MedPath

Radiation Therapy With or Without Androgen-Deprivation Therapy in Treating Patients With Prostate Cancer

Phase 3
Active, not recruiting
Conditions
Prostate Cancer
Interventions
Radiation: Dose-Escalated Radiation Therapy
Drug: LHRH agonist (antagonist) therapy
Registration Number
NCT00936390
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

RATIONALE: Radiation therapy uses high-energy x-rays and other types of radiation to kill tumor cells and shrink tumors. Androgens can cause the growth of prostate cancer cells. Androgen-deprivation therapy may lessen the amount of androgens made by the body. It is not yet known whether radiation therapy is more effective with or without androgen-deprivation therapy in treating patients with prostate cancer.

PURPOSE: This randomized phase III trial is studying radiation therapy to see how well it works compared with radiation therapy given together with androgen-deprivation therapy in treating patients with prostate cancer.

Detailed Description

OBJECTIVES:

Primary

* Demonstrate an overall survival (OS) advantage in patients with intermediate-risk prostate cancer treated with dose-escalated radiotherapy (RT) with versus without short-term androgen-deprivation therapy (ADT).

Secondary

* Determine whether the addition of ADT to dose-escalated RT versus RT alone improves clinical failures, biochemical failure by the "nadir +2", freedom from failure, rate of salvage ADT, and prostate cancer-specific mortality in these patients.

* Estimate the magnitude of benefit of ADT with respect to OS in patients treated with different RT modalities (i.e., external-beam radiation therapy alone vs low-dose rate brachytherapy boost vs high-dose rate brachytherapy boost).

* Compare acute and late treatment adverse events of these regimens and correlate these events with the presence or absence of pre-existing comorbidity as documented by the Adult Comorbidity Evaluation 27 assessment.

OUTLINE: This is a multicenter, dose-escalation study of radiotherapy. Patients are stratified according to number of risk factors (1 vs 2-3), comorbidity (ACE-27 grade ≥ 2 vs \< 2), and radiotherapy (RT) modality (dose-escalated external-beam RT \[EBRT\] vs EBRT and low-dose rate brachytherapy boost vs EBRT and high-dose rate brachytherapy boost). Patients are randomized to 1 of 2 treatment arms. After completion of study therapy, patients are followed up periodically.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Male
Target Recruitment
1538
Inclusion Criteria
  1. Pathologically (histologically) proven diagnosis of prostatic adenocarcinoma, at intermediate risk for recurrence, within 180 days prior to registration as determined by having one or more of the following intermediate-risk features: Gleason score 7; prostate-specific antigen (PSA) >10 but ≤20; clinical stage T2b-T2c.

    • Patients previously diagnosed with low risk (Gleason score ≤ 6, clinical stage < T2a, and PSA < 10) prostate cancer undergoing active surveillance who are re-biopsied and found to have intermediate risk disease according to the protocol criteria are eligible for enrollment within 180 days of the repeat biopsy procedure.
  2. Clinically negative lymph nodes as established by imaging (pelvic +/- abdominal CT or MRI), nodal sampling, or dissection within 60 days prior to registration, except as noted immediately below:

    • Patients with a single intermediate risk factor only do not require abdominopelvic imaging, but these studies may be obtained at the discretion of the treating physician. Patients with 2 or 3 risk factors are required to undergo pelvic +/- abdominal CT or MRI.
    • Patients with lymph nodes equivocal or questionable by imaging are eligible without biopsy if the nodes are ≤1.5 cm; any node larger than this on imaging will require negative biopsy for eligibility.
  3. No evidence of bone metastases (M0) on bone scan within 60 days prior to registration.

    • Bone scan is not required for patients enrolled with a single intermediate risk factor only, but this scan may be obtained at the discretion of the treating physician. Patients with 2 or 3 risk factors will require a negative bone scan for eligibility.
    • Equivocal bone scan findings are allowed if plain film x-rays are negative for metastasis.
  4. History/physical examination (to include, at a minimum, digital rectal examination of the prostate and examination of the skeletal system and abdomen, and formal comorbidity assessment via the ACE-27 instrument) within 60 days prior to registration.

  5. Zubrod Performance Status 0-1

  6. Age ≥ 18

  7. Baseline serum PSA value performed with an FDA-approved assay (e.g., Abbott, Hybritech) within 60 days prior to registration

    • Study entry PSA must not be obtained during the following time frames: (1) 10-day period following prostate biopsy; (2) following initiation of ADT; (3) within 30 days after discontinuation of finasteride; or (4) within 90 days after discontinuation of dutasteride.
  8. For patients undergoing brachytherapy only: complete blood count (CBC)/differential obtained within 60 days prior to registration, with adequate bone marrow function defined as follows:

    • Absolute neutrophil count (ANC) ≥ 1,800 cells/mm3
    • Platelets ≥ 100,000 cells/mm3
    • Hemoglobin (Hgb) ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable.)
  9. Patient must be able to provide study-specific informed consent prior to study entry.

Exclusion Criteria
  1. Patients with Gleason Score ≥ 8; PSA > 20; OR Clinical Stage ≥ T3 are ineligible for this trial.

    • Should findings of extracapsular extension or seminal vesicle invasion be noted on prostate MRI, this study, if used, will not render patients ineligible for accrual to this protocol. Primary tumor staging for eligibility purposes is to be based on palpable or core biopsy evidence only with respect to extracapsular extension or seminal vesicle involvement.
  2. Patients with all three intermediate risk factors who also have ≥ 50% of the number of their biopsy cores positive for cancer are ineligible for this trial.

  3. Prior invasive malignancy (except non-melanomatous skin cancer) or hematological (e.g., leukemia, lymphoma, myeloma) malignancy unless disease free for a minimum of 5 years (prior diagnoses of carcinoma in situ are permitted)

  4. Prior radical surgery (prostatectomy), high-intensity focused ultrasound (HIFU) or cryosurgery for prostate cancer

  5. Prior hormonal therapy, such as LHRH agonists (e.g., goserelin, leuprolide), antiandrogens (e.g., flutamide, bicalutamide), estrogens (e.g., DES), or bilateral orchiectomy

  6. Use of finasteride within 30 days prior to registration

  7. Use of dutasteride within 90 days prior to registration

  8. Prior or concurrent cytotoxic chemotherapy for prostate cancer; prior chemotherapy for a different cancer is permitted.

  9. Prior RT, including brachytherapy, to the region of the study cancer that would result in overlap of RT fields

    • Any patient undergoing brachytherapy must have transrectal ultrasound confirmation of prostate volume <60 cc, American Urological Association Symptom Index (AUA-SI) score ≤15 within 60 days of registration, and no history of prior transurethral resection of the prostate (TURP); prior TURP is permitted for patients who receive EBRT only)
  10. Severe, active co-morbidity, defined as follows:

    • Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
    • 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 within 30 days before registration
    • Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol.
    • Acquired Immune Deficiency Syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that HIV testing is not required for entry into this protocol. While the treatment employed in this study is not significantly immunosuppressive, it is felt that a diagnosis of AIDS associated with prostate cancer is likely to impact this study's primary endpoint of overall survival. Patients who are HIV seropositive but do not meet criteria for diagnosis of AIDS are eligible for study participation.
  11. Men who are sexually active with a woman of child-bearing potential and not willing/able to use medically acceptable forms of contraception (e.g., surgical, barrier, medicinal) during protocol treatment and during the first 3 months after cessation of protocol treatment; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dose-Escalated Radiation Therapy AloneDose-Escalated Radiation TherapyRadiation therapy consists of 79.2 Gy EBRT only or 45 Gy EBRT followed by low- or high-dose rate brachytherapy. EBRT is delivered in 1.8 Gy daily fractions.
Dose-Escalated Radiation Therapy and Short-Term Androgen-DeprivationflutamideRadiation therapy consists of 79.2 Gy EBRT only or 45 Gy EBRT followed by low- or high-dose rate brachytherapy. EBRT is delivered in 1.8 Gy daily fractions. Six months of androgen-deprivation therapy starts 8 weeks prior to start of radiation therapy and consists of luteinizing-hormone releasing-hormone (LHRH) agonist (antagonist) therapy (leuprolide, goserelin, buserelin. triptorelin, or degarelix) and anti-androgen therapy (bicalutamide or flutamide).
Dose-Escalated Radiation Therapy and Short-Term Androgen-DeprivationLHRH agonist (antagonist) therapyRadiation therapy consists of 79.2 Gy EBRT only or 45 Gy EBRT followed by low- or high-dose rate brachytherapy. EBRT is delivered in 1.8 Gy daily fractions. Six months of androgen-deprivation therapy starts 8 weeks prior to start of radiation therapy and consists of luteinizing-hormone releasing-hormone (LHRH) agonist (antagonist) therapy (leuprolide, goserelin, buserelin. triptorelin, or degarelix) and anti-androgen therapy (bicalutamide or flutamide).
Dose-Escalated Radiation Therapy and Short-Term Androgen-DeprivationDose-Escalated Radiation TherapyRadiation therapy consists of 79.2 Gy EBRT only or 45 Gy EBRT followed by low- or high-dose rate brachytherapy. EBRT is delivered in 1.8 Gy daily fractions. Six months of androgen-deprivation therapy starts 8 weeks prior to start of radiation therapy and consists of luteinizing-hormone releasing-hormone (LHRH) agonist (antagonist) therapy (leuprolide, goserelin, buserelin. triptorelin, or degarelix) and anti-androgen therapy (bicalutamide or flutamide).
Dose-Escalated Radiation Therapy and Short-Term Androgen-DeprivationbicalutamideRadiation therapy consists of 79.2 Gy EBRT only or 45 Gy EBRT followed by low- or high-dose rate brachytherapy. EBRT is delivered in 1.8 Gy daily fractions. Six months of androgen-deprivation therapy starts 8 weeks prior to start of radiation therapy and consists of luteinizing-hormone releasing-hormone (LHRH) agonist (antagonist) therapy (leuprolide, goserelin, buserelin. triptorelin, or degarelix) and anti-androgen therapy (bicalutamide or flutamide).
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Alive (Overall Survival)From randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Overall survival time is defined as time from randomization to the date of death from any cause or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Secondary Outcome Measures
NameTimeMethod
Quality Adjusted Life Years (QALYs)Last week of RT (approximately 9 and 17 weeks from start of protocol treatment for Arm 1 and 2, respectively), then 6 months, 1 year and 5 years from end of RT.
Correlation Between PROMIS Fatigue Score Change and Plasma Cytokine ChangeFrom date of randomization to 3 weeks from start of RT.
Percentage of Participants With Biochemical FailureFrom randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Biochemical failure is defined as an increase of at least 2 ng/ml above the nadir PSA. Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants With Local RecurrenceFrom randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Local recurrence (failure) is defined as clinical (palpable) suspicion of local recurrence \[this date is used\] confirmed by biopsy. Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants With Regional RecurrenceFrom randomization to last follow-up. Maximum follow-up at time of analysis was 10.3 years.

Regional recurrence is defined as the documented progression in pelvic lymph nodes. If discovered on image of the pelvis prompted by a biochemical failure, then the event date would be the date of documented biochemical failure.

Percentage of Participants With Distant MetastasisFrom randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Distant metastasis (failure) is defined as metastatic disease documented by any method. If diagnosed on diagnostic imaging prompted by biochemical failure, then the event date will be the date of biochemical progression.

Failure time is defined as time from randomization to the date of first failure, last known follow-up (competing risk), or death without failure (censored). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants Dead Due to Prostate Cancer (Prostate Cancer-specific Mortality)From randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Prostate cancer specific mortality (failure) is defined as death due to prostate cancer or a complication from treatment. Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants Dead Due to Cause Other Than Prostate Cancer (Non-Prostate Cancer-specific Mortality)From randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Non-prostate cancer specific mortality is defined as a death without evidence of prostate cancer or a complication from treatment. . Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants Receiving Salvage Androgen Deprivation Therapy (ADT)From randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Salvage (non-protocol) ADT administration is defined as the first administration of subsequent ADT (either LHRH agonist or anti-androgen) Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Salvage ADT rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of salvage ADT times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants Alive (Overall Survival) by Radiation Therapy ModalityFrom randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates reported here.

Overall survival time is defined as time from randomization to the date of death from any cause or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Number of Participants With Acute Adverse EventsFrom randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years.

Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data. Acute adverse events are defined as occuring within 30 days of completion of radiation therapy.

Percentage of Participants With Late Grade 3+ Adverse EventsFrom randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates are reported here.

Common Terminology Criteria for Adverse Events (version 4.0) grades adverse event severity from 1=mild to 5=death. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data. Late adverse events are defined as occurring more than 30 days after the end of radiation therapy. Failure is defined as grade 3 or higher late adverse event. Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Percentage of Participants Failed (Freedom From Failure)From randomization to last follow-up. Follow-up schedule: end of RT (2nd arm only), then every 3 months for a year, every 4 months for 4 years, then yearly. Maximum follow-up at time of analysis was 10.3 years. Five-year rates are reported here.

Failure is defined as biochemical failure, local failure, or distant metastasis. Failure time is defined as time from randomization to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rates are estimated using the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided here. Analysis was planned to occur after 218 deaths were reported.

Change From Baseline in Expanded Prostate Cancer Index Composite (EPIC) Urinary Domain ScoreLast week of RT (approximately 9 and 17 weeks from start of protocol treatment for Arm 1 and 2, respectively), then 6 months, 1 year and 5 years from end of RT.

The EPIC assesses disease-specific aspects of prostate cancer and it's therapies and consists of four summary domains (bowel, urinary, sexual, and hormonal), each ranging from 0-100, with higher scores representing better health-related quality of life. Change is calculated as time point value - baseline value, such that a positive change indicates improvement.

Change From Baseline in Expanded Prostate Cancer Index Composite (EPIC) Bowel Domain ScoreLast week of RT (approximately 9 and 17 weeks from start of protocol treatment for Arm 1 and 2, respectively), then 6 months, 1 year and 5 years from end of RT.

The EPIC assesses disease-specific aspects of prostate cancer and it's therapies and consists of four summary domains (bowel, urinary, sexual, and hormonal), each ranging from 0-100, with higher scores representing better health-related quality of life. Change is calculated as time point value - baseline value, such that a positive change indicates improvement.

Change From Baseline in Expanded Prostate Cancer Index Composite (EPIC) Hormonal Domain ScoreLast week of RT (approximately 9 and 17 weeks from start of protocol treatment for Arm 1 and 2, respectively), then 6 months, 1 year and 5 years from end of RT.

The EPIC assesses disease-specific aspects of prostate cancer and it's therapies and consists of four summary domains (bowel, urinary, sexual, and hormonal), each ranging from 0-100, with higher scores representing better health-related quality of life. Change is calculated as time point value - baseline value, such that a positive change indicates improvement.

Change From Baseline in Expanded Prostate Cancer Index Composite (EPIC) Sexual Domain ScoreLast week of RT (approximately 9 and 17 weeks from start of protocol treatment for Arm 1 and 2, respectively), then 6 months, 1 year and 5 years from end of RT.

The EPIC assesses disease-specific aspects of prostate cancer and it's therapies and consists of four summary domains (bowel, urinary, sexual, and hormonal), each ranging from 0-100, with higher scores representing better health-related quality of life. Change is calculated as time point value - baseline value, such that a positive change indicates improvement.

Change From Baseline in Patient Reported Outcome Measurement Information System (PROMIS) Fatigue Domain ScoreLast week of RT (approximately 9 and 17 weeks from start of protocol treatment for Arm 1 and 2, respectively), then 6 months, 1 year and 5 years from end of RT.

The PROMIS Fatigue short form 8a contains 8 questions, each with 5 responses ranging from 1 to 5, evaluating self-reported fatigue symptoms over the past 7 days. The total score is the sum of all questions which is then converted into a pro-rated T-score with a mean of 50 and standard deviation of 10, with a possible range of 33.1 to 77.8. Higher scores indicate more fatigue. Change is defined as value at one year - value at baseline. Positive change from baseline indicates increased fatigue at one year.

Trial Locations

Locations (517)

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

Riverside Methodist Hospital

🇺🇸

Columbus, Ohio, United States

Grant Medical Center

🇺🇸

Columbus, Ohio, United States

The Mark H Zangmeister Center

🇺🇸

Columbus, Ohio, United States

Mount Carmel Health Center West

🇺🇸

Columbus, Ohio, United States

Doctors Hospital

🇺🇸

Columbus, Ohio, United States

Texas Cancer Center - Medical City Dallas

🇺🇸

Dallas, Texas, United States

UT Southwestern/Simmons Cancer Center-Dallas

🇺🇸

Dallas, Texas, United States

John H Stroger Jr Hospital of Cook County

🇺🇸

Chicago, Illinois, United States

Advocate Illinois Masonic Medical Center

🇺🇸

Chicago, Illinois, United States

Case Western Reserve University

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Cancer Center/Fairview Hospital

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Virginia Mason CCOP

🇺🇸

Seattle, Washington, United States

Virginia Mason Medical Center

🇺🇸

Seattle, Washington, United States

Memorial Hermann Memorial City Medical Center

🇺🇸

Houston, Texas, United States

M D Anderson Cancer Center

🇺🇸

Houston, Texas, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

🇺🇸

Miami, Florida, United States

IU Health Methodist Hospital

🇺🇸

Indianapolis, Indiana, United States

IU Health Central Indiana Cancer Centers-East

🇺🇸

Indianapolis, Indiana, United States

Kaiser Permanente-Redwood City

🇺🇸

Redwood City, California, United States

Kaiser Permanente-Santa Teresa-San Jose

🇺🇸

San Jose, California, United States

University of California San Diego

🇺🇸

San Diego, California, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Columbus CCOP

🇺🇸

Columbus, Ohio, United States

Kaiser Permanente-San Francisco

🇺🇸

San Francisco, California, United States

UCSF Medical Center-Mount Zion

🇺🇸

San Francisco, California, United States

California Pacific Medical Center-Pacific Campus

🇺🇸

San Francisco, California, United States

Utah Cancer Specialists-Salt Lake City

🇺🇸

Salt Lake City, Utah, United States

LDS Hospital

🇺🇸

Salt Lake City, Utah, United States

Lawrence Memorial Hospital

🇺🇸

Lawrence, Kansas, United States

Mid Dakota Clinic

🇺🇸

Bismarck, North Dakota, United States

Trinity Cancer Care Center

🇺🇸

Minot, North Dakota, United States

Saint Alexius Medical Center

🇺🇸

Bismarck, North Dakota, United States

Cancer Center of Kansas-Wichita Medical Arts Tower

🇺🇸

Wichita, Kansas, United States

Via Christi Regional Medical Center

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas - Winfield

🇺🇸

Winfield, Kansas, United States

Cancer Center of Kansas - Main Office

🇺🇸

Wichita, Kansas, United States

Sanford Medical Center-Fargo

🇺🇸

Fargo, North Dakota, United States

Welch Cancer Center

🇺🇸

Sheridan, Wyoming, United States

Sanford Bismarck Medical Center

🇺🇸

Bismarck, North Dakota, United States

Baystate Medical Center

🇺🇸

Springfield, Massachusetts, United States

Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Abington Memorial Hospital

🇺🇸

Abington, Pennsylvania, United States

Newark Beth Israel Medical Center

🇺🇸

Newark, New Jersey, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Saint Elizabeth Regional Medical Center

🇺🇸

Lincoln, Nebraska, United States

Kootenai Cancer Center

🇺🇸

Post Falls, Idaho, United States

Maine Medical Center- Scarborough Campus

🇺🇸

Scarborough, Maine, United States

Princeton Radiation Oncology Center

🇺🇸

Monroe, New Jersey, United States

21st Century Oncology-Scottsdale

🇺🇸

Scottsdale, Arizona, United States

Mayo Clinic in Arizona

🇺🇸

Scottsdale, Arizona, United States

Helen F Graham Cancer Center

🇺🇸

Newark, Delaware, United States

Idaho Urologic Institute-Meridian

🇺🇸

Meridian, Idaho, United States

Dartmouth Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

UMDNJ - New Jersey Medical School

🇺🇸

Newark, New Jersey, United States

Mercy Cancer Center-Hot Springs

🇺🇸

Hot Springs, Arkansas, United States

Concord Hospital

🇺🇸

Concord, New Hampshire, United States

Saint Joseph's Hospital and Medical Center

🇺🇸

Phoenix, Arizona, United States

Arizona Oncology Services Foundation

🇺🇸

Scottsdale, Arizona, United States

Arizona Oncology Associates-West Orange Grove

🇺🇸

Tucson, Arizona, United States

Fairbanks Memorial Hospital

🇺🇸

Fairbanks, Alaska, United States

Arizona Center for Cancer Care-Peoria

🇺🇸

Peoria, Arizona, United States

Montana Cancer Consortium CCOP

🇺🇸

Billings, Montana, United States

Christiana Care Health System-Christiana Hospital

🇺🇸

Newark, Delaware, United States

Midstate Medical Center

🇺🇸

Meriden, Connecticut, United States

The Hospital of Central Connecticut

🇺🇸

New Britain, Connecticut, United States

Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

Saint Francis Hospital and Medical Center

🇺🇸

Hartford, Connecticut, United States

Berdeaux, Donald MD (UIA Investigator)

🇺🇸

Great Falls, Montana, United States

University of Alabama at Birmingham Cancer Center

🇺🇸

Birmingham, Alabama, United States

The Urology Center of Colorado

🇺🇸

Denver, Colorado, United States

Northern Rockies Radiation Oncology Center

🇺🇸

Billings, Montana, United States

Great Falls Clinic

🇺🇸

Great Falls, Montana, United States

Cooper Hospital University Medical Center

🇺🇸

Camden, New Jersey, United States

Ocean Medical Center

🇺🇸

Brick, New Jersey, United States

Prostate Cancer Center of New Jersey

🇺🇸

West Orange, New Jersey, United States

Virtua West Jersey Hospital Voorhees

🇺🇸

Voorhees, New Jersey, United States

Greenville Health System Cancer Institute-Faris

🇺🇸

Greenville, South Carolina, United States

Cheshire Medical Center-Dartmouth-Hitchcock Keene

🇺🇸

Keene, New Hampshire, United States

Jersey Shore Medical Center

🇺🇸

Neptune, New Jersey, United States

Southwestern Vermont Medical Center

🇺🇸

Bennington, Vermont, United States

McGill University Department of Oncology

🇨🇦

Montreal, Quebec, Canada

Norris Cotton Cancer Center-North

🇺🇸

Saint Johnsbury, Vermont, United States

Elliot Hospital

🇺🇸

Manchester, New Hampshire, United States

University of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County

🇺🇸

Mount Holly, New Jersey, United States

Community Medical Center

🇺🇸

Toms River, New Jersey, United States

The Medical Center At Princeton

🇺🇸

Princeton, New Jersey, United States

UMDNJ - Robert Wood Johnson University Hospital

🇺🇸

New Brunswick, New Jersey, United States

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

Greenville Health System Cancer Institute-Greer

🇺🇸

Greer, South Carolina, United States

MD Anderson Cancer Center at Cooper-Voorhees

🇺🇸

Voorhees, New Jersey, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Saint John Hospital and Medical Center

🇺🇸

Detroit, Michigan, United States

Gibbs Cancer Center-Pelham

🇺🇸

Greer, South Carolina, United States

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

Greenville Health System Cancer Institute-Seneca

🇺🇸

Seneca, South Carolina, United States

Blount Memorial Hospital

🇺🇸

Maryville, Tennessee, United States

QEII Health Sciences Centre/Capital District Health Authority

🇨🇦

Halifax, Nova Scotia, Canada

Rapid City Regional Hospital

🇺🇸

Rapid City, South Dakota, United States

Wellmont Holston Valley Hospital and Medical Center

🇺🇸

Kingsport, Tennessee, United States

CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)

🇨🇦

Quebec City, Quebec, Canada

Thompson Cancer Survival Center

🇺🇸

Knoxville, Tennessee, United States

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

Western Oncology Research Consortium

🇺🇸

Portland, Oregon, United States

Providence Saint Vincent Medical Center

🇺🇸

Portland, Oregon, United States

Rutland Regional Medical Center

🇺🇸

Rutland, Vermont, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Missouri Valley Cancer Consortium

🇺🇸

Omaha, Nebraska, United States

Nebraska Methodist Hospital

🇺🇸

Omaha, Nebraska, United States

Alegent Health Immanuel Medical Center

🇺🇸

Omaha, Nebraska, United States

Alegent Health Bergan Mercy Medical Center

🇺🇸

Omaha, Nebraska, United States

Alegent Health Lakeside Hospital

🇺🇸

Omaha, Nebraska, United States

Creighton University Medical Center

🇺🇸

Omaha, Nebraska, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Columbia Saint Mary's Water Tower Medical Commons

🇺🇸

Milwaukee, Wisconsin, United States

Froedtert and the Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Zablocki Veterans Administration Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Mercy Hospital Springfield

🇺🇸

Springfield, Missouri, United States

North Shore University Hospital

🇺🇸

Manhasset, New York, United States

West Texas Cancer Center

🇺🇸

Odessa, Texas, United States

University of Colorado Cancer Center - Anschutz Cancer Pavilion

🇺🇸

Aurora, Colorado, United States

James A. Haley Veterans Affairs Hospital

🇺🇸

Tampa, Florida, United States

Rocky Mountain Cancer Centers-Aurora

🇺🇸

Aurora, Colorado, United States

Walter Reed National Military Medical Center

🇺🇸

Bethesda, Maryland, United States

Sutter General Hospital

🇺🇸

Sacramento, California, United States

University of California Davis Comprehensive Cancer Center

🇺🇸

Sacramento, California, United States

Mercy General Hospital Radiation Oncology Center

🇺🇸

Sacramento, California, United States

Kaiser Permanente-South Sacramento

🇺🇸

Sacramento, California, United States

South Sacramento Cancer Center

🇺🇸

Sacramento, California, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Southeast Cancer Consortium-Upstate NCORP

🇺🇸

Winston-Salem, North Carolina, United States

Yale-New Haven Hospital Saint Raphael Campus

🇺🇸

New Haven, Connecticut, United States

Florida Hospital Orlando

🇺🇸

Orlando, Florida, United States

The James Graham Brown Cancer Center at University of Louisville

🇺🇸

Louisville, Kentucky, United States

Alta Bates Summit Medical Center-Herrick Campus

🇺🇸

Berkeley, California, United States

Sutter Cancer Centers Radiation Oncology Services-Auburn

🇺🇸

Auburn, California, United States

Sutter Cancer Centers Radiation Oncology Services-Cameron Park

🇺🇸

Cameron Park, California, United States

Mercy San Juan Medical Center

🇺🇸

Carmichael, California, United States

Enloe Medical Center

🇺🇸

Chico, California, United States

21st Century Oncology - El Segundo

🇺🇸

El Segundo, California, United States

Fresno Cancer Center

🇺🇸

Fresno, California, United States

Marin General Hospital

🇺🇸

Greenbrae, California, United States

USC / Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

Los Angeles County-USC Medical Center

🇺🇸

Los Angeles, California, United States

Memorial Medical Center

🇺🇸

Springfield, Illinois, United States

Desert Regional Medical Center

🇺🇸

Palm Springs, California, United States

Kaiser Permanente-Oakland

🇺🇸

Oakland, California, United States

Kaiser Permanente Oakland-Broadway

🇺🇸

Oakland, California, United States

Stanford Cancer Institute

🇺🇸

Palo Alto, California, United States

Feather River Cancer Center

🇺🇸

Paradise, California, United States

Pomona Valley Hospital Medical Center

🇺🇸

Pomona, California, United States

Kaiser Permanente-Rancho Cordova Cancer Center

🇺🇸

Rancho Cordova, California, United States

Kaiser Permanente-Richmond

🇺🇸

Richmond, California, United States

Kaiser Permanente-Roseville

🇺🇸

Roseville, California, United States

Rohnert Park Cancer Center

🇺🇸

Rohnert Park, California, United States

Sutter Cancer Centers Radiation Oncology Services-Roseville

🇺🇸

Roseville, California, United States

The Permanente Medical Group-Roseville Radiation Oncology

🇺🇸

Roseville, California, United States

Kaiser Permanente - Sacramento

🇺🇸

Sacramento, California, United States

Kaiser Permanente San Leandro

🇺🇸

San Leandro, California, United States

Kaiser Permanente-San Rafael

🇺🇸

San Rafael, California, United States

Kaiser Permanente Medical Center - Santa Clara

🇺🇸

Santa Clara, California, United States

Kaiser Permanente-South San Francisco

🇺🇸

South San Francisco, California, United States

Kaiser Permanente Cancer Treatment Center

🇺🇸

South San Francisco, California, United States

Kaiser Permanente-Stockton

🇺🇸

Stockton, California, United States

David Grant United States Air Force Medical Center

🇺🇸

Travis Air Force Base, California, United States

Tahoe Forest Cancer Center

🇺🇸

Truckee, California, United States

Sutter Solano Medical Center/Cancer Center

🇺🇸

Vallejo, California, United States

Kaiser Permanente-Walnut Creek

🇺🇸

Walnut Creek, California, United States

Poudre Valley Hospital

🇺🇸

Fort Collins, Colorado, United States

The Shaw Regional Cancer Center

🇺🇸

Edwards, Colorado, United States

Saint Mary's Hospital and Regional Medical Center

🇺🇸

Grand Junction, Colorado, United States

Florida Hospital Kissimmee

🇺🇸

Kissimmee, Florida, United States

Lakeland Regional Cancer Center

🇺🇸

Lakeland, Florida, United States

The Watson Clinic

🇺🇸

Lakeland, Florida, United States

Jackson Memorial Hospital-Holtz Children's Hospital

🇺🇸

Miami, Florida, United States

South Miami Hospital

🇺🇸

Miami, Florida, United States

Bay Medical Center

🇺🇸

Panama City, Florida, United States

Piedmont Hospital

🇺🇸

Atlanta, Georgia, United States

Emory University/Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Grady Health System

🇺🇸

Atlanta, Georgia, United States

Northside Hospital-Forsyth

🇺🇸

Cumming, Georgia, United States

Memorial University Medical Center

🇺🇸

Savannah, Georgia, United States

Northeast Georgia Medical Center

🇺🇸

Gainesville, Georgia, United States

John B Amos Cancer Center

🇺🇸

Columbus, Georgia, United States

Piedmont Fayette Hospital

🇺🇸

Fayetteville, Georgia, United States

Saint Anthony's Health

🇺🇸

Alton, Illinois, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Memorial Hospital of Carbondale

🇺🇸

Carbondale, Illinois, United States

University of Chicago Comprehensive Cancer Center

🇺🇸

Chicago, Illinois, United States

Crossroads Cancer Center

🇺🇸

Effingham, Illinois, United States

Hines Veterans Administration Hospital

🇺🇸

Hines, Illinois, United States

Pekin Cancer Treatment Center

🇺🇸

Pekin, Illinois, United States

OSF Saint Francis Medical Center Radiation Oncology Service at the Central Illinois Comprehensive CC

🇺🇸

Peoria, Illinois, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

SwedishAmerican Regional Cancer Center/ACT

🇺🇸

Rockford, Illinois, United States

OSF Saint Francis Medical Center

🇺🇸

Peoria, Illinois, United States

Memorial and Saint Elizabeth's Health Care Services LLP

🇺🇸

Swansea, Illinois, United States

Saint John's Hospital

🇺🇸

Springfield, Illinois, United States

Saint Vincent Anderson Regional Hospital/Cancer Center

🇺🇸

Anderson, Indiana, United States

IU Health West Hospital

🇺🇸

Avon, Indiana, United States

IU Health Bloomington

🇺🇸

Bloomington, Indiana, United States

IU Health Goshen Center for Cancer Care

🇺🇸

Goshen, Indiana, United States

Radiation Oncology Associates PC

🇺🇸

Fort Wayne, Indiana, United States

Parkview Hospital Randallia

🇺🇸

Fort Wayne, Indiana, United States

Indiana University/Melvin and Bren Simon Cancer Center

🇺🇸

Indianapolis, Indiana, United States

Richard L. Roudebush Veterans Affairs Medical Center

🇺🇸

Indianapolis, Indiana, United States

McFarland Clinic PC-William R Bliss Cancer Center

🇺🇸

Ames, Iowa, United States

Medical Oncology and Hematology Associates-West Des Moines

🇺🇸

Clive, Iowa, United States

Finley Hospital

🇺🇸

Dubuque, Iowa, United States

Associates In Womens Health

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas - El Dorado

🇺🇸

El Dorado, Kansas, United States

Cancer Center of Kansas - Dodge City

🇺🇸

Dodge City, Kansas, United States

Cancer Center of Kansas - Wellington

🇺🇸

Wellington, Kansas, United States

Kansas City Cancer Centers-Southwest

🇺🇸

Overland Park, Kansas, United States

Wichita CCOP

🇺🇸

Wichita, Kansas, United States

Owensboro Health Mitchell Memorial Cancer Center

🇺🇸

Owensboro, Kentucky, United States

Central Maine Medical Center

🇺🇸

Lewiston, Maine, United States

Anne Arundel Medical Center

🇺🇸

Annapolis, Maryland, United States

University of Maryland/Greenebaum Cancer Center

🇺🇸

Baltimore, Maryland, United States

Central Maryland Radiation Oncology in Howard County

🇺🇸

Columbia, Maryland, United States

Saint Agnes Hospital

🇺🇸

Baltimore, Maryland, United States

Greater Baltimore Medical Center

🇺🇸

Baltimore, Maryland, United States

Upper Chesapeake Medical Center

🇺🇸

Bel Air, Maryland, United States

Tate Cancer Center

🇺🇸

Glen Burnie, Maryland, United States

Holy Cross Hospital

🇺🇸

Silver Spring, Maryland, United States

Massachusetts General Hospital Cancer Center

🇺🇸

Boston, Massachusetts, United States

Mass General/North Shore Cancer Center

🇺🇸

Danvers, Massachusetts, United States

Cape Cod Hospital

🇺🇸

Hyannis, Massachusetts, United States

Saint Anne's Hospital

🇺🇸

Fall River, Massachusetts, United States

Lowell General Hospital

🇺🇸

Lowell, Massachusetts, United States

Berkshire Hematology Oncology PC

🇺🇸

Pittsfield, Massachusetts, United States

Beth Israel Deaconess Hospital-Plymouth

🇺🇸

Plymouth, Massachusetts, United States

D'Amour Center for Cancer Care

🇺🇸

Springfield, Massachusetts, United States

Saint Vincent Hospital/Reliant Medical Group

🇺🇸

Worcester, Massachusetts, United States

Bixby Medical Center

🇺🇸

Adrian, Michigan, United States

Veteran's Administration Medical Center - Ann Arbor

🇺🇸

Ann Arbor, Michigan, United States

Bronson Battle Creek

🇺🇸

Battle Creek, Michigan, United States

Saint Joseph Mercy Hospital

🇺🇸

Ann Arbor, Michigan, United States

McLaren-Bay Region

🇺🇸

Bay City, Michigan, United States

Henry Ford Macomb Hospital

🇺🇸

Clinton Township, Michigan, United States

Huron Valley-Sinai Hospital

🇺🇸

Commerce, Michigan, United States

Green Bay Oncology - Escanaba

🇺🇸

Escanaba, Michigan, United States

McLaren-Flint

🇺🇸

Flint, Michigan, United States

21st Century Oncology-Farmington Hills

🇺🇸

Farmington Hills, Michigan, United States

Botsford General Hospital

🇺🇸

Farmington, Michigan, United States

Genesys Regional Medical Center-West Flint Campus

🇺🇸

Flint, Michigan, United States

Genesys Hurley Cancer Institute

🇺🇸

Flint, Michigan, United States

Mercy Health Saint Mary's

🇺🇸

Grand Rapids, Michigan, United States

Green Bay Oncology - Iron Mountain

🇺🇸

Iron Mountain, Michigan, United States

Spectrum Health at Butterworth Campus

🇺🇸

Grand Rapids, Michigan, United States

Borgess Medical Center

🇺🇸

Kalamazoo, Michigan, United States

McLaren-Macomb

🇺🇸

Mount Clemens, Michigan, United States

Bronson Methodist Hospital

🇺🇸

Kalamazoo, Michigan, United States

West Michigan Cancer Center

🇺🇸

Kalamazoo, Michigan, United States

Great Lakes Cancer Institute-Lapeer Campus

🇺🇸

Lapeer, Michigan, United States

McLaren-Central Michigan

🇺🇸

Mount Pleasant, Michigan, United States

Sparrow Hospital

🇺🇸

Lansing, Michigan, United States

Mercy Health Mercy Campus

🇺🇸

Muskegon, Michigan, United States

Northern Michigan Regional Hospital

🇺🇸

Petoskey, Michigan, United States

McLaren Cancer Institute-Owosso

🇺🇸

Owosso, Michigan, United States

Saint Joseph Mercy Oakland

🇺🇸

Pontiac, Michigan, United States

Crittenton Hospital

🇺🇸

Rochester, Michigan, United States

Saint Joseph Mercy Port Huron

🇺🇸

Port Huron, Michigan, United States

William Beaumont Hospital-Royal Oak

🇺🇸

Royal Oak, Michigan, United States

Saint Mary's of Michigan

🇺🇸

Saginaw, Michigan, United States

21st Century Oncology-Troy

🇺🇸

Troy, Michigan, United States

Downriver Center for Oncology

🇺🇸

Trenton, Michigan, United States

William Beaumont Hospital - Troy

🇺🇸

Troy, Michigan, United States

Saint John Macomb-Oakland Hospital

🇺🇸

Warren, Michigan, United States

Miller-Dwan Hospital

🇺🇸

Duluth, Minnesota, United States

Mayo Clinic Health System in Albert Lea

🇺🇸

Albert Lea, Minnesota, United States

Henry Ford West Bloomfield Hospital

🇺🇸

West Bloomfield, Michigan, United States

Sanford Clinic North-Bemidgi

🇺🇸

Bemidji, Minnesota, United States

Saint Luke's Hospital of Duluth

🇺🇸

Duluth, Minnesota, United States

Regions Hospital

🇺🇸

Saint Paul, Minnesota, United States

Fairview-Southdale Hospital

🇺🇸

Edina, Minnesota, United States

Mayo Clinic Health Systems-Mankato

🇺🇸

Mankato, Minnesota, United States

Saint Francis Medical Center

🇺🇸

Cape Girardeau, Missouri, United States

Mercy Hospital-Joplin

🇺🇸

Joplin, Missouri, United States

Phelps County Regional Medical Center

🇺🇸

Rolla, Missouri, United States

Kansas City Cancer Center-Lee's Summit

🇺🇸

Lee's Summit, Missouri, United States

Siteman Cancer Center-South County

🇺🇸

Saint Louis, Missouri, United States

Missouri Baptist Medical Center

🇺🇸

Saint Louis, Missouri, United States

Mercy Hospital Saint Louis

🇺🇸

Saint Louis, Missouri, United States

Barnes-Jewish West County Hospital

🇺🇸

Saint Louis, Missouri, United States

Saint Louis-Cape Girardeau CCOP

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center - Saint Peters

🇺🇸

Saint Peters, Missouri, United States

CoxHealth South Hospital

🇺🇸

Springfield, Missouri, United States

Billings Clinic Cancer Center

🇺🇸

Billings, Montana, United States

Exeter Hospital

🇺🇸

Exeter, New Hampshire, United States

Veterans Adminstration New Jersey Health Care System

🇺🇸

East Orange, New Jersey, United States

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

Sparta Cancer Treatment Center

🇺🇸

Sparta, New Jersey, United States

Riverview Medical Center/Booker Cancer Center

🇺🇸

Red Bank, New Jersey, United States

Memorial Medical Center - Las Cruces

🇺🇸

Las Cruces, New Mexico, United States

Saint Peters Hospital-Albany

🇺🇸

Albany, New York, United States

New York Oncology Hematology PC - Albany

🇺🇸

Albany, New York, United States

Southside Hospital

🇺🇸

Bay Shore, New York, United States

State University of New York Downstate Medical Center

🇺🇸

Brooklyn, New York, United States

Lourdes Hospital

🇺🇸

Binghamton, New York, United States

Veteran Affairs New York Harbor Healthcare System-Brooklyn Campus

🇺🇸

Brooklyn, New York, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Arnot Ogden Medical Center/Falck Cancer Center

🇺🇸

Elmira, New York, United States

North Shore-LIJ Health System NCORP

🇺🇸

Manhasset, New York, United States

Long Island Jewish Medical Center

🇺🇸

New Hyde Park, New York, United States

North Shore-LIJ Health System/Center for Advanced Medicine

🇺🇸

New Hyde Park, New York, United States

Hudson Valley Oncology Associates

🇺🇸

Poughkeepsie, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Cone Health Cancer Center

🇺🇸

Greensboro, North Carolina, United States

Randolph Hospital

🇺🇸

Asheboro, North Carolina, United States

Mary Imogene Bassett Hospital

🇺🇸

Cooperstown, New York, United States

Sands Cancer Center

🇺🇸

Canandaigua, New York, United States

South Atlantic Radiation Oncology

🇺🇸

Supply, North Carolina, United States

Rex Cancer Center

🇺🇸

Raleigh, North Carolina, United States

The Coleman Radiation Center-Carteret General Hospital

🇺🇸

Morehead City, North Carolina, United States

CarolinaEast Health System-Medical Center

🇺🇸

New Bern, North Carolina, United States

Duke Cancer Institute Macon Pond

🇺🇸

Raleigh, North Carolina, United States

New Hanover Regional Medical Center/Zimmer Cancer Center

🇺🇸

Wilmington, North Carolina, United States

Coastal Carolina Radiation Oncology

🇺🇸

Wilmington, North Carolina, United States

Summa Akron City Hospital/Cooper Cancer Center

🇺🇸

Akron, Ohio, United States

Sanford Clinic North-Fargo

🇺🇸

Fargo, North Dakota, United States

Akron General Medical Center

🇺🇸

Akron, Ohio, United States

Summa Barberton Hospital

🇺🇸

Barberton, Ohio, United States

Geaugra Hospital

🇺🇸

Chardon, Ohio, United States

UHHS-Chagrin Highlands Medical Center

🇺🇸

Beachwood, Ohio, United States

Adena Regional Medical Center

🇺🇸

Chillicothe, Ohio, United States

Grady Memorial Hospital

🇺🇸

Delaware, Ohio, United States

Toledo Clinic Cancer Centers-Maumee

🇺🇸

Maumee, Ohio, United States

Mercy Cancer Center-Elyria

🇺🇸

Elyria, Ohio, United States

Marietta Memorial Hospital

🇺🇸

Marietta, Ohio, United States

Cleveland Clinic Cancer Center Independence

🇺🇸

Independence, Ohio, United States

Hillcrest Hospital Cancer Center

🇺🇸

Mayfield Heights, Ohio, United States

Lake University Ireland Cancer Center

🇺🇸

Mentor, Ohio, United States

Southwest General Health Center Ireland Cancer Center

🇺🇸

Middleburg Heights, Ohio, United States

Southern Ohio Medical Center

🇺🇸

Portsmouth, Ohio, United States

University Hospitals Parma Medical Center

🇺🇸

Parma, Ohio, United States

Summa Health Center at Lake Medina

🇺🇸

Medina, Ohio, United States

Saint Charles Hospital

🇺🇸

Oregon, Ohio, United States

Licking Memorial Hospital

🇺🇸

Newark, Ohio, United States

Cancer Care Center, Incorporated

🇺🇸

Salem, Ohio, United States

Robinson Radiation Oncology

🇺🇸

Ravenna, Ohio, United States

North Coast Cancer Care

🇺🇸

Sandusky, Ohio, United States

Ireland Cancer Center at Firelands Regional Medical Center

🇺🇸

Sandusky, Ohio, United States

Flower Hospital

🇺🇸

Sylvania, Ohio, United States

University of Toledo

🇺🇸

Toledo, Ohio, United States

Mercy Saint Anne Hospital

🇺🇸

Toledo, Ohio, United States

Saint Ann's Hospital

🇺🇸

Westerville, Ohio, United States

Genesis HealthCare System

🇺🇸

Zanesville, Ohio, United States

University Pointe

🇺🇸

West Chester, Ohio, United States

UHHS-Westlake Medical Center

🇺🇸

Westlake, Ohio, United States

Cleveland Clinic Wooster Specialty Center

🇺🇸

Wooster, Ohio, United States

Cancer Treatment Center

🇺🇸

Wooster, Ohio, United States

Willamette Valley Cancer Center

🇺🇸

Eugene, Oregon, United States

Wright-Patterson Medical Center

🇺🇸

Wright-Patterson Air Force Base, Ohio, United States

Clackamas Radiation Oncology Center

🇺🇸

Clackamas, Oregon, United States

Legacy Mount Hood Medical Center

🇺🇸

Gresham, Oregon, United States

Asante Health System

🇺🇸

Medford, Oregon, United States

Providence Medford Medical Center

🇺🇸

Medford, Oregon, United States

Three Rivers Community Hospital

🇺🇸

Grants Pass, Oregon, United States

Providence Milwaukie Hospital

🇺🇸

Milwaukie, Oregon, United States

Legacy Good Samaritan Hospital and Medical Center

🇺🇸

Portland, Oregon, United States

Saint Luke's University Hospital-Bethlehem Campus

🇺🇸

Bethlehem, Pennsylvania, United States

Legacy Meridian Park Hospital

🇺🇸

Tualatin, Oregon, United States

Bryn Mawr Hospital

🇺🇸

Bryn Mawr, Pennsylvania, United States

Mercy Fitzgerald Hospital

🇺🇸

Darby, Pennsylvania, United States

Geisinger Medical Center

🇺🇸

Danville, Pennsylvania, United States

Delaware County Memorial Hospital

🇺🇸

Drexel Hill, Pennsylvania, United States

Northeast Radiation Oncology Center

🇺🇸

Dunmore, Pennsylvania, United States

The Regional Cancer Center

🇺🇸

Erie, Pennsylvania, United States

Fox Chase Cancer Center Buckingham

🇺🇸

Furlong, Pennsylvania, United States

Adams Cancer Center

🇺🇸

Gettysburg, Pennsylvania, United States

Cherry Tree Cancer Center

🇺🇸

Hanover, Pennsylvania, United States

Academic Urology Prostate Center

🇺🇸

King Of Prussia, Pennsylvania, United States

Saint Mary Medical and Regional Cancer Center

🇺🇸

Langhorne, Pennsylvania, United States

Upper Delaware Valley Cancer Center

🇺🇸

Milford, Pennsylvania, United States

Thomas Jefferson University Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

Albert Einstein Medical Center

🇺🇸

Philadelphia, Pennsylvania, United States

Paoli Memorial Hospital

🇺🇸

Paoli, Pennsylvania, United States

Temple University Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

Reading Hospital

🇺🇸

West Reading, Pennsylvania, United States

Lankenau Medical Center

🇺🇸

Wynnewood, Pennsylvania, United States

Mainline Health CCOP

🇺🇸

Wynnewood, Pennsylvania, United States

Greenville Health System Cancer Institute-Eastside

🇺🇸

Greenville, South Carolina, United States

Self Regional Healthcare

🇺🇸

Greenwood, South Carolina, United States

Greenville Health System Cancer Institute-Spartanburg

🇺🇸

Spartanburg, South Carolina, United States

Carolina Regional Cancer Center

🇺🇸

Myrtle Beach, South Carolina, United States

Texas Oncology Bedford

🇺🇸

Bedford, Texas, United States

Texas Oncology-Denton South

🇺🇸

Denton, Texas, United States

Texas Oncology Methodist Charlton Cancer Center

🇺🇸

Dallas, Texas, United States

Brooke Army Medical Center

🇺🇸

Fort Sam Houston, Texas, United States

University of Texas Medical Branch

🇺🇸

Galveston, Texas, United States

The Klabzuba Cancer Center

🇺🇸

Fort Worth, Texas, United States

UTMB Cancer Center at Victory Lakes

🇺🇸

League City, Texas, United States

Texas Oncology - Lewisville

🇺🇸

Lewisville, Texas, United States

Texas Oncology-Longview Cancer Center

🇺🇸

Longview, Texas, United States

Texas Oncology-Seton Williamson

🇺🇸

Round Rock, Texas, United States

Texas Oncology Cancer Center Sugar Land

🇺🇸

Sugar Land, Texas, United States

Texas Cancer Center-Sherman

🇺🇸

Sherman, Texas, United States

Texas Oncology-Wichita Falls Texoma Cancer Center

🇺🇸

Wichita Falls, Texas, United States

Intermountain Medical Center

🇺🇸

Murray, Utah, United States

Dixie Medical Center Regional Cancer Center

🇺🇸

Saint George, Utah, United States

Texas Oncology - Round Rock Cancer Center

🇺🇸

Round Rock, Texas, United States

Sandra L Maxwell Cancer Center

🇺🇸

Cedar City, Utah, United States

Utah Valley Regional Medical Center

🇺🇸

Provo, Utah, United States

Huntsman Cancer Institute/University of Utah

🇺🇸

Salt Lake City, Utah, United States

Inova Alexandria Hospital

🇺🇸

Alexandria, Virginia, United States

Danville Regional Medical Center

🇺🇸

Danville, Virginia, United States

Augusta Health Cancer Center

🇺🇸

Fishersville, Virginia, United States

Sentara Rockingham Memorial Hospital Hahn Cancer Center

🇺🇸

Harrisonburg, Virginia, United States

Sentara Hospitals

🇺🇸

Norfolk, Virginia, United States

Sentara Cancer Institute at Sentara CarePlex Hospital

🇺🇸

Hampton, Virginia, United States

Naval Medical Center - Portsmouth

🇺🇸

Portsmouth, Virginia, United States

Southwest VA Regional Cancer Center

🇺🇸

Norton, Virginia, United States

Oncology and Hematology Associates of Southwest Virginia

🇺🇸

Roanoke, Virginia, United States

PeaceHealth Saint Joseph Medical Center

🇺🇸

Bellingham, Washington, United States

Saint Francis Hospital

🇺🇸

Federal Way, Washington, United States

Sentara Virginia Beach General Hospital

🇺🇸

Virginia Beach, Virginia, United States

Cancer Care Northwest - Spokane South

🇺🇸

Spokane, Washington, United States

PeaceHealth Southwest Medical Center

🇺🇸

Vancouver, Washington, United States

Cancer Care Northwest-North Spokane

🇺🇸

Spokane, Washington, United States

Legacy Salmon Creek Hospital

🇺🇸

Vancouver, Washington, United States

Compass Oncology Vancouver

🇺🇸

Vancouver, Washington, United States

Appleton Medical Center

🇺🇸

Appleton, Wisconsin, United States

Bellin Memorial Hospital

🇺🇸

Green Bay, Wisconsin, