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A Phase III Randomized Study of Hypofractionated 3D-CRT/MRT Versus Conventionally Fractionated 3D-CRT/MRT in Patients With Favorable-Risk Prostate Cancer


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

Thank you

Trial Information

A Phase III Randomized Study of Hypofractionated 3D-CRT/MRT Versus Conventionally Fractionated 3D-CRT/MRT in Patients With Favorable-Risk Prostate Cancer


OBJECTIVES:

Primary

- Compare the disease-free survival (DFS) of patients with favorable-risk stage II
prostate cancer treated with hypofractionated vs conventionally fractionated
three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy
(IMRT).

Secondary

- Compare time to local progression, freedom from biochemical recurrence, and
disease-specific and overall survival of patients treated with these regimens.

- Determine the incidence of gastrointestinal and genitourinary toxic effects in patients
treated with these regimens.

- Compare the degree, duration, and significant differences in disease-specific
health-related quality of life (HRQOL) decrements, using the Expanded Prostate Cancer
Index Composite (EPIC), in patients treated with these regimens.

- Determine whether anxiety and/or depression, as measured by the Hopkins Symptom
Checklist-25 (HSCL-25), are decreased with therapy that improves DFS of these patients
.

- Determine whether the incremental gain in DFS outweighs decrements in the generic
domains of HRQOL (i.e., mobility, self care, usual activities, pain/discomfort, and
anxiety/depression) in patients treated with these regimens.

- Conduct a cost-utility analysis of hypofractionated 3D-CRT or IMRT as a prostate cancer
therapy if this regimen is shown to be as effective as conventionally fractionated
3D-CRT or IMRT in improving DFS.

OUTLINE: This is a randomized, controlled, multicenter study. Patients are stratified
according to Gleason score (2-4 vs 5-6), prostate-specific antigen (PSA) level (< 4 ng/mL vs
4-9 ng/mL), and planned radiotherapy modality (three-dimensional conformal radiotherapy
[3D-CRT] vs intensity-modulated radiotherapy [IMRT]). Patients are randomized to 1 of 2
treatment arms.

- Arm I: Patients undergo conventionally fractionated 3D-CRT or IMRT once daily 5 days a
week for 8.2 weeks (total of 41 treatments).

- Arm II: Patients undergo hypofractionated 3D-CRT or IMRT once daily 5 days a week for
5.6 weeks (total of 28 treatments).

Quality of life, anxiety, and depression are assessed at baseline and then at 6 months and
1, 2, and 5 years after the start of radiotherapy.

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 1,067 patients will be accrued to this study.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed adenocarcinoma of the prostate within the past 6 months

- Clinical stage T1-2c

- Combined Gleason score 2-6

- Prostate-specific antigen (PSA) < 10 ng/mL within the past 6 months

- No PSA measurement for ≥ 10 days after prostate biopsy

- No PSA measurement for ≥ 30 days after discontinuation of finasteride (90 days
after discontinuation of dutasteride)

- No regional lymph node involvement

- No distant metastases

PATIENT CHARACTERISTICS:

- Zubrod performance status 0-1

- 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 IV antibiotics

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

- No hepatic insufficiency resulting in clinical jaundice and/or coagulation defects

- No known AIDS

- No prior or concurrent lymphomatous/hematogenous malignancy or other invasive
malignancy except nonmelanomatous skin cancer or any other cancer for which the
patient has been continually disease-free for ≥ 5 years (e.g., carcinoma in situ of
the bladder or oral cavity)

- No other severe, active comorbidity

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- No prior radical prostatectomy or cryosurgery for prostate cancer

- No prior hormonal therapy, including any of the following:

- Luteinizing hormone-releasing hormone agonists (e.g., goserelin or leuprolide)

- Antiandrogens (e.g., flutamide or bicalutamide)

- Estrogens (e.g., diethylstilbestrol [DES])

- Surgical castration (bilateral orchiectomy)

- No prior pelvic radiotherapy or prostate brachytherapy

- No prior or concurrent cytotoxic chemotherapy for prostate cancer

- At least 30 days since prior finasteride

- At least 90 days since prior dutasteride

- No concurrent neoadjuvant or adjuvant hormonal therapy

- Concurrent warfarin or other blood-thinning agents allowed

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Disease-free survival at 5 years as measured by Kaplan-Meier

Safety Issue:

No

Principal Investigator

W. Robert Lee, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Duke Cancer Institute

Authority:

United States: Federal Government

Study ID:

CDR0000481119

NCT ID:

NCT00331773

Start Date:

April 2006

Completion Date:

Related Keywords:

  • Prostate Cancer
  • adenocarcinoma of the prostate
  • stage IIB prostate cancer
  • stage IIA prostate cancer
  • Prostatic Neoplasms

Name

Location

Roswell Park Cancer InstituteBuffalo, New York  14263
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Mayo Clinic - JacksonvilleJacksonville, Florida  32224
Mayo Clinic Cancer CenterRochester, Minnesota  55905
University of Chicago Cancer Research CenterChicago, Illinois  60637
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
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
CCOP - Christiana Care Health ServicesWilmington, Delaware  19899
CCOP - North Shore University HospitalManhasset, New York  11030
Veterans Affairs Medical Center - Atlanta (Decatur)Decatur, Georgia  30033
CCOP - Illinois Oncology Research AssociationPeoria, Illinois  61602
Beth Israel Deaconess Medical CenterBoston, Massachusetts  02215
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
St. Joseph Regional Cancer CenterBryan, Texas  77802
Aurora Presbyterian HospitalAurora, Colorado  80012
Boulder Community HospitalBoulder, Colorado  80301-9019
Penrose Cancer Center at Penrose HospitalColorado Springs, Colorado  80933
Porter Adventist HospitalDenver, Colorado  80210
Presbyterian - St. Luke's Medical CenterDenver, Colorado  80218
St. Joseph HospitalDenver, Colorado  80218
Swedish Medical CenterEnglewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502
Sky Ridge Medical CenterLone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United HospitalLongmont, Colorado  80502
St. Mary - Corwin Regional Medical CenterPueblo, Colorado  81004
North Suburban Medical CenterThornton, Colorado  80229
Methodist Cancer Center at Methodist HospitalIndianapolis, Indiana  46202
Siouxland Hematology-Oncology Associates, LLPSioux City, Iowa  51101
MeritCare BemidjiBemidji, Minnesota  56601
Fairview Ridges HospitalBurnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy HospitalCoon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - DuluthDuluth, Minnesota  55805-1983
CCOP - DuluthDuluth, Minnesota  55805
Miller - Dwan Medical CenterDuluth, Minnesota  55805
Fairview Southdale HospitalEdina, Minnesota  55435
Mercy and Unity Cancer Center at Unity HospitalFridley, Minnesota  55432
Minnesota Oncology Hematology, PA - MaplewoodMaplewood, Minnesota  55109
HealthEast Cancer Care at St. John's HospitalMaplewood, Minnesota  55109
Hennepin County Medical Center - MinneapolisMinneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern HospitalMinneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Outpatient CenterRobbinsdale, Minnesota  55422-2900
St. Francis Cancer Center at St. Francis Medical CenterShakopee, Minnesota  55379
Park Nicollet Cancer CenterSt. Louis Park, Minnesota  55416
Regions Hospital Cancer Care CenterSt. Paul, Minnesota  55101
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Minnesota Oncology Hematology, PA - WoodburyWoodbury, Minnesota  55125
MeritCare BroadwayFargo, North Dakota  58122
CCOP - MeritCare HospitalFargo, North Dakota  58122
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical CenterWilkes-Barre, Pennsylvania  18711
Medical College of Wisconsin Cancer CenterMilwaukee, Wisconsin  53226
Rapid City Regional HospitalRapid City, South Dakota  57709
Providence Saint Joseph Medical Center - BurbankBurbank, California  91505
Veterans Affairs Medical Center - Long BeachLong Beach, California  90822
Kaiser Permanente Medical Center - Los AngelesLos Angeles, California  90027
CCOP - Bay Area Tumor InstituteOakland, California  94609-3305
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Veterans Affairs Medical Center - Ann ArborAnn Arbor, Michigan  48105
CCOP - Montana Cancer ConsortiumBillings, Montana  59101
Newark Beth Israel Medical CenterNewark, New Jersey  07112
Albert Einstein Cancer CenterPhiladelphia, Pennsylvania  19141
LDS HospitalSalt Lake City, Utah  84143
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
MultiCare Regional Cancer Center at Tacoma General HospitalTacoma, Washington  98405
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
CCOP - NorthwestTacoma, Washington  98405-0986
Utah Valley Regional Medical Center - ProvoProvo, Utah  84604
Veterans Affairs Medical Center - RichmondRichmond, Virginia  23249
University of California Davis Cancer CenterSacramento, California  95817
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer InstituteBoston, Massachusetts  02115
Fletcher Allen Health Care - University Health Center CampusBurlington, Vermont  05401
Kaiser Permanente Medical Center - San Francisco Geary CampusSan Francisco, California  94115
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
James Graham Brown Cancer Center at University of LouisvilleLouisville, Kentucky  40202
McDowell Cancer Center at Akron General Medical CenterAkron, Ohio  44307
Mercy Fitzgerald HospitalDarby, Pennsylvania  19023
Long Island Jewish Medical CenterNew Hyde Park, New York  11040
Kaiser Permanente Medical Center - OaklandSacramento, California  95825
University of Florida Shands Cancer CenterGainesville, Florida  32610-0232
Baptist-South Miami Regional Cancer ProgramMiami, Florida  33176
Winship Cancer Institute of Emory UniversityAtlanta, Georgia  30322
NYU Cancer Institute at New York University Medical CenterNew York, New York  10016
Naval Medical Center - PortsmouthPortsmouth, Virginia  23708-2197
James P. Wilmot Cancer Center at University of Rochester Medical CenterRochester, New York  14642
CCOP - Hematology-Oncology Associates of Central New YorkEast Syracuse, New York  13057
Lourdes Regional Cancer CenterBinghamton, New York  13905
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
Saint Anthony's Hospital at Saint Anthony's Health CenterAlton, Illinois  62002
David C. Pratt Cancer Center at St. John's MercySt. Louis, Missouri  63141
Northern Rockies Radiation Oncology CenterBillings, Montana  59101
Big Sky OncologyGreat Falls, Montana  59405
Wayne Memorial Hospital, IncorporatedGoldsboro, North Carolina  27534
Utah Cancer Specialists at UCS Cancer CenterSalt Lake City, Utah  84106
Greenebaum Cancer Center at University of Maryland Medical CenterBaltimore, Maryland  21201
UCSF Helen Diller Family Comprehensive Cancer CenterSan Francisco, California  94115
Kaiser Permanente Medical Center - Santa Clara Kiely CampusSanta Clara, California  95051-5386
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
Don Monti Comprehensive Cancer Center at North Shore University HospitalManhasset, New York  11030
Oklahoma University Cancer InstituteOklahoma City, Oklahoma  73104
Geisinger Cancer Institute at Geisinger HealthDanville, Pennsylvania  17822-0001
West Virginia University Health Sciences Center - CharlestonCharleston, West Virginia  25302
Kaiser Permanente Medical Center - SacramentoSacramento, California  95825
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
General Robert Huyser Cancer Center at David Grant Medical CenterTravis Air Force Base, California  94535
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
Fox Chase Virtua Health Cancer Program at Virtua West JerseyVoorhees, New Jersey  08043
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
All Saints Cancer Center at Wheaton Franciscan HealthcareRacine, Wisconsin  53405
Peninsula Medical CenterBurlingame, California  94010
Sutter Health - Western Division Cancer Research GroupGreenbrae, California  94904
Marin Cancer Institute at Marin General HospitalGreenbrae, California  94904
Kaiser Permanente Medical Center - HaywardHayward, California  94545
Alta Bates Summit Medical Center - Summit CampusOakland, California  94609
Kaiser Permanente Medical Center - Redwood CityRedwood City, California  94063
Kaiser Permanente Medical Center - RichmondRichmond, California  94801
Kaiser Permanente Medical Center - RosevilleRoseville, California  95661
South Sacramento Kaiser-Permanente Medical CenterSacramento, California  95823
California Pacific Medical Center - California CampusSan Francisco, California  94118
Kaiser Permanente Medical Center - Santa TeresaSan Jose, California  95119
Kaiser Foundation Hospital - San RafaelSan Rafael, California  94903
Kaiser Permanente Medical Center - Santa RosaSanta Rosa, California  95403
Kaiser Permanente Medical Center - South San FranciscoSouth San Francisco, California  94080
Kaiser Permanente Medical Facility - StocktonStockton, California  95210
Sutter Solano Medical CenterVallejo, California  94589
Kaiser Permanente Medical Center - Walnut CreekWalnut Creek, California  94596
St. Joseph Medical CenterBloomington, Illinois  61701
BroMenn Regional Medical CenterNormal, Illinois  61761
Community Cancer CenterNormal, Illinois  61761
Cancer Treatment Center at Pekin HospitalPekin, Illinois  61554
Oncology Hematology Associates of Central Illinois, PC - PeoriaPeoria, Illinois  61615
OSF St. Francis Medical CenterPeoria, Illinois  61637
Coborn Cancer CenterSaint Cloud, Minnesota  56303
CentraCare Clinic - River CampusSt. Cloud, Minnesota  56303
Saint Francis Medical CenterCape Girardeau, Missouri  63701
Kingsbury Center for Cancer Care at Cheshire Medical CenterKeene, New Hampshire  03431
Cancer Institute of New Jersey at Cooper - VoorheesVoorhees, New Jersey  08043
Highland Hospital of RochesterRochester, New York  14620
Wayne Radiation OncologyGoldsboro, North Carolina  27534
Bismarck Cancer CenterBismarck, North Dakota  58501
Cleveland Clinic - WoosterWooster, Ohio  44691
Bryn Mawr HospitalBryn Mawr, Pennsylvania  19010
St. Mary Regional Cancer CenterLanghorne, Pennsylvania  19047
Lankenau Cancer Center at Lankenau HospitalWynnewood, Pennsylvania  19096
Cancer Therapy and Research CenterSan Antonio, Texas  78229
Dixie Regional Medical Center - East CampusSaint George, Utah  84770
Danville Regional Medical CenterDanville, Virginia  24541
Welch Cancer Center at Sheridan Memorial HospitalSheridan, Wyoming  82801
Massachusetts General HospitalBoston, Massachusetts  02114-2617
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
St. Francis HospitalFederal Way, Washington  98003
Good Samaritan Cancer CenterPuyallup, Washington  98371
Poudre Valley Radiation OncologyFort Collins, Colorado  80528
Mercy Cancer Center at Mercy Medical Center - North IowaMason City, Iowa  50401
Great Lakes Cancer Institute at McLaren Regional Medical CenterFlint, Michigan  48532
Cancer Treatment CenterWooster, Ohio  44691
Alta Bates Summit Comprehensive Cancer CenterBerkeley, California  94704
McFarland Clinic, PCAmes, Iowa  50010
Foote Memorial HospitalJackson, Michigan  49201
St. Luke's Hospital Cancer Care CenterDuluth, Minnesota  55805
Billings Clinic - DowntownBillings, Montana  59107-7000
Bozeman Deaconess Cancer CenterBozeman, Montana  59715
Great Falls Clinic - Main FacilityGreat Falls, Montana  59405
Sletten Cancer Institute at Benefis HealthcareGreat Falls, Montana  59405
Frederick R. and Betty M. Smith Cancer Treatment CenterSparta, New Jersey  07871
Summa Center for Cancer Care at Akron City HospitalAkron, Ohio  44309-2090
Barberton Citizens HospitalBarberton, Ohio  44203
Guthrie Cancer Center at Guthrie Clinic SayreSayre, Pennsylvania  18840
York Cancer Center at Apple Hill Medical CenterYork, Pennsylvania  17405
Sandra L. Maxwell Cancer CenterCedar City, Utah  84720
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
Franciscan Cancer Center at St. Joseph Medical CenterTacoma, Washington  98405-3004
Mid Dakota Clinic, PCBismarck, North Dakota  58501
Fox Chase Cancer Center CCOP Research BasePhiladelphia, Pennsylvania  19140
Arizona Oncology Services FoundationPhoenix, Arizona  85013
Radiological Associates of Sacramento Medical Group, IncorporatedSacramento, California  95815
MetroWest Medical Center - Framingham Union HospitalFramingham, Massachusetts  01702
Lowell General HospitalLowell, Massachusetts  01854
Dartmouth - Hitchcock ConcordConcord, New Hampshire  03301
Gibbs Regional Cancer Center at Spartanburg Regional Medical CenterSpartanburg, South Carolina  29303
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
Dana-Farber/Brigham and Women's Cancer CenterBoston, Massachusetts  02115
St. John's Regional Medical CenterJoplin, Missouri  64804
Sentara Cancer Institute at Sentara Norfolk General HospitalNorfolk, Virginia  23507
Great Falls, Montana  59405
Solano Radiation Oncology CenterVacaville, California  95687
Doctors Medical Center - San Pablo CampusSan Pablo, California  94806
Boston University Cancer Research CenterBoston, Massachusetts  02118
Mercy General HospitalSacramento, California  95819
East Bay Radiation Oncology CenterCastro Valley, California  94546
Larry G Strieff MD Medical CorporationOakland, California  94609
Tom K Lee, IncorporatedOakland, California  94609
Bay Area Breast Surgeons, IncorporatedOakland, California  94609
Valley Medical Oncology Consultants - PleasantonPleasanton, California  94588
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
Franciscan Skemp Healthcare - La Crosse CampusLa Crosse, Wisconsin  54601
Fountain Valley, California  92708
Cancer Care Center, IncorporatedSalem, Ohio  44460
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia FieldsOlympia Fields, Illinois  60461
Medcenter One Hospital Cancer Care CenterBismarck, North Dakota  58501
St. Alexius Medical Center Cancer CenterBismarck, North Dakota  58502
Bay MedicalPanama City, Florida  32401
Veterans Affairs Medical Center - MilwaukeeMilwaukee, Wisconsin  53295
Albert Lea Cancer Center at Albert Lea Medical CenterAlbert Lea, Minnesota  56007
CaroMont Cancer Center at Gaston Memorial HospitalGastonia, North Carolina  28053
Central Maryland Oncology CenterColumbia, Maryland  21044
Saint Mary's Regional Medical CenterReno, Nevada  89503
Cancer Institute of New Jersey at Cooper University Hospital - CamdenCamden, New Jersey  08103
Lovelace Medical Center - DowntownAlbuquerque, New Mexico  87102
Precision Radiotherapy at University PointeWest Chester, Ohio  45069
MNAP Oncologic CenterPhiladelphia, Pennsylvania  19115
Valley Medical Oncology Consultants - Castro ValleyCastro Valley, California  94546
Valley Medical OncologyFremont, California  94538
Hudner Oncology Center at Saint Anne's Hospital - Fall RiverFall River, Massachusetts  02721
Immanuel St. Joseph'sMankato, Minnesota  56002
Columbia Saint Mary's Hospital - OzaukeeMequon, Wisconsin  53097
Columbia-Saint Mary's Cancer Care CenterMilwaukee, Wisconsin  53211
Frankford Hospital Cancer Center - Torresdale CampusPhiladelphia, Pennsylvania  19114
Georgia Cancer Center for Excellence at Grady Memorial HospitalAtlanta, Georgia  30303
CentraState Medical CenterFreehold, New Jersey  07728
University Medical Center at PrincetonPrinceton, New Jersey  08540
Emory Crawford Long HospitalAtlanta, Georgia  30308
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
Radiation Oncology Associates - RenoReno, Nevada  89509
Hudson Valley Oncology AssociatesPoughkeepsie, New York  12601
Harrison Medical CenterBremerton, Washington  98310
Inova Alexandria HospitalAlexandria, Virginia  22304
Mercy Cancer Center at Mercy San Juan Medical CenterCarmichael, California  95608
Kaiser Permanente - Division of Research - OaklandOakland, California  94611
Kaiser Permanente Medical Center - Rancho CordovaRancho Cordova, California  95670
Rohnert Park Cancer CenterRohnert Park, California  94928
South Sacramento Cancer CenterSacramento, California  95823
Siteman Cancer Center at Barnes-Jewish St. Peters Hospital - St. PetersSaint Peters, Missouri  63376
Norris Cotton Cancer Center - NorthSaint Johnsbury, Vermont  05819
Kansas City Cancer Centers - SouthwestOverland Park, Kansas  66210
Capital Health Regional Cancer CenterTrenton, New Jersey  08618
Northeast Radiation Oncology CenterDunmore, Pennsylvania  18512
Central Indiana Cancer Centers - EastIndianapolis, Indiana  46219
Kansas City Cancer Centers - NorthKansas City, Missouri  64154
Cayuga Medical Center of IthacaIthaca, New York  14850
Saint Francis Hospital Cancer CenterPoughkeepsie, New York  12601
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
Princeton Radiation Oncology CenterJamesburg, New Jersey  08831
Upper Delaware Valley Cancer CenterMilford, Pennsylvania  18337
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
Celilo Cancer Center at Mid-Columbia Medical CenterThe Dalles, Oregon  97058
Texas Oncology, PA at Texas Cancer Center Dallas SouthwestDallas, Texas  75237
Tate Cancer Center at Baltimore Washington Medical CenterGlen Burnie, Maryland  21061
Helen P. Denit Cancer Center at Montgomery General HospitalOlney, Maryland  20832
Carolina Regional Cancer CenterMyrtle Beach, South Carolina  29577