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A Phase III Protocol of Androgen Suppression (AS) and 3DCTR/IMRT Vs AS and 3DCTR/IMRT Followed by Chemotherapy With Docetaxel and Prednisone for Localized, High-Risk, Prostate Cancer


Phase 3
18 Years
N/A
Open (Enrolling)
Male
Prostate Cancer

Thank you

Trial Information

A Phase III Protocol of Androgen Suppression (AS) and 3DCTR/IMRT Vs AS and 3DCTR/IMRT Followed by Chemotherapy With Docetaxel and Prednisone for Localized, High-Risk, Prostate Cancer


OBJECTIVES:

Primary

- Compare the relative efficacy, in terms of overall survival, of the combination of
androgen suppression and radiotherapy versus androgen suppression and radiotherapy
followed by docetaxel and prednisone in patients with localized, high-risk prostate
cancer.

Secondary

- Compare the disease-free survival and incidence of adverse events in patients treated
with these regimens.

- Compare the biochemical control, local control, and freedom from distant metastases in
patients treated with these regimens.

- Determine the validity of prostate-specific antigen (PSA)-defined endpoints as a
surrogate for overall survival of patients treated with these regimens.

- Compare the time interval between biochemical failure and distant metastases with
respect to testosterone level in patients treated with these regimens.

OUTLINE: This is an open-label, randomized, multicenter study. Patients are stratified
according to risk group.

- Arm I: Patients receive androgen suppression therapy comprising luteinizing
hormone-releasing hormone (LHRH) agonist (e.g., leuprolide acetate, goserelin,
buserelin, or triptorelin) and oral antiandrogen (i.e., oral flutamide 3 times daily
for 2 months or oral bicalutamide once daily for 2 months). Beginning at week 8,
patients undergo radiotherapy 5 days a week for approximately 8 weeks. Antiandrogen
therapy is discontinued at completion of radiotherapy, but LHRH agonist therapy
continues for 20 months.

- Arm II: Patients receive androgen suppression therapy and undergo radiotherapy as in
arm I. Beginning 4 weeks after completion of radiotherapy, patients receive docetaxel
IV over 1 hour on day 1 and oral prednisone daily on days 1-21. Treatment repeats every
21 days for up to 6 courses in the absence of disease progression or unacceptable
toxicity. Patients continue LHRH agonist therapy as in arm I.

After completion of study treatment, patients are followed every 3 months for 2 years, every
6 months for 3 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 600 patients will be accrued for this study.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed prostate cancer at high-risk for recurrence within the past
180 days as determined by 1 of the following combinations (risk groups):

- Gleason score ≥ 9, prostate-specific antigen (PSA) ≤ 150 ng/mL, and any T stage

- Gleason score 8, PSA < 20 ng/mL, and stage ≥ T2

- Gleason score 8, PSA 20-150 ng/mL, and any T stage

- Gleason score 7, PSA 20-150 ng/mL, and any T stage

- Clinically negative lymph nodes by imaging (pelvic CT scan or pelvic MRI), nodal
sampling, or dissection within 90 days prior to study entry

- Equivocal or questionable lymph nodes ≤ 1.5 cm by imaging allowed

- Positive lymph nodes by capromab pendetide (ProstaScint^®) scan with a
corresponding lymph node ≤ 1.5 cm by CT scan or MRI allowed

- PSA ≤ 150 ng/mL

- Cannot have been obtained during any of the following time points:

- 10-day period after prostate biopsy

- After initiation of hormonal therapy

- Within 30 days after discontinuation of finasteride

- Within 90 days after discontinuation of dutasteride

- No distant metastases by physical exam and bone scan

- Equivocal bone scan findings allowed if plain films are negative

PATIENT CHARACTERISTICS:

- Zubrod performance status 0-1

- Platelet count ≥ 100,000/mm^3

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

- Hemoglobin ≥ 8 g/dL (transfusion or other intervention allowed)

- ALT and AST ≤ 1.5 times upper limit of normal (ULN)

- Alkaline phosphatase ≤ 2.5 times ULN

- Bilirubin ≤ 1.5 times ULN

- Fertile patients must use effective contraception during and for at least 3 months
after completion of study treatment

- No prior invasive malignancy, except nonmelanomatous skin cancer or other malignancy,
unless disease-free for ≥ 3 years (e.g., carcinoma in situ of the oral cavity or
bladder are allowed)

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

- No transmural myocardial infarction within the past 6 months

- No acute bacterial or fungal infection requiring intravenous antibiotics

- No AIDS

- No prior allergic reaction to any study drugs or other drugs formulated with
polysorbate 80

- No existing peripheral neuropathy ≥ grade 2

PRIOR CONCURRENT THERAPY:

- At least 60 days since prior 5-alpha reductase inhibitor (e.g., finasteride) for
prostatic hypertrophy

- At least 90 days since prior testosterone

- Prior pharmacologic androgen ablation for prostate cancer allowed provided androgen
ablation was initiated no more than 50 days prior to study entry

- No prior radical prostatectomy, cryosurgery for prostate cancer, or bilateral
orchiectomy

- No prior systemic chemotherapy for prostate cancer

- Prior chemotherapy for a different cancer is allowed

- No prior radiotherapy, including brachytherapy, to the region of prostate cancer that
would result in overlap of radiotherapy fields

- Intensity modulated radiotherapy allowed

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Survival at 4 years after registration

Safety Issue:

No

Principal Investigator

Howard M. Sandler, MD

Investigator Role:

Study Chair

Investigator Affiliation:

University of Michigan Cancer Center

Authority:

United States: Federal Government

Study ID:

CDR0000462375

NCT ID:

NCT00288080

Start Date:

December 2005

Completion Date:

Related Keywords:

  • Prostate Cancer
  • stage III prostate cancer
  • stage IIB prostate cancer
  • stage IIA prostate cancer
  • stage IV prostate cancer
  • Prostatic Neoplasms

Name

Location

Suburban HospitalBethesda, Maryland  20814
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Barbara Ann Karmanos Cancer InstituteDetroit, Michigan  48201
Duke Comprehensive Cancer CenterDurham, North Carolina  27710
Cleveland Clinic Cancer CenterCleveland, Ohio  44195
CCOP - Upstate CarolinaSpartanburg, South Carolina  29303
Medical City Dallas HospitalDallas, Texas  75230
CCOP - Missouri Valley Cancer ConsortiumOmaha, Nebraska  68131
CCOP - Christiana Care Health ServicesWilmington, Delaware  19899
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
St. Joseph Regional Cancer CenterBryan, Texas  77802
Swedish Medical CenterEnglewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Fairview Ridges HospitalBurnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy HospitalCoon Rapids, Minnesota  55433
Fairview Southdale HospitalEdina, Minnesota  55435
Mercy and Unity Cancer Center at Unity HospitalFridley, Minnesota  55432
Minnesota Oncology Hematology, PA - MaplewoodMaplewood, Minnesota  55109
Virginia Piper Cancer Institute at Abbott - Northwestern HospitalMinneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Outpatient CenterRobbinsdale, Minnesota  55422-2900
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Natalie Warren Bryant Cancer Center at St. Francis HospitalTulsa, Oklahoma  74136
Penn State Cancer Institute at Milton S. Hershey Medical CenterHershey, Pennsylvania  17033-0850
Medical College of Wisconsin Cancer CenterMilwaukee, Wisconsin  53226
CCOP - OchsnerNew Orleans, Louisiana  70121
Providence Saint Joseph Medical Center - BurbankBurbank, California  91505
CCOP - Bay Area Tumor InstituteOakland, California  94609-3305
Bridgeport HospitalBridgeport, Connecticut  06610
Northwest Community HospitalArlington Heights, Illinois  60005
CCOP - Montana Cancer ConsortiumBillings, Montana  59101
Veterans Affairs Medical Center - DaytonDayton, Ohio  45428
Grand View HospitalSellersville, Pennsylvania  18960
CCOP - GreenvilleGreenville, South Carolina  29615
Holden Comprehensive Cancer Center at University of IowaIowa City, Iowa  52242-1002
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical CenterLebanon, New Hampshire  03756-0002
Charles M. Barrett Cancer Center at University HospitalCincinnati, Ohio  45267-0526
Kimmel Cancer Center at Thomas Jefferson University - PhiladelphiaPhiladelphia, Pennsylvania  19107
UPMC Cancer Center at Magee-Womens HospitalPittsburgh, Pennsylvania  15213-3180
Cancer Research Center of HawaiiHonolulu, Hawaii  96813
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
CCOP - NorthwestTacoma, Washington  98405-0986
Veterans Affairs Medical Center - RichmondRichmond, Virginia  23249
Veterans Affairs Medical Center - SyracuseSyracuse, New York  13210
Rebecca and John Moores UCSD Cancer CenterLa Jolla, California  92093-0658
University of California Davis Cancer CenterSacramento, California  95817
Fletcher Allen Health Care - University Health Center CampusBurlington, Vermont  05401
St. Vincent Mercy Medical CenterToledo, Ohio  43608
Kansas Masonic Cancer Research Institute at the University of Kansas Medical CenterKansas City, Kansas  66160-7353
Josephine Ford Cancer Center at Henry Ford HospitalDetroit, Michigan  48202
Thompson Cancer Survival CenterKnoxville, Tennessee  37916
Maine Center for Cancer Medicine and Blood Disorders - ScarboroughScarborough, Maine  04074
Blumenthal Cancer Center at Carolinas Medical CenterCharlotte, North Carolina  28232-2861
Hulston Cancer Center at Cox Medical Center SouthSpringfield, Missouri  65807
St. John's Regional Health CenterSpringfield, Missouri  65804
CCOP - Toledo Community HospitalToledo, Ohio  43623-3456
Mercy Fitzgerald HospitalDarby, Pennsylvania  19023
Yale Cancer CenterNew Haven, Connecticut  06520-8028
University of Florida Shands Cancer CenterGainesville, Florida  32610-0232
Winship Cancer Institute of Emory UniversityAtlanta, Georgia  30322
Breslin Cancer Center at Ingham Regional Medical CenterLansing, Michigan  48910
SUNY Upstate Medical University HospitalSyracuse, New York  13210
Presbyterian Cancer Center at Presbyterian HospitalCharlotte, North Carolina  28233-3549
