Know Cancer

forgot password

Phase III Trial Comparing Conventional Adjuvant Temozolomide With Dose-Intensive Temozolomide in Patients With Newly Diagnosed Glioblastoma

Phase 3
18 Years
Not Enrolling
Brain and Central Nervous System Tumors

Thank you

Trial Information

Phase III Trial Comparing Conventional Adjuvant Temozolomide With Dose-Intensive Temozolomide in Patients With Newly Diagnosed Glioblastoma



- Determine if dose-intensifying (increasing the "dose-density") the adjuvant
temozolomide component of the chemoradiation treatment enhances treatment efficacy as
measured by overall survival of patients with newly diagnosed glioblastoma or


- Determine if dose-intensifying the adjuvant temozolomide component of the
chemoradiation treatment enhances treatment efficacy as measured by progression-free

- Determine in patients with unmethylated MGMT if dose-intensifying the adjuvant
temozolomide component of the chemoradiation treatment enhances treatment efficacy
(overall and progression-free survival) compared with patients receiving conventional
temozolomide dosing.

- Determine in patients with methylated MGMT if dose-intensifying the adjuvant
temozolomide component of the chemoradiation treatment enhances treatment efficacy
(overall and progression-free survival) compared with patients receiving conventional
temozolomide dosing.

- Determine if there is an association between tumor MGMT gene methylation status and
treatment response.

- Compare and record the toxicities of the conventional and dose-intense chemotherapy

- Evaluate whether 6-month progression-free survival is associated with overall survival.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
recursive partitioning analysis class (III vs IV vs V), MGMT gene methylation status
(methylated vs nonmethylated vs indeterminate), and radiotherapy criteria used (standard vs
revised European).

Patients undergo radiotherapy daily, 5 days per week for 6 weeks. Patients also receive oral
temozolomide daily during radiotherapy. Patients are then randomized to 1 of 2 treatment
arms. Randomized treatment begins approximately 4 weeks after completion of radiotherapy.

- Arm I: Patients receive oral temozolomide on days 1-5.

- Arm II: Patients receive oral temozolomide on days 1-21. In both arms, treatment
repeats every 28 days for up to 6 courses in the absence of disease progression or
unacceptable toxicity. Patients with responding disease may receive up to 6 more
courses of temozolomide.

After completion of study treatment, patients are followed every 3 months for 1 year, every
4 months for 2 years, and then every 6 months thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 834 patients will be accrued for this study.

Inclusion Criteria


- Histologically proven glioblastoma or gliosarcoma

- Diagnosis must be made by open biopsy or tumor resection

- Diagnosis by stereotactic biopsy not allowed

- Tumor must have supratentorial component

- Contrast-enhanced MRI or CT scan (if MRI is not available) of the brain must be
performed preoperatively and postoperatively prior to initiation of
radiotherapy, within 28 days prior to study entry

- If pre- and postoperative contrast-enhanced CT scans are obtained, must be
of sufficient quality

- Meets 1 of the following recursive positioning analysis classifications:

- Class III

- Age < 50 years and Karnofsky performance status (KPS) 90-100%

- Class IV, meeting 1 of the following criteria:

- Age < 50 years and KPS < 90%

- Age ≥ 50 years and KPS 70-100% and underwent prior partial or total tumor
resection with no worse than minor neurofunction impairment

- Class V, meeting 1 of the following criteria:

- Age ≥ 50 years and KPS 70-100% and underwent prior partial or total tumor
resection with worse than minor neurofunction impairment

- Age ≥ 50 years and KPS 70-100% and underwent prior tumor biopsy only

- Age ≥ 50 years and KPS < 70%

- Underwent most recent brain tumor surgery within the past 5 weeks

- No recurrent or multifocal malignant gliomas

- At least 1 block of tissue available for analysis of MGMT gene methylation status

- No metastases detected below the tentorium or beyond the cranial vault


- KPS 60-100%

- Absolute neutrophil count ≥ 1,500 cells/mm^3

- Platelet count ≥ 100,000 cells/mm^3

- Hemoglobin ≥ 10 g/dL (transfusion or other intervention allowed)

- BUN ≤ 25 mg/dL

- Creatinine ≤ 1.7 mg/dL

- Bilirubin ≤ 2.0 mg/dL

- AST and ALT ≤ 3 times normal

- Negative pregnancy test

- Not pregnant or nursing

- Fertile patients must use effective contraception

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

- No severe, active comorbidity, including any of the following:

- Unstable angina and/or congestive heart failure requiring hospitalization

- Transmural myocardial infarction within the last 6 months

- Acute bacterial or fungal infection requiring intravenous antibiotics at the
time of registration

