
CCOP - Greenville Greenville, South Carolina  29615
Harrington Cancer Center Amarillo, Texas  79106
Joe Arrington Cancer Research and Treatment Center Lubbock, Texas  79410-1894
LDS Hospital Salt Lake City, Utah  84143
Rush University Medical Center Chicago, Illinois  60612-3824
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CCOP - Grand Rapids Grand Rapids, Michigan  49503
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
Charles M. Barrett Cancer Center at University Hospital Cincinnati, Ohio  45267-0526
CCOP - Columbia River Oncology Program Portland, Oregon  97225
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
Veterans Affairs Medical Center - Denver Denver, Colorado  80220
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Utah Valley Regional Medical Center - Provo Provo, Utah  84604
Veterans Affairs Medical Center - Richmond Richmond, Virginia  23249
Rebecca and John Moores UCSD Cancer Center La Jolla, California  92093-0658
University of California Davis Cancer Center Sacramento, California  95817
City of Hope Comprehensive Cancer Center Duarte, California  91010
Medical Center of Central Georgia Macon, Georgia  31201
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center Kansas City, Kansas  66160-7353
Josephine Ford Cancer Center at Henry Ford Hospital Detroit, Michigan  48202
James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Northside Hospital Cancer Center Atlanta, Georgia  30342-1611
Washington Cancer Institute at Washington Hospital Center Washington, District of Columbia  20010
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
McDowell Cancer Center at Akron General Medical Center Akron, Ohio  44307
Mercy Fitzgerald Hospital Darby, Pennsylvania  19023
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
Winship Cancer Institute of Emory University Atlanta, Georgia  30322
Mission Hospitals - Memorial Campus Asheville, North Carolina  28801
Presbyterian Cancer Center at Presbyterian Hospital Charlotte, North Carolina  28233-3549
Rhode Island Hospital Comprehensive Cancer Center Providence, Rhode Island  02903
Hollings Cancer Center at Medical University of South Carolina Charleston, South Carolina  29425
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas Dallas, Texas  75390
Naval Medical Center - Portsmouth Portsmouth, Virginia  23708-2197
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Lahey Clinic Medical Center - Burlington Burlington, Massachusetts  01805
Saint Peter's University Hospital New Brunswick, New Jersey  08901-1780
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
CCOP - Hematology-Oncology Associates of Central New York East Syracuse, New York  13057
St. Vincent's Comprehensive Cancer Center - Manhattan New York, New York  10011
St. Mary's Hospital Medical Center - Green Bay Green Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital Green Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Baptist Cancer Institute - Jacksonville Jacksonville, Florida  32207
Saint Anthony's Hospital at Saint Anthony's Health Center Alton, Illinois  62002
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
Munson Medical Center Traverse City, Michigan  49684
Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital Gape Girardeau, Missouri  63701
David C. Pratt Cancer Center at St. John's Mercy St. Louis, Missouri  63141
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Wayne Memorial Hospital, Incorporated Goldsboro, North Carolina  27534
Adena Regional Medical Center Chillicothe, Ohio  54601
Doctors Hospital at Ohio Health Columbus, Ohio  43228
Riverside Methodist Hospital Cancer Care Columbus, Ohio  43214
Grady Memorial Hospital Delaware, Ohio  43015
Strecker Cancer Center at Marietta Memorial Hospital Marietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial Hospital Newark, Ohio  43055
Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
Memorial Cancer Institute at Memorial Regional Hospital Hollywood, Florida  33021
UCSF Helen Diller Family Comprehensive Cancer Center San Francisco, California  94115
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center Washington, District of Columbia  20007
M.D. Anderson Cancer Center at Orlando Orlando, Florida  32806
Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center Savannah, Georgia  31403-3089
Mountain States Tumor Institute at St. Luke's Regional Medical Center Boise, Idaho  83712-6297
University of Illinois Cancer Center Chicago, Illinois  60612-7243
Advocate Lutheran General Cancer Care Center Park Ridge, Illinois  60068-1174
Swedish-American Regional Cancer Center Rockford, Illinois  61104-2315
Lucille P. Markey Cancer Center at University of Kentucky Lexington, Kentucky  40536-0093
Tulane Cancer Center Office of Clinical Research Alexandria, Louisiana  71315-3198
University of Mississippi Cancer Clinic Jackson, Mississippi  39216-4505
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School New Brunswick, New Jersey  08903
Maimonides Cancer Center at Maimonides Medical Center Brooklyn, New York  11219
Oklahoma University Cancer Institute Oklahoma City, Oklahoma  73104
Legacy Emanuel Hospital and Health Center and Children's Hospital Portland, Oregon  97227
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
M. D. Anderson Cancer Center at University of Texas Houston, Texas  77030-4009
Virginia Commonwealth University Massey Cancer Center Richmond, Virginia  23298-0037
Gundersen Lutheran Center for Cancer and Blood La Crosse, Wisconsin  54601
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
General Robert Huyser Cancer Center at David Grant Medical Center Travis Air Force Base, California  94535
Huntsman Cancer Institute at University of Utah Salt Lake City, Utah  84112
Decatur Memorial Hospital Cancer Care Institute Decatur, Illinois  62526
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
Peninsula Medical Center Burlingame, California  94010
Sutter Health - Western Division Cancer Research Group Greenbrae, California  94904
Marin Cancer Institute at Marin General Hospital Greenbrae, California  94904
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
California Pacific Medical Center - California Campus San Francisco, California  94118
Sutter Solano Medical Center Vallejo, California  94589
John Muir/Mt. Diablo Comprehensive Cancer Center Walnut Creek, California  94598
Ella Milbank Foshay Cancer Center at Jupiter Medical Center Jupiter, Florida  33458
Saint Joseph's Hospital of Atlanta Atlanta, Georgia  30342-1701
Piedmont Hospital Atlanta, Georgia  30309
Charles B. Eberhart Cancer Center at DeKalb Medical Center Decatur, Georgia  30033
Kennestone Cancer Center at Wellstar Kennestone Hospital Marietta, Georgia  30060
Southern Regional Medical Center Riverdale, Georgia  30274-2600
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center Boise, Idaho  83706
St. Joseph Medical Center Bloomington, Illinois  61701
InterCommunity Cancer Center of Western Illinois Galesburg, Illinois  61401
Ingalls Cancer Care Center at Ingalls Memorial Hospital Harvey, Illinois  60426
BroMenn Regional Medical Center Normal, Illinois  61761
Community Cancer Center Normal, Illinois  61761
Cancer Treatment Center at Pekin Hospital Pekin, Illinois  61554
Oncology Hematology Associates of Central Illinois, PC - Peoria Peoria, Illinois  61615
OSF St. Francis Medical Center Peoria, Illinois  61637
Valley Cancer Center Spring Valley, Illinois  61362
St. Francis Hospital and Health Centers - Beech Grove Campus Beech Grove, Indiana  46107
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Pennington Cancer Center at Baton Rouge General Baton Rouge, Louisiana  70806
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Feist-Weiller Cancer Center at Louisiana State University Health Sciences Shreveport, Louisiana  71130-3932
Providence Cancer Institute at Providence Hospital - Southfield Campus Southfield, Michigan  48075
Saint Francis Medical Center Cape Girardeau, Missouri  63701
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Kingsbury Center for Cancer Care at Cheshire Medical Center Keene, New Hampshire  03431
Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
Charles R. Wood Cancer Center at Glens Falls Hospital Glens Falls, New York  12801
Highland Hospital of Rochester Rochester, New York  14620
Wayne Radiation Oncology Goldsboro, North Carolina  27534
Forsyth Regional Cancer Center at Forsyth Medical Center Winston-Salem, North Carolina  27103
Samaritan North Cancer Care Center Dayton, Ohio  45415
Grandview Hospital Dayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
Good Samaritan Hospital Dayton, Ohio  45406
Blanchard Valley Medical Associates Findlay, Ohio  45840
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Middletown Regional Hospital Middletown, Ohio  45044
Mercy Medical Center Springfield, Ohio  45504
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Legacy Mount Hood Medical Center Gresham, Oregon  97030
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Providence Cancer Center at Providence Portland Medical Center Portland, Oregon  97213-2967
Providence St. Vincent Medical Center Portland, Oregon  97225
Legacy Meridian Park Hospital Tualatin, Oregon  97062
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
Danville Regional Medical Center Danville, Virginia  24541
Southwest Washington Medical Center Cancer Center Vancouver, Washington  98668
San Francisco General Hospital Medical Center San Francisco, California  94110
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
St. Francis Hospital Federal Way, Washington  98003
Poudre Valley Radiation Oncology Fort Collins, Colorado  80528
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida Tampa, Florida  33612
Northeast Georgia Medical Center Gainesville, Georgia  30501
Good Shepherd Hospital Barrington, Illinois  60010
Creticos Cancer Center at Advocate Illinois Masonic Medical Center Chicago, Illinois  60657
Great Lakes Cancer Institute at McLaren Regional Medical Center Flint, Michigan  48532
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
Cancer Treatment Center Wooster, Ohio  44691
St. Joseph Medical Center Reading, Pennsylvania  19604
Alta Bates Summit Comprehensive Cancer Center Berkeley, California  94704
Stanford Cancer Center Stanford, California  94305-5824
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
University of Miami Sylvester Comprehensive Cancer Center - Miami Miami, Florida  33136
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler Savannah, Georgia  31405
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
Menorah Medical Center Overland Park, Kansas  66209
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
Cotton-O'Neil Cancer Center Topeka, Kansas  66606
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
St. Luke's Hospital Cancer Care Center Duluth, Minnesota  55805
Truman Medical Center - Hospital Hill Kansas City, Missouri  64108
St. Joseph Medical Center Kansas City, Missouri  64114
North Kansas City Hospital Kansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's Hospital Kansas City, Missouri  64111
Research Medical Center Kansas City, Missouri  64132
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Billings Clinic - Downtown Billings, Montana  59107-7000
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Frederick R. and Betty M. Smith Cancer Treatment Center Sparta, New Jersey  07871
Leo W. Jenkins Cancer Center at ECU Medical School Greenville, North Carolina  27834
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Grant Medical Center Cancer Care Columbus, Ohio  43215
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Adventist Medical Center Portland, Oregon  97216
Legacy Good Samaritan Hospital & Comprehensive Cancer Center Portland, Oregon  97210
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
York Cancer Center at Apple Hill Medical Center York, Pennsylvania  17405
Sandra L. Maxwell Cancer Center Cedar City, Utah  84720
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center Murray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center Ogden, Utah  84403
Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham Birmingham, Alabama  35294
Saint Louis University Cancer Center Saint Louis, Missouri  63110
John H. Stroger, Jr. Hospital of Cook County Chicago, Illinois  60612-9985
Radiological Associates of Sacramento Medical Group, Incorporated Sacramento, California  95815
Parkview Regional Cancer Center at Parkview Health Fort Wayne, Indiana  46805
Good Samaritan Cancer Center at Good Samaritan Hospital Kearney, Nebraska  68848-1990
Dartmouth - Hitchcock Concord Concord, New Hampshire  03301
Elliot Regional Cancer Center at Elliot Hospital Manchester, New Hampshire  03103
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Rex Cancer Center at Rex Hospital Raleigh, North Carolina  27607
Wilmed Radiation Oncology Services Wilson, North Carolina  27893
Three Rivers Community Hospital Grants Pass, Oregon  97527
Dubs Cancer Center at Rogue Valley Medical Center Medford, Oregon  97504
Theda Care Cancer Institute Appleton, Wisconsin  54911