Wake Forest University Comprehensive Cancer CenterWinston-Salem, North Carolina  27157-1096
Medical University of Ohio Cancer CenterToledo, Ohio  43614
Hollings Cancer Center at Medical University of South CarolinaCharleston, South Carolina  29425
Naval Medical Center - PortsmouthPortsmouth, Virginia  23708-2197
Providence Cancer Center at Sacred Heart Medical CenterSpokane, Washington  99220-2555
St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54307-3508
Saint Peter's University HospitalNew Brunswick, New Jersey  08901-1780
James P. Wilmot Cancer Center at University of Rochester Medical CenterRochester, New York  14642
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54301-3526
Bay Area Cancer Care Center at Bay Area Medical CenterMarinette, Wisconsin  54143
Torrance Memorial Medical CenterTorrance, California  90505
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
William Beaumont Hospital - Royal Oak CampusRoyal Oak, Michigan  48073
David C. Pratt Cancer Center at St. John's MercySt. Louis, Missouri  63141
Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical CenterSavannah, Georgia  31403-3089
Advocate Lutheran General Cancer Care CenterPark Ridge, Illinois  60068-1174
Tulane Cancer Center Office of Clinical ResearchAlexandria, Louisiana  71315-3198
Siteman Cancer Center at Barnes-Jewish Hospital - Saint LouisSt. Louis, Missouri  63110
CCOP - Nevada Cancer Research FoundationLas Vegas, Nevada  89109-2306
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical SchoolNew Brunswick, New Jersey  08903
University of New Mexico Cancer CenterAlbuquerque, New Mexico  87131-5636
Oklahoma University Cancer InstituteOklahoma City, Oklahoma  73104
Knight Cancer Institute at Oregon Health and Science UniversityPortland, Oregon  97239-3098
M. D. Anderson Cancer Center at University of TexasHouston, Texas  77030-4009
Virginia Commonwealth University Massey Cancer CenterRichmond, Virginia  23298-0037
Madigan Army Medical Center - TacomaTacoma, Washington  98431
West Virginia University Health Sciences Center - CharlestonCharleston, West Virginia  25302
Gundersen Lutheran Center for Cancer and BloodLa Crosse, Wisconsin  54601
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
Huntsman Cancer Institute at University of UtahSalt Lake City, Utah  84112
Decatur Memorial Hospital Cancer Care InstituteDecatur, Illinois  62526
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital MarltonMarlton, New Jersey  08053
Cleveland Clinic Cancer Center at Fairview HospitalCleveland, Ohio  44111
Hillcrest Cancer Center at Hillcrest HospitalMayfield Heights, Ohio  44124
Rosenfeld Cancer Center at Abington Memorial HospitalAbington, Pennsylvania  19001
Fox Chase Cancer Center - PhiladelphiaPhiladelphia, Pennsylvania  19111-2497
Lucy Curci Cancer Center at Eisenhower Memorial Hospital and Medical CenterRancho Mirage, California  92270
California Pacific Medical Center - California CampusSan Francisco, California  94118
John Muir/Mt. Diablo Comprehensive Cancer CenterWalnut Creek, California  94598
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
Hickman Cancer Center at Bixby Medical CenterAdrian, Michigan  49221
Immanuel Medical CenterOmaha, Nebraska  68122
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Kingsbury Center for Cancer Care at Cheshire Medical CenterKeene, New Hampshire  03431
Cancer Institute of New Jersey at Cooper - VoorheesVoorhees, New Jersey  08043
Forsyth Regional Cancer Center at Forsyth Medical CenterWinston-Salem, North Carolina  27103
Samaritan North Cancer Care CenterDayton, Ohio  45415
Grandview HospitalDayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley HospitalDayton, Ohio  45409
Good Samaritan HospitalDayton, Ohio  45406
Charles F. Kettering Memorial HospitalKettering, Ohio  45429
Lima Memorial HospitalLima, Ohio  45804
Northwest Ohio Oncology CenterMaumee, Ohio  43537
Middletown Regional HospitalMiddletown, Ohio  45044
St. Charles Mercy HospitalOregon, Ohio  43616
UVMC Cancer Care Center at Upper Valley Medical CenterTroy, Ohio  45373-1300
Cleveland Clinic - WoosterWooster, Ohio  44691
Ruth G. McMillan Cancer Center at Greene Memorial HospitalXenia, Ohio  45385
Delaware County Regional Cancer Center at Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
Lankenau Cancer Center at Lankenau HospitalWynnewood, Pennsylvania  19096
Dixie Regional Medical Center - East CampusSaint George, Utah  84770
Massachusetts General HospitalBoston, Massachusetts  02114-2617
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
DeCesaris Cancer Institute at Anne Arundel Medical CenterAnnapolis, Maryland  21401
Poudre Valley Radiation OncologyFort Collins, Colorado  80528
William W. Backus HospitalNorwich, Connecticut  06360
Northeast Georgia Medical CenterGainesville, Georgia  30501
South Suburban Oncology CenterQuincy, Massachusetts  02169
Regional Cancer Center at Singing River HospitalPascagoula, Mississippi  39581
Cancer Treatment CenterWooster, Ohio  44691
UAB Comprehensive Cancer CenterBirmingham, Alabama  35294
Eastern Connecticut Hematology and Oncology AssociatesNorwich, Connecticut  06360
John B. Amos Cancer CenterColumbus, Georgia  31904
McFarland Clinic, PCAmes, Iowa  50010
St. Luke's Hospital Cancer Care CenterDuluth, Minnesota  55805
Great Falls Clinic - Main FacilityGreat Falls, Montana  59405
Sletten Cancer Institute at Benefis HealthcareGreat Falls, Montana  59405
Alegant Health Cancer Center at Bergan Mercy Medical CenterOmaha, Nebraska  68124
Leo W. Jenkins Cancer Center at ECU Medical SchoolGreenville, North Carolina  27834
Summa Center for Cancer Care at Akron City HospitalAkron, Ohio  44309-2090
Barberton Citizens HospitalBarberton, Ohio  44203
Flower Hospital Cancer CenterSylvania, Ohio  43560
Salem Hospital Regional Cancer Care ServicesSalem, Oregon  97309-5014
McGlinn Family Regional Cancer Center at Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
Guthrie Cancer Center at Guthrie Clinic SayreSayre, Pennsylvania  18840
York Cancer Center at Apple Hill Medical CenterYork, Pennsylvania  17405
Jon and Karen Huntsman Cancer Center at Intermountain Medical CenterMurray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital CenterOgden, Utah  84403
Vince Lombardi Cancer Clinic - SheboyganSheboygan, Wisconsin  53081
Regional Cancer Center at Memorial Medical CenterSpringfield, Illinois  62781-0001
Arizona Oncology Services FoundationPhoenix, Arizona  85013
Enloe Cancer Center at Enloe Medical CenterChico, California  95926
Washington Township HospitalFremont, California  94538
Radiological Associates of Sacramento Medical Group, IncorporatedSacramento, California  95815
St. Vincent's Medical CenterBridgeport, Connecticut  06606
Hospital of Saint RaphaelNew Haven, Connecticut  06511
Parkview Regional Cancer Center at Parkview HealthFort Wayne, Indiana  46805
Dartmouth - Hitchcock ConcordConcord, New Hampshire  03301
Elliot Regional Cancer Center at Elliot HospitalManchester, New Hampshire  03103
Community Cancer Center at Rutland Regional Medical CenterRutland, Vermont  05701
Theda Care Cancer InstituteAppleton, Wisconsin  54911
Community Memorial Hospital Cancer Care CenterMenomonee Falls, Wisconsin  53051
Cancer Institute at St. John's HospitalSpringfield, Illinois  62701
St. John's Regional Medical CenterJoplin, Missouri  64804
Providence Cancer CenterAnchorage, Alaska  99508
University of Wisconcin Cancer Center at Aspirus Wausau HospitalWausau, Wisconsin  54401
Solano Radiation Oncology CenterVacaville, California  95687
Center for Cancer Care at OSF Saint Anthony Medical CenterRockford, Illinois  61108
Mercy General HospitalSacramento, California  95819
Memorial Medical CenterModesto, California  95355
Elmhurst Memorial HospitalElmhurst, Illinois  60126
Veterans Affairs Medical Center - IndianapolisIndianapolis, Indiana  46202
Center for Cancer Care at Exeter HospitalExeter, New Hampshire  03833
Cancer Center of Paoli Memorial HospitalPaoli, Pennsylvania  19301-1792
CCOP - Main Line HealthWynnewood, Pennsylvania  19096
Cancer Care Center, IncorporatedSalem, Ohio  44460
University of Colorado Cancer Center at UC Health Sciences CenterAurora, Colorado  80045
UPMC Cancer Center at UPMC PresbyterianPittsburgh, Pennsylvania  15213
Bay MedicalPanama City, Florida  32401
Cancer Institute of Cape Girardeau, LLCCape Girardeau, Missouri  63703
High Point Regional HospitalHigh Point, North Carolina  27261
Veterans Affairs Medical Center - MilwaukeeMilwaukee, Wisconsin  53295
CaroMont Cancer Center at Gaston Memorial HospitalGastonia, North Carolina  28053
Cancer Institute of New Jersey at Cooper University Hospital - CamdenCamden, New Jersey  08103
Lovelace Medical Center - DowntownAlbuquerque, New Mexico  87102
Hudner Oncology Center at Saint Anne's Hospital - Fall RiverFall River, Massachusetts  02721
NSMC Cancer Center - PeabodyPeabody, Massachusetts  01960
Columbia Saint Mary's Hospital - OzaukeeMequon, Wisconsin  53097
Columbia-Saint Mary's Cancer Care CenterMilwaukee, Wisconsin  53211
Cancer Care Center at John Muir Health - Concord CampusConcord, California  94524-4110
Georgia Cancer Center for Excellence at Grady Memorial HospitalAtlanta, Georgia  30303
CentraState Medical CenterFreehold, New Jersey  07728
UPMC Cancer Center at Beaver Medical CenterBeaver, Pennsylvania  15009
UPMC Cancer Center at Jefferson Regional Medical CenterClairton, Pennsylvania  15025
UPMC Cancer Center - Arnold Palmer PavilionGreensburg, Pennsylvania  15601
UPMC Cancer Center at the John P. Murtha PavilionJohnstown, Pennsylvania  15901
UPMC - MoonMoon Township, Pennsylvania  15108
UPMC Cancer Center - Natrona HeightsNatrona Heights, Pennsylvania  15065
Jameson Memorial Hospital - North CampusNew Castle, Pennsylvania  16105
UPMC - ShadysidePittsburgh, Pennsylvania  15213-2582
UPMC Cancer Center at UPMC St. MargaretPittsburgh, Pennsylvania  15215
UPMC Cancer Center at UPMC PassavantPittsburgh, Pennsylvania  15237
UPMC Cancer Center at UPMC NorthwestSeneca, Pennsylvania  16346
Washington Hospital Cancer CenterWashington, Pennsylvania  15301
Radiation Oncology Associates, PAAlbuquerque, New Mexico  87109
New York Oncology Hematology, PC at Albany Regional Cancer CareAlbany, New York  12208
Auburn Radiation OncologyAuburn, California  95603
Radiation Oncology Centers - Cameron ParkCameron Park, California  95682
Radiation Oncology Center - RosevilleRoseville, California  95661
Saint John's Cancer Center at Saint John's Medical CenterAnderson, Indiana  46016
Bassett Healthcare Regional Cancer Program at Mary Imogene Bassett HospitalCooperstown, New York  13326
Mercy Cancer Center at Mercy San Juan Medical CenterCarmichael, California  95608
St. Agnes Hospital Cancer CenterBaltimore, Maryland  21229
Shields Radiation Oncology Center - MansfieldMansfield, Massachusetts  02048
Nevada Cancer InstituteLas Vegas, Nevada  89135
Sierra Nevada Cancer Center at Sierra Nevada Memorial HospitalGrass Valley, California  95945
Kansas City Cancer Centers - SouthwestOverland Park, Kansas  66210
Northeast Radiation Oncology CenterDunmore, Pennsylvania  18512
New Mexico Cancer CenterAlbuquerque, New Mexico  87109
Radiation Oncology Associates SouthwestFort Wayne, Indiana  46804
Central Indiana Cancer Centers - EastIndianapolis, Indiana  46219
Kansas City Cancer Centers - NorthKansas City, Missouri  64154
Seacoast Cancer Center at Wentworth - Douglass HospitalDover, New Hampshire  03820
Willamette Valley Cancer Center - EugeneEugene, Oregon  97401
Texas Oncology, PA at Harris Center HEBBedford, Texas  76022
Klabzuba Cancer Center at Harris Methodist Fort Worth HospitalFort Worth, Texas  76104
Texas Oncology, PA at Texas Cancer Center - ShermanSherman, Texas  75090
Texas Oncology, PA at Texas Oncology Cancer Center Sugar LandSugar Land, Texas  77479
Arizona Oncology - TucsonTucson, Arizona  85704
Rocky Mountain Cancer Centers - AuroraAurora, Colorado  80012
Norton Suburban HospitalLouisville, Kentucky  40207
Kansas City Cancer Centers - SouthKansas City, Missouri  64131
Cancer Institute of New MexicoSanta Fe, New Mexico  87505
New Hanover Radiation Oncology, PAWilmington, North Carolina  28401
Celilo Cancer Center at Mid-Columbia Medical CenterThe Dalles, Oregon  97058
Cancer Center at Clarion HospitalClarion, Pennsylvania  16214
UPMC Cancer Center at UPMC McKeesportMcKeesport, Pennsylvania  15132
UPMC Cancer Center - Upper St. ClairPittsburgh, Pennsylvania  15243
UPMC Cancer Center - UniontownUniontown, Pennsylvania  15401
Texas Oncology, PA at Texas Cancer Center Dallas SouthwestDallas, Texas  75237