- Chronic obstructive pulmonary disease exacerbation or other respiratory illness
requiring hospitalization or precluding study therapy at the time of

- Known hepatic insufficiency resulting in clinical jaundice and/or coagulation

- Known AIDS based upon current CDC definition

- Major medical illnesses or psychiatric impairments that, in the investigator's
opinion, will prevent administration or completion of protocol therapy

- Active connective tissue disorders, such as lupus or scleredema that, in the
opinion of the treating physician, may put the patient at high risk for
radiation toxicity

- No prior allergic reaction to temozolomide


- See Disease Characteristics

- Recovered from the effects of surgery, postoperative infection, and other
complications prior to study entry

- No prior chemotherapy or radiosensitizers (including polifeprosan 20 with carmustine
implant [Gliadel wafers] or any other intratumoral or intracavitary treatment) for
cancers of the head and neck region

- Prior chemotherapy for a different cancer is allowed

- No prior radiotherapy to the head or neck (except for T1 glottic cancer) that would
result in an overlap of radiation fields

- No treatment on other therapeutic clinical protocols within 30 days prior to study
entry or during participation in the study

- No concurrent prophylactic growth factors

- No other concurrent investigational drugs

- No concurrent surgical procedures for tumor debulking

- No other concurrent chemotherapy, immunotherapy, or biologic therapy

- No additional concurrent stereotactic boost radiotherapy

- No concurrent intensity-modulated radiotherapy

- Concurrent steroids allowed provided dose is stable or decreasing in the past 5 days

Type of Study:


Study Design:

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

Outcome Measure:

Overall survival (OS)

Outcome Time Frame:

From randomization to date of death or last follow-up. Analysis occurs after 647 deaths have been reported.

Safety Issue:


Principal Investigator

Mark R. Gilbert, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

M.D. Anderson Cancer Center


United States: Food and Drug Administration

Study ID:




Start Date:

January 2006

Completion Date:

Related Keywords:

  • Brain and Central Nervous System Tumors
  • adult glioblastoma
  • adult giant cell glioblastoma
  • adult gliosarcoma
  • Glioblastoma
  • Nervous System Neoplasms
  • Central Nervous System Neoplasms
  • Gliosarcoma



Memorial Sloan-Kettering Cancer Center New York, New York  10021
Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic - Jacksonville Jacksonville, Florida  32224
Mayo Clinic Cancer Center Rochester, Minnesota  55905
Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
University of Chicago Cancer Research Center Chicago, Illinois  60637
Cleveland Clinic Cancer Center Cleveland, Ohio  44195
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
CCOP - Wichita Wichita, Kansas  67214-3882
Hurley Medical Center Flint, Michigan  48503
Medical City Dallas Hospital Dallas, Texas  75230
CCOP - Kansas City Kansas City, Missouri  64131
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - North Shore University Hospital Manhasset, New York  11030
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Iowa Oncology Research Association Des Moines, Iowa  50309-1016
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Penrose Cancer Center at Penrose Hospital Colorado Springs, Colorado  80933
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
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
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
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
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Minnesota Oncology Hematology, PA - Woodbury Woodbury, Minnesota  55125
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
Aultman Cancer Center at Aultman Hospital Canton, Ohio  44710-1799
Natalie Warren Bryant Cancer Center at St. Francis Hospital Tulsa, Oklahoma  74136
Penn State Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
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
Medical X-Ray Center, PC Sioux Falls, South Dakota  57105
Avera Cancer Institute Sioux Falls, South Dakota  57105
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Madison, Wisconsin  53792-6164
Rapid City Regional Hospital Rapid City, South Dakota  57709
Providence Saint Joseph Medical Center - Burbank Burbank, California  91505
Kaiser Permanente Medical Center - Los Angeles Los Angeles, California  90027
Northwest Community Hospital Arlington Heights, Illinois  60005
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
New York Methodist Hospital Brooklyn, New York  11215-3609
CCOP - Columbus Columbus, Ohio  43206
Joe Arrington Cancer Research and Treatment Center Lubbock, Texas  79410-1894
LDS Hospital Salt Lake City, Utah  84143
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
CCOP - Columbia River Oncology Program Portland, Oregon  97225
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
CCOP - Virginia Mason Research Center Seattle, Washington  98101
Utah Valley Regional Medical Center - Provo Provo, Utah  84604
Wesley Medical Center Wichita, Kansas  67214
City of Hope Comprehensive Cancer Center Duarte, California  91010
Fletcher Allen Health Care - University Health Center Campus Burlington, Vermont  05401
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Josephine Ford Cancer Center at Henry Ford Hospital Detroit, Michigan  48202
Thompson Cancer Survival Center Knoxville, Tennessee  37916
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
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
Long Island Jewish Medical Center New Hyde Park, New York  11040
Yale Cancer Center New Haven, Connecticut  06520-8028
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Baptist-South Miami Regional Cancer Program Miami, Florida  33176
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Mission Hospitals - Memorial Campus Asheville, North Carolina  28801
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
Hollings Cancer Center at Medical University of South Carolina Charleston, South Carolina  29425
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
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
Baptist Cancer Institute - Jacksonville Jacksonville, Florida  32207
Southwest Medical Center Liberal, Kansas  67901
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
Kalispell Regional Medical Center Kalispell, Montana  59901
Glacier Oncology, PLLC Kalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
Community Medical Center Missoula, Montana  59801
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
Fairfield Medical Center Lancaster, Ohio  43130
Strecker Cancer Center at Marietta Memorial Hospital Marietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial Hospital Newark, Ohio  43055
Community Hospital of Springfield and Clark County Springfield, Ohio  45505
Genesis - Good Samaritan Hospital Zanesville, Ohio  43701
American Fork Hospital American Fork, Utah  84003
Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
University Cancer Center at University of Washington Medical Center Seattle, Washington  98195
UCSF Helen Diller Family Comprehensive Cancer Center San Francisco, California  94115
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
St. Barnabas Medical Center Cancer Center Livingston, New Jersey  07039
Don Monti Comprehensive Cancer Center at North Shore University Hospital Manhasset, New York  11030
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
Huntsman Cancer Institute at University of Utah Salt Lake City, Utah  84112
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
South Bend Clinic South Bend, Indiana  46617
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Cleveland Clinic Cancer Center at Fairview Hospital Cleveland, Ohio  44111
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Rosenfeld Cancer Center at Abington Memorial Hospital Abington, Pennsylvania  19001
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Piedmont Hospital Atlanta, Georgia  30309
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center Boise, Idaho  83706
St. Joseph Medical Center Bloomington, Illinois  61701
Graham Hospital Canton, Illinois  61520
Memorial Hospital Carthage, Illinois  62321
Eureka Community Hospital Eureka, Illinois  61530
Galesburg Cottage Hospital Galesburg, Illinois  61401
InterCommunity Cancer Center of Western Illinois Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
Hopedale Medical Complex Hopedale, Illinois  61747
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Community Cancer Center Normal, Illinois  61761
Community Hospital of Ottawa Ottawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa Ottawa, Illinois  61350
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
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Perry Memorial Hospital Princeton, Illinois  61356
St. Margaret's Hospital Spring Valley, Illinois  61362
Valley Cancer Center Spring Valley, Illinois  61362
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Mercy Capitol Hospital Des Moines, Iowa  50307
Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Cancer Center of Kansas, PA - Dodge City Dodge City, Kansas  67801
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Community Cancer Center of Monroe Monroe, Michigan  48162
Providence Cancer Institute at Providence Hospital - Southfield Campus Southfield, Michigan  48075
Alexandria, Minnesota  56308
Coborn Cancer Center Saint Cloud, Minnesota  56303
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
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
Wayne Radiation Oncology Goldsboro, North Carolina  27534
Wood County Oncology Center Bowling Green, Ohio  43402
Lima Memorial Hospital Lima, Ohio  45804
St. Luke's Hospital Maumee, Ohio  43537
Northwest Ohio Oncology Center Maumee, Ohio  43537
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Mercy Medical Center Springfield, Ohio  45504
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
Fulton County Health Center Wauseon, Ohio  43567
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
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Lankenau Cancer Center at Lankenau Hospital Wynnewood, Pennsylvania  19096
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
Southwest Washington Medical Center Cancer Center Vancouver, Washington  98668
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima, Washington  98902
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital Fairbanks, Alaska  99701
DeCesaris Cancer Institute at Anne Arundel Medical Center Annapolis, Maryland  21401
St. Francis Hospital Federal Way, Washington  98003
Cascade Cancer Center at Evergreen Hospital Medical Center Kirkland, Washington  98034-3013
Poudre Valley Radiation Oncology Fort Collins, Colorado  80528
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida Tampa, Florida  33612
Mercy Cancer Center at Mercy Medical Center - North Iowa Mason City, Iowa  50401
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Cancer Research UK Medical Oncology Unit at Churchill Hospital & Weatherall Institute of Molecular Medicine - Oxford Salem, Ohio  44460
Cancer Treatment Center Wooster, Ohio  44691
Allegheny Cancer Center at Allegheny General Hospital Pittsburgh, Pennsylvania  15212
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
John B. Amos Cancer Center Columbus, Georgia  31904
McFarland Clinic, PC Ames, Iowa  50010
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Menorah Medical Center Overland Park, Kansas  66209
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Union Hospital Cancer Program at Union Hospital Elkton MD, Maryland  21921
Foote Memorial Hospital Jackson, Michigan  49201
Haematology-Oncology Associates of Ohio and Michigan, PC Lambertville, Michigan  48144
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
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
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Northern Montana Hospital Havre, Montana  59501
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
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
Monter Cancer Center of the North Shore-LIJ Health System Lake Success, New York  11042
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Mary Rutan Hospital Bellefontaine, Ohio  43311
Grant Medical Center Cancer Care Columbus, Ohio  43215
Flower Hospital Cancer Center Sylvania, Ohio  43560
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
Salem Hospital Regional Cancer Care Services Salem, Oregon  97309-5014
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
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
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
St. Joseph Cancer Center Bellingham, Washington  98225
John H. Stroger, Jr. Hospital of Cook County Chicago, Illinois  60612-9985
Arizona Oncology Services Foundation Phoenix, Arizona  85013
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
Rutherford Hospital Rutherfordton, North Carolina  28139
Wilmed Radiation Oncology Services Wilson, North Carolina  27893
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Theda Care Cancer Institute Appleton, Wisconsin  54911
Community Memorial Hospital Cancer Care Center Menomonee Falls, Wisconsin  53051
Regional Cancer Center at Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
St. John's Regional Medical Center Joplin, Missouri  64804
Sentara Cancer Institute at Sentara Norfolk General Hospital Norfolk, Virginia  23507
Great Falls, Montana  59405
Guardian Oncology and Center for Wellness Missoula, Montana  59804
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
Lipson Cancer and Blood Center at Rochester General Hospital Rochester, New York  14621
Galesburg Clinic, PC Galesburg, Illinois  61401
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Independence Regional Health Center Independence, Missouri  64050
Parvin Radiation Oncology Kansas City, Missouri  64116
Mercy General Hospital Sacramento, California  95819
Riddle Memorial Hospital Cancer Center Media, Pennsylvania  19063
Cancer Center of Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
CCOP - Main Line Health Wynnewood, Pennsylvania  19096
AnMed Cancer Center Anderson, South Carolina  29621
Dale and Frances Hughes Cancer Center at Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Integrated Community Oncology Network - Orange Park Orange Park, Florida  32073
Frankford Hospital Cancer Center - Torresdale Campus Philadelphia, Pennsylvania  19114
Eugene M. and Christine E. Lynn Cancer Institute at Boca Raton Community Hospital - Main Campus Boca Raton, Florida  33486
Auburn Radiation Oncology Auburn, California  95603
Radiation Oncology Centers - Cameron Park Cameron Park, California  95682
Radiation Oncology Center - Roseville Roseville, California  95661
Hudson Valley Oncology Associates Poughkeepsie, New York  12601
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
Kansas City Cancer Centers - Southwest Overland Park, Kansas  66210
Northeast Radiation Oncology Center Dunmore, Pennsylvania  18512
Radiation Oncology Associates Southwest Fort Wayne, Indiana  46804
Central Indiana Cancer Centers - East Indianapolis, Indiana  46219
Willamette Valley Cancer Center - Eugene Eugene, Oregon  97401
Intercommunity Cancer Center Monroeville, Pennsylvania  15146
Klabzuba Cancer Center at Harris Methodist Fort Worth Hospital Fort Worth, Texas  76104
Texas Oncology, PA at Texas Cancer Center - Sherman Sherman, Texas  75090
Texas Oncology, PA at Texas Oncology Cancer Center Sugar Land Sugar Land, Texas  77479
Alle-Kiski Medical Center Natrona Heights, Pennsylvania  15065
Upper Delaware Valley Cancer Center Milford, Pennsylvania  18337
Arizona Oncology - Tucson Tucson, Arizona  85704
Kansas City Cancer Centers - South Kansas City, Missouri  64131
Texas Oncology, PA at Texas Cancer Center Dallas Southwest Dallas, Texas  75237
Somerset Oncology Center Somerset, Pennsylvania  15501
Thompson Cancer Survival Center West Knoxville, Tennessee  37392
Thompson Cancer Survival Center at Methodist Oak Ridge, Tennessee  37830
Door County Cancer Center at Door County Memorial Hospital Sturgeon Bay, Wisconsin  54235-1495