Miriam Hospital Providence, Rhode Island  02906
Cancer Institute at St. John's Hospital Springfield, Illinois  62701
Sentara Cancer Institute at Sentara Norfolk General Hospital Norfolk, Virginia  23507
Providence Cancer Center Anchorage, Alaska  99508
Lacks Cancer Center at Saint Mary's Health Care Grand Rapids, Michigan  49503
Great Falls, Montana  59405
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Solano Radiation Oncology Center Vacaville, California  95687
Integrated Community Oncology Network Jacksonville Beach, Florida  32250
Baptist Medical Center South Jascksonville, Florida  32258
Florida Cancer Center - Palatka Palatka, Florida  32177
Flagler Cancer Center Saint Augustine, Florida  32086
Center for Cancer Care at OSF Saint Anthony Medical Center Rockford, Illinois  61108
Doctors Medical Center - San Pablo Campus San Pablo, California  94806
Boston University Cancer Research Center Boston, Massachusetts  02118
Independence Regional Health Center Independence, Missouri  64050
Parvin Radiation Oncology Kansas City, Missouri  64116
Lynchburg Hematology-Oncology Clinic Lynchburg, Virginia  24501
Mercy General Hospital Sacramento, California  95819
East Bay Radiation Oncology Center Castro Valley, California  94546
Memorial Medical Center Modesto, California  95355
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tom K Lee, Incorporated Oakland, California  94609
Bay Area Breast Surgeons, Incorporated Oakland, California  94609
Valley Medical Oncology Consultants - Pleasanton Pleasanton, California  94588
Bay Area Hospital Coos Bay, Oregon  97420
Dale and Frances Hughes Cancer Center at Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields Olympia Fields, Illinois  60461
University of Colorado Cancer Center at UC Health Sciences Center Aurora, Colorado  80045
Center for Cancer Care at Goshen General Hospital Goshen, Indiana  46526
Bay Medical Panama City, Florida  32401
Cancer Institute of Cape Girardeau, LLC Cape Girardeau, Missouri  63703
Ocean Medical Center at Meridian Health Brick, New Jersey  08724
J. Phillip Citta Regional Cancer Center at Community Medical Center Toms River, New Jersey  08755
Providence Cancer Center at PMCC Medford, Oregon  97504
Veterans Affairs Medical Center - Milwaukee Milwaukee, Wisconsin  53295
Cancer Centers of North Carolina - Raleigh Raleigh, North Carolina  27607
Precision Radiotherapy at University Pointe West Chester, Ohio  45069
Valley Medical Oncology Consultants - Castro Valley Castro Valley, California  94546
Valley Medical Oncology Fremont, California  94538
Integrated Community Oncology Network - Orange Park Orange Park, Florida  32073
NSMC Cancer Center - Peabody Peabody, Massachusetts  01960
Columbia Saint Mary's Hospital - Ozaukee Mequon, Wisconsin  53097
Columbia-Saint Mary's Cancer Care Center Milwaukee, Wisconsin  53211
Cancer Care Center at John Muir Health - Concord Campus Concord, California  94524-4110
Georgia Cancer Center for Excellence at Grady Memorial Hospital Atlanta, Georgia  30303
Oregon Health and Science University Cancer Institute Portland, Oregon  97239-3098
University Medical Center at Princeton Princeton, New Jersey  08540
Virginia K. Crosson Cancer Center at St. Jude Medical Center Fullerton, California  92835
Emory Crawford Long Hospital Atlanta, Georgia  30308
Auburn Radiation Oncology Auburn, California  95603
Radiation Oncology Centers - Cameron Park Cameron Park, California  95682
Radiation Oncology Center - Roseville Roseville, California  95661
Saint John's Cancer Center at Saint John's Medical Center Anderson, Indiana  46016
Inova Alexandria Hospital Alexandria, Virginia  22304
Mercy Cancer Center at Mercy San Juan Medical Center Carmichael, California  95608
St. Agnes Hospital Cancer Center Baltimore, Maryland  21229
Norris Cotton Cancer Center - North Saint Johnsbury, Vermont  05819
Integrated Community Oncology Network at Southside Cancer Center Jacksonville, Florida  32207
Northeast Radiation Oncology Center Dunmore, Pennsylvania  18512
New Mexico Cancer Center Albuquerque, New Mexico  87109
Good Samaritan Cancer Care Center at Advocate Good Samaritan Hospital Downers Grove, Illinois  60515-1500
Radiation Oncology Associates Southwest Fort Wayne, Indiana  46804
Princeton Radiation Oncology Center Jamesburg, New Jersey  08831
Upper Delaware Valley Cancer Center Milford, Pennsylvania  18337