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Phase III Comparison of Thoracic Radiotherapy Regimens in Patients With Limited Small Cell Lung Cancer Also Receiving Cisplatin and Etoposide


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Lung Cancer

Thank you

Trial Information

Phase III Comparison of Thoracic Radiotherapy Regimens in Patients With Limited Small Cell Lung Cancer Also Receiving Cisplatin and Etoposide


OBJECTIVES:

Primary

- To determine whether administering high-dose thoracic radiotherapy, 70 Gy (2 Gy once
daily over 7 weeks) or 61.2 Gy (1.8 Gy once daily for 16 days followed by 1.8 Gy twice
daily for 9 days), will improve median and 2-year survival compared with 45 Gy (1.5 Gy
twice daily over 3 weeks) in patients with limited-stage small cell lung cancer.

Secondary

- To compare treatment-related toxic effects of thoracic radiotherapy regimens in
patients with limited-stage small cell lung cancer.

- To compare response rates, failure-free survival, and toxicity of thoracic radiotherapy
regimens in patients with limited-stage small cell lung cancer.

- To compare rates of local relapse, distant metastases, and brain metastases with these
regimens.

- To describe the patterns of use of thoracic intensity-modulated radiotherapy (IMRT) in
patients with limited-stage small cell lung cancer.

OUTLINE: This is a 2-part, multicenter, randomized study. Patients are stratified according
to gender, weight loss 6 months prior to study entry (≤ 5% of body weight vs > 5% of body
weight), ECOG performance status (0 vs 1 vs 2), radiotherapy technique (intensity-modulated
radiotherapy vs 3-dimensional conformal radiotherapy), and radiotherapy start time (at first
course of protocol chemotherapy, after one course of prior non-protocol chemotherapy vs at
first course of protocol chemotherapy, without prior non-protocol chemotherapy vs at second
course of protocol chemotherapy, without prior non-protocol chemotherapy).

- Part 1: Patients are randomized to 1 of 3 treatment arms.

- Arm I: Patients undergo standard-dose (45 Gy given in 30 treatments) thoracic
radiotherapy twice daily, 5 days a week, for 3 weeks. Patients also receive
cisplatin IV on day 1 and etoposide IV on days 1, 2, and 3.

- Arm II: Patients undergo higher-dose (70 Gy given in 35 treatments) thoracic
radiotherapy once daily, 5 days a week, for 7 weeks. Patients also receive
cisplatin and etoposide as in arm I.

- Arm III: (discontinued as of 03/10/13) Patients undergo higher-dose (61.2 Gy given
in 34 treatments) thoracic radiotherapy once daily, 5 days a week, during the
initial 16 days (approximately 3 weeks) of treatment and then twice daily, 5 days
a week, for the final 9 days (approximately 2 weeks) of treatment. Patients also
receive cisplatin and etoposide as in arm I.

In all arms, treatment with cisplatin and etoposide repeats every 21 days for 4 courses in
the absence of disease progression or unacceptable toxicity.

- Part 2: An interim analysis was conducted after accrual of 30 patients per arm and one
experimental arm based upon a comparison of treatment-related toxicity was selected.
The most toxic experimental arm was discontinued, and the trial continues comparing
standard therapy (arm I) to the selected experimental regimen (arm II) as described in
part 1.

Prophylactic radiotherapy: Within 3-6 weeks after completion of chemotherapy, patients with
responding disease are eligible to undergo prophylactic radiotherapy to the brain once a
day, 5 days a week, for 2 weeks.

After completion of study treatment, patients are followed up at least every 3 months for 2
years, every 6 months for 3 years, and then annually for 5 years or until disease
progression. At disease progression, patients are followed up every 6 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically documented small cell lung cancer (SCLC)

- Limited-stage disease

- Disease restricted to one hemithorax with regional lymph node metastases,
including ipsilateral hilar, ipsilateral and contralateral mediastinal, and
ipsilateral supraclavicular lymph nodes

- The following patients are not eligible:

- Patients with disease involvement of the contralateral hilar or supraclavicular
lymph nodes

- Patients with pleural effusions that are visible on plain chest radiographs,
whether cytologically positive or not

- Patients with cytologically positive pleural or pericardial fluid, regardless of
the appearance on plain x-ray

- Measurable disease, defined as at least one unidimensionally measurable lesion ≥ 2 cm
by conventional techniques OR ≥ 1 cm by spiral CT scan

PATIENT CHARACTERISTICS:

- Eastern Cooperative Oncology Group (ECOG) performance status 0-2

- Granulocytes ≥ 1,500/µl

- Platelet count ≥ 100,000/µl

- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)

- AST ≤ 2.0 times ULN

- Serum creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 70 mL/min

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

- Patients may have received one and only one course of chemotherapy prior to enrolling
on CALGB 30610, which must have included cisplatin and etoposide

- If a patient has had one course of cisplatin/etoposide prior to registration,
the patient must have had all of the prior-to-registration tests prior to
starting their first course of chemotherapy

- Registration to CALGB-30610 must take place within 14-21 days after the start of
the non-protocol therapy; failing to do all of the above will make the patient
NOT eligible for CALGB-30610

- No prior radiotherapy or chemotherapy (except for the chemotherapy described above)
for SCLC

- No prior mediastinal or thoracic radiotherapy

- No prior complete surgical resection of SCLC

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Overall survival time between 3 treatment arms

Outcome Time Frame:

Up to 10 years

Safety Issue:

No

Principal Investigator

Jeffrey A. Bogart, MD

Investigator Role:

Study Chair

Investigator Affiliation:

State University of New York - Upstate Medical University

Authority:

United States: Food and Drug Administration

Study ID:

CDR0000588879

NCT ID:

NCT00632853

Start Date:

March 2008

Completion Date:

Related Keywords:

  • Lung Cancer
  • limited stage small cell lung cancer
  • Lung Neoplasms
  • Small Cell Lung Carcinoma

Name

Location

Albert Einstein College of MedicineBronx, New York  10461
Memorial Sloan Kettering Cancer CenterNew York, New York  10021
Cleveland Clinic FoundationCleveland, Ohio  44195
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Mayo Clinic ScottsdaleScottsdale, Arizona  85259
University of Chicago Cancer Research CenterChicago, Illinois  60637
Barbara Ann Karmanos Cancer InstituteDetroit, Michigan  48201
Washington University School of MedicineSaint Louis, Missouri  63110
Cleveland Clinic Cancer CenterCleveland, Ohio  44195
CCOP - Upstate CarolinaSpartanburg, South Carolina  29303
CCOP - WichitaWichita, Kansas  67214-3882
Hurley Medical CenterFlint, Michigan  48503
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
CCOP - Missouri Valley Cancer ConsortiumOmaha, Nebraska  68131
CCOP - Christiana Care Health ServicesWilmington, Delaware  19899
CCOP - Mount Sinai Medical CenterMiami Beach, Florida  33140
CCOP - Illinois Oncology Research AssociationPeoria, Illinois  61602
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
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
CCOP - Michigan Cancer Research ConsortiumAnn Arbor, Michigan  48106
Saint Joseph Mercy Cancer CenterAnn Arbor, Michigan  48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical CenterDearborn, Michigan  48123-2500
Genesys Hurley Cancer InstituteFlint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical CenterGrosse Pointe Woods, Michigan  48236
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Sparrow Regional Cancer CenterLansing, Michigan  48912-1811
St. John Macomb HospitalWarren, Michigan  48093
MeritCare BemidjiBemidji, Minnesota  56601
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
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
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
MeritCare BroadwayFargo, North Dakota  58122
CCOP - MeritCare HospitalFargo, North Dakota  58122
Aultman Cancer Center at Aultman HospitalCanton, Ohio  44710-1799
Case Comprehensive Cancer CenterCleveland, Ohio  44106-5065
Natalie Warren Bryant Cancer Center at St. Francis HospitalTulsa, Oklahoma  74136
Abramson Cancer Center of the University of PennsylvaniaPhiladelphia, Pennsylvania  19104-4283
Sanford Cancer Center at Sanford USD Medical CenterSioux Falls, South Dakota  57117-5039
Medical College of Wisconsin Cancer CenterMilwaukee, Wisconsin  53226
CCOP - OchsnerNew Orleans, Louisiana  70121
CCOP - Bay Area Tumor InstituteOakland, California  94609-3305
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Memorial Hospital of South BendSouth Bend, Indiana  46601
CCOP - Montana Cancer ConsortiumBillings, Montana  59101
Fox Chase Cancer Center at Virtua-Memorial Hospital Burlington CountyMount Holly, New Jersey  08060
CCOP - ColumbusColumbus, Ohio  43206
Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
Harrington Cancer CenterAmarillo, Texas  79106
University of Texas Medical BranchGalveston, Texas  77555-1329
CCOP - Northern Indiana CR ConsortiumSouth Bend, Indiana  46601
Saint Joseph Regional Medical CenterSouth Bend, Indiana  46617
UMASS Memorial Cancer Center - University CampusWorcester, Massachusetts  01605-2982
Ellis Fischel Cancer Center at University of Missouri - ColumbiaColumbia, Missouri  65203
Charles M. Barrett Cancer Center at University HospitalCincinnati, Ohio  45267-0526
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
MBCCOP - LSU Health Sciences CenterNew Orleans, Louisiana  70112
Kaiser Permanente Medical Center - VallejoVallejo, California  94589
Peninsula Regional Medical CenterSalisbury, Maryland  21801
Veterans Affairs Medical Center - BuffaloBuffalo, New York  14215
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
Wesley Medical CenterWichita, Kansas  67214
Veterans Affairs Medical Center - BaltimoreBaltimore, Maryland  21201
Kaiser Permanente Medical Center - San Francisco Geary CampusSan Francisco, California  94115
Arkansas Cancer Research Center at University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
Thompson Cancer Survival CenterKnoxville, Tennessee  37916
James Graham Brown Cancer Center at University of LouisvilleLouisville, Kentucky  40202
McDowell Cancer Center at Akron General Medical CenterAkron, Ohio  44307
Lake/University Ireland Cancer CenterMentor, Ohio  44060
Mercy Fitzgerald HospitalDarby, Pennsylvania  19023
Kaiser Permanente Medical Center - OaklandSacramento, California  95825
Florida Hospital Cancer Institute at Florida Hospital OrlandoOrlando, Florida  32803-1273
Winship Cancer Institute of Emory UniversityAtlanta, Georgia  30322
Advocate Christ Medical CenterOak Lawn, Illinois  60453
Via Christi Cancer Center at Via Christi Regional Medical CenterWichita, Kansas  67214
Alvin and Lois Lapidus Cancer Institute at Sinai HospitalBaltimore, Maryland  21215
SUNY Upstate Medical University HospitalSyracuse, New York  13210
Mission Hospitals - Memorial CampusAsheville, North Carolina  28801
Presbyterian Cancer Center at Presbyterian HospitalCharlotte, North Carolina  28233-3549
Wake Forest University Comprehensive Cancer CenterWinston-Salem, North Carolina  27157-1096
Hollings Cancer Center at Medical University of South CarolinaCharleston, South Carolina  29425
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - DallasDallas, Texas  75390
St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54307-3508
James P. Wilmot Cancer Center at University of Rochester Medical CenterRochester, New York  14642
Green Bay Oncology, Limited - EscanabaEscanaba, Michigan  49431
Dickinson County Healthcare SystemIron Mountain, Michigan  49801
St. Mary's Hospital Medical Center - Green BayGreen Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's HospitalGreen Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical CenterMarinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto FallsOconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon BaySturgeon Bay, Wisconsin  54235
Parma Community General HospitalParma, Ohio  44129
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
Baptist Cancer Institute - JacksonvilleJacksonville, Florida  32207
William Beaumont Hospital - Royal Oak CampusRoyal Oak, Michigan  48073
Wayne Memorial Hospital, IncorporatedGoldsboro, North Carolina  27534
Adena Regional Medical CenterChillicothe, Ohio  54601
Doctors Hospital at Ohio HealthColumbus, Ohio  43228
Riverside Methodist Hospital Cancer CareColumbus, Ohio  43214
Grady Memorial HospitalDelaware, Ohio  43015
Strecker Cancer Center at Marietta Memorial HospitalMarietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial HospitalNewark, Ohio  43055
Community Hospital of Springfield and Clark CountySpringfield, Ohio  45505
Genesis - Good Samaritan HospitalZanesville, Ohio  43701
Greenebaum Cancer Center at University of Maryland Medical CenterBaltimore, Maryland  21201
Kaiser Permanente Medical Center - Santa Clara Kiely CampusSanta Clara, California  95051-5386
M.D. Anderson Cancer Center at OrlandoOrlando, Florida  32806
Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical CenterSavannah, Georgia  31403-3089
Swedish-American Regional Cancer CenterRockford, Illinois  61104-2315
Lucille P. Markey Cancer Center at University of KentuckyLexington, Kentucky  40536-0093
Tulane Cancer Center Office of Clinical ResearchAlexandria, Louisiana  71315-3198
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer InstituteBoston, Massachusetts  02115
University of Mississippi Cancer ClinicJackson, Mississippi  39216-4505
Siteman Cancer Center at Barnes-Jewish Hospital - Saint LouisSt. Louis, Missouri  63110
CCOP - Nevada Cancer Research FoundationLas Vegas, Nevada  89109-2306
Oklahoma University Cancer InstituteOklahoma City, Oklahoma  73104
M. D. Anderson Cancer Center at University of TexasHouston, Texas  77030-4009
Gundersen Lutheran Center for Cancer and BloodLa Crosse, Wisconsin  54601
Kaiser Permanente Medical Center - SacramentoSacramento, California  95825
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
Decatur Memorial Hospital Cancer Care InstituteDecatur, Illinois  62526
Paoli Memorial HospitalPaoli, Pennsylvania  19301-1792
Elkhart General HospitalElkhart, Indiana  46515
Howard Community HospitalKokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. JosephSt. Joseph, Michigan  49085
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
Mount Carmel Health - West HospitalColumbus, Ohio  43222
Hillcrest Cancer Center at Hillcrest HospitalMayfield Heights, Ohio  44124
Rosenfeld Cancer Center at Abington Memorial HospitalAbington, Pennsylvania  19001
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
All Saints Cancer Center at Wheaton Franciscan HealthcareRacine, Wisconsin  53405
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
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
Kaiser Permanente Medical Center - Walnut CreekWalnut Creek, California  94596
Ella Milbank Foshay Cancer Center at Jupiter Medical CenterJupiter, Florida  33458
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
St. Joseph Medical CenterBloomington, Illinois  61701
Swedish Covenant HospitalChicago, Illinois  60625
Eureka Community HospitalEureka, Illinois  61530
BroMenn Regional Medical CenterNormal, Illinois  61761
Community Cancer CenterNormal, Illinois  61761
Community Hospital of OttawaOttawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - OttawaOttawa, Illinois  61350
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
Proctor HospitalPeoria, Illinois  61614
Illinois Valley Community HospitalPeru, Illinois  61354
Valley Cancer CenterSpring Valley, Illinois  61362
Center for Cancer Therapy at LaPorte Hospital and Health ServicesLa Porte, Indiana  46350
Cancer Center of Kansas, PA - Dodge CityDodge City, Kansas  67801
Mary Bird Perkins Cancer Center - Baton RougeBaton Rouge, Louisiana  70809
Medical Center of Louisiana - New OrleansNew Orleans, Louisiana  70112
Providence Cancer Institute at Providence Hospital - Southfield CampusSouthfield, Michigan  48075
Immanuel Medical CenterOmaha, Nebraska  68122
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Cancer Institute of New Jersey at Cooper - VoorheesVoorhees, New Jersey  08043
Charles R. Wood Cancer Center at Glens Falls HospitalGlens Falls, New York  12801
Highland Hospital of RochesterRochester, New York  14620
Iredell Memorial HospitalStatesville, North Carolina  28677
North Coast Cancer Care, IncorporatedSandusky, Ohio  44870
Cleveland Clinic - WoosterWooster, Ohio  44691
Bryn Mawr HospitalBryn Mawr, Pennsylvania  19010
Delaware County Regional Cancer Center at Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
Bon Secours St. Francis Health SystemGreenville, South Carolina  29601
Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical CenterKingsport, Tennessee  37662
Massachusetts General HospitalBoston, Massachusetts  02114-2617
St. Anthony Central HospitalDenver, Colorado  80204-1335
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
Trinity Medical CenterMoline, Illinois  61265-1291
California Cancer Center - Woodward Park OfficeFresno, California  93720
Northeast Georgia Medical CenterGainesville, Georgia  30501
Creticos Cancer Center at Advocate Illinois Masonic Medical CenterChicago, Illinois  60657
Cancer Center at Ball Memorial HospitalMuncie, Indiana  47303
Regional Cancer Center at Singing River HospitalPascagoula, Mississippi  39581
Saint Luke's HospitalChesterfield, Missouri  63017
Cancer Resource Center - LincolnLincoln, Nebraska  68510
Altru Cancer Center at Altru HospitalGrand Forks, North Dakota  58201
Cancer Treatment CenterWooster, Ohio  44691
UAB Comprehensive Cancer CenterBirmingham, Alabama  35294
Stanford Cancer CenterStanford, California  94305-5824
Tunnell Cancer Center at Beebe Medical CenterLewes, Delaware  19958
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross HospitalFort Lauderdale, Florida  33308
John B. Amos Cancer CenterColumbus, Georgia  31904
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/CandlerSavannah, Georgia  31405
Evanston HospitalEvanston, Illinois  60201-1781
Michiana Hematology-Oncology, PC - ElkhartElkhart, Indiana  46514
Elkhart Clinic, LLCElkhart, Indiana  46514-2098
Michiana Hematology Oncology PC - La PorteLa Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South BendMishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - PlymouthPlymouth, Indiana  46563
Cancer Center of Kansas, PA - El DoradoEl Dorado, Kansas  67042
Lawrence Memorial HospitalLawrence, Kansas  66044
Menorah Medical CenterOverland Park, Kansas  66209
Saint Luke's Hospital - SouthOverland Park, Kansas  66213
Cancer Center of Kansas, PA - SalinaSalina, Kansas  67401
Cotton-O'Neil Cancer CenterTopeka, Kansas  66606
Cancer Center of Kansas, PA - WellingtonWellington, Kansas  67152
Cancer Center of Kansas, PA - WichitaWichita, Kansas  67214
Associates in Womens Health, PA - North ReviewWichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas, PA - WinfieldWinfield, Kansas  67156
Greater Baltimore Medical Center Cancer CenterBaltimore, Maryland  21204
Foote Memorial HospitalJackson, Michigan  49201
St. Mary Mercy HospitalLivonia, Michigan  48154
St. Joseph Mercy OaklandPontiac, Michigan  48341-2985
Seton Cancer Institute at Saint Mary's - SaginawSaginaw, Michigan  48601
Lakeside Cancer Specialists, PLLCSaint Joseph, Michigan  49085
Willmar Cancer Center at Rice Memorial HospitalWillmar, Minnesota  56201
Heartland Hematology Oncology Associates, IncorporatedKansas City, Missouri  64118
North Kansas City HospitalKansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's HospitalKansas City, Missouri  64111
Research Medical CenterKansas City, Missouri  64132
Saint Luke's East - Lee's SummitLee's Summit, Missouri  64086
Heartland Regional Medical CenterSaint Joseph, Missouri  64506
Saint Joseph Oncology, IncorporatedSaint Joseph, Missouri  64507
Billings Clinic - DowntownBillings, Montana  59107-7000
Alegant Health Cancer Center at Bergan Mercy Medical CenterOmaha, Nebraska  68124
Summa Center for Cancer Care at Akron City HospitalAkron, Ohio  44309-2090
Barberton Citizens HospitalBarberton, Ohio  44203
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer CenterColumbus, Ohio  43210-1240
Grant Medical Center Cancer CareColumbus, Ohio  43215
Mount Carmel St. Ann's Cancer CenterWesterville, Ohio  43081
Penn State Hershey Cancer Institute at Milton S. Hershey Medical CenterHershey, Pennsylvania  17033-0850
York Cancer Center at Apple Hill Medical CenterYork, Pennsylvania  17405
Southwest Virginia Regional Cancer Center at Wellmonth HealthNorton, Virginia  24273
FirstHealth Moore Regional Community Hospital Comprehensive Cancer CenterPinehurst, North Carolina  28374
Mid Dakota Clinic, PCBismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical CenterSpringfield, Illinois  62781-0001
John H. Stroger, Jr. Hospital of Cook CountyChicago, Illinois  60612-9985
Elliot Regional Cancer Center at Elliot HospitalManchester, New Hampshire  03103
Pardee Memorial HospitalHendersonville, North Carolina  28791
Gibbs Regional Cancer Center at Spartanburg Regional Medical CenterSpartanburg, South Carolina  29303
Union Hospital of Cecil CountyElkton MD, Maryland  21921
Dana-Farber/Brigham and Women's Cancer CenterBoston, Massachusetts  02115
Duke Cancer InstituteDurham, North Carolina  27710
Kinston Medical SpecialistsKinston, North Carolina  28501
Resurrection Medical CenterChicago, Illinois  60631
Wellmont Holston Valley Hospital and Medical CenterKingsport, Tennessee  37662
Highlands Oncology Group - SpringdaleSpringdale, Arkansas  72764
La Grange Memorial HospitalLa Grange, Illinois  60525
University of Wisconcin Cancer Center at Aspirus Wausau HospitalWausau, Wisconsin  54401
Integrated Community Oncology NetworkJacksonville Beach, Florida  32250
Baptist Medical Center SouthJascksonville, Florida  32258
Florida Cancer Center - PalatkaPalatka, Florida  32177
Flagler Cancer CenterSaint Augustine, Florida  32086
Center for Cancer Care at OSF Saint Anthony Medical CenterRockford, Illinois  61108
Doctors Medical Center - San Pablo CampusSan Pablo, California  94806
Galesburg Clinic, PCGalesburg, Illinois  61401
Providence Cancer Center at Providence HospitalMobile, Alabama  36608
East Bay Radiation Oncology CenterCastro Valley, California  94546
Contra Costa Regional Medical CenterMartinez, California  94553-3156
Memorial Medical CenterModesto, California  95355
El Camino Hospital Cancer CenterMountain View, California  94040
Larry G Strieff MD Medical CorporationOakland, California  94609
Tom K Lee, IncorporatedOakland, California  94609
Bay Area Breast Surgeons, IncorporatedOakland, California  94609
Illinois CancerCare - BloomingtonBloomington%, Illinois  61701
Illinois CancerCare - CantonCanton, Illinois  61520
Illinois CancerCare - EurekaEureka, Illinois  61530
Illinois CancerCare - MacombMacomb, Illinois  61455
Trinity Cancer Center at Trinity Medical Center - 7th Street CampusMoline, Illinois  61265
Illinois CancerCare - Community Cancer CenterNormal, Illinois  61761
Illinois CancerCare - PekinPekin, Illinois  61603
Illinois CancerCare - PeruPeru, Illinois  61354
Illinois CancerCare - Spring ValleySpring Valley, Illinois  61362
Caritas St. Elizabeth's Medical CenterBrighton, Massachusetts  02135-2997
Christian Hospital Northeast Cancer Care CenterSaint Louis, Missouri  63136
Center for Cancer Care at Exeter HospitalExeter, New Hampshire  03833
Trinity CancerCare CenterMinot, North Dakota  58701
AnMed Cancer CenterAnderson, South Carolina  29621
U.T. Medical Center Cancer InstituteKnoxville, Tennessee  37920-6999
Dale and Frances Hughes Cancer Center at Pocono Medical CenterEast Stroudsburg, Pennsylvania  18301
Cancer Care Center, IncorporatedSalem, Ohio  44460
Nebraska Methodist HospitalOmaha, Nebraska  68114
Medcenter One Hospital Cancer Care CenterBismarck, North Dakota  58501
St. Alexius Medical Center Cancer CenterBismarck, North Dakota  58502
Case Western Reserve UniversityCleveland, Ohio  44106
Veterans Affairs Medical Center - MilwaukeeMilwaukee, Wisconsin  53295
Saint Mary's Regional Medical CenterReno, Nevada  89503
Integrated Community Oncology Network - Orange ParkOrange Park, Florida  32073
Provena St. Mary's Regional Cancer Center - KankakeeKankakee, Illinois  60901
Frankford Hospital Cancer Center - Torresdale CampusPhiladelphia, Pennsylvania  19114
Minnesota Oncology - MaplewoodMaplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient CenterRobbinsdale, Minnesota  55422-2900
Minnesota Oncology - WoodburyWoodbury, Minnesota  55125
Tulane University Health Sciences CenterNew Orleans, Louisiana  70112
Lankenau HospitalWynnewood, Pennsylvania  19096
UPMC Cancer Center at Beaver Medical CenterBeaver, Pennsylvania  15009
UPMC - ShadysidePittsburgh, Pennsylvania  15213-2582
Blue Ridge Medical Specialists, PCBristol, Tennessee  37620
Emory Crawford Long HospitalAtlanta, Georgia  30308
CCOP - Kansas CityPrairie Village, Kansas  66208
St. Agnes Hospital Cancer CenterBaltimore, Maryland  21229
Renown Institute for Cancer at Renown Regional Medical CenterReno, Nevada  89502
Sands Cancer CenterCanandiaqua, New York  14424
University Radiation Oncology at Parkridge HospitalRochester, New York  14626
Coastal Carolina Radiation Oncology CenterWilmington, North Carolina  28401
Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical CenterBurbank, California  91505
Langlade Memorial HospitalAntigo, Wisconsin  54409
Integrated Community Oncology Network at Southside Cancer CenterJacksonville, Florida  32207
Southwest General Health CenterMiddleburgh Heights, Ohio  44130
UHHS Chagrin Highlands Medical CenterOrange Villager, Ohio  44122
UHHS Westlake Medical CenterWestlaker, Ohio  44145
Clemens Regional Medical CenterMount Clemens, Michigan  48043
Lakeside HospitalOmaha, Nebraska  68130
Cleveland Clinic Foundation - StrongsvilleStrongsville, Ohio  44136
Littleton Adventist HospitalLittleton, Colorado  80122
Roger Maris Cancer Center at MeritCare HospitalFargo, North Dakota  58122
OSF Saint Francis Medical CenterPeoria, Illinois  61637
Saint Helena HospitalSaint Helena, California  94574
The Medical Center of AuroraAurora, Colorado  80012
Saint Francis HospitalEvanston, Illinois  60202
Illinois CancerCare-Ottawa ClinicOttawa, Illinois  61350
Ottawa Regional Hospital and Healthcare CenterOttawa, Illinois  61350
Illinois CancerCare-PeoriaPeoria, Illinois  61615
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Summa Barberton HospitalBarberton, Ohio  44203
Aria Health-Torresdale CampusPhiladelphia, Pennsylvania  19114
Mainline Health CCOPWynnewood, Pennsylvania  19096
Southwest VA Regional Cancer CenterNorton, Virginia  24273
Southern Ohio Medical Center Cancer CenterPortsmouth, Ohio  45662
Georgetown Memorial HospitalGeorgetown, South Carolina  29440
Michiana Hematology Oncology PC-South BendSouth Bend, Indiana  46601
New Hanover Regional Medical Center/Zimmer Cancer CenterWilmington, North Carolina  28401
Celilo Cancer Center at Mid-Columbia Medical CenterThe Dalles, Oregon  97058
Adams Cancer CenterGettysburg, Pennsylvania  17325
Cherry Tree Cancer CenterHanover, Pennsylvania  17331
Charles A. & Betty Bott Cancer Center at Holy Redeemer HospitalMeadowbrook, Pennsylvania  19046
Sanford Cancer Center Oncology ClinicSioux Falls, South Dakota  57104
Saint Vincent Oncology CenterIndianapolis, Indiana  46260
Dana-Farber/Brigham and Women's Cancer Center at Milford Regional Medical CenterMilford, Massachusetts  01757
Zangmeister CenterColumbus, Ohio  43219
Montefiore Medical Center - Moses CampusBronx, New York  10467
Sanford Roger Maris Cancer CenterFargo, North Dakota  
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
Sanford Clinic North-FargoFargo, North Dakota  58102
Sanford Medical Center-FargoFargo, North Dakota  58122
Dana-Farber/Brigham and Women's Cancer Center at South ShoreSouth Weymouth, Massachusetts  02190
Botsford Cancer Center at Botsford HospitalFarmington, Michigan  48336-5919
South Atlantic Radiation OncologySupply, North Carolina  28462
Memorial University Medical CenterSavannah, Georgia  31404
Sanford Clinic North-BemidgiBemidji, Minnesota  56601
Sanford Bismarck Medical CenterBismarck, North Dakota  58501
Springfield Regional Medical CenterSpringfield, Ohio  45505
Memorial Sloan-Kettering Cancer Center at SuffolkCommack, New York  11725
Jameson Health System North CampusNew Castle, Pennsylvania  16105
Benefis Sletten Cancer InstituteGreat Falls, Montana  59405
Hematology and Oncology Associates-OaklandOakland, California  94609
Integrated Community Oncology Network-Cancer Center of PutnamPalatka, Florida  32177
Memorial Sloan Kettering Cancer Center at Basking RidgeBasking Ridge, New Jersey  07920
Memorial Sloan-Kettering Cancer Center Rockville CentreRockville Centre, New York  11570
Memorial Sloan-Kettering Cancer Center at PhelpsSleepy Hollow, New York  10591
Cancer Care Center IncorporatedSalem, Ohio  44460
Reading HospitalWest Reading, Pennsylvania  19612
Saint Agnes Hospital/Agnesian Cancer CenterFond Du Lac, Wisconsin  54935
Westfields Hospital/Cancer Center of Western WisconsinNew Richmond, Wisconsin  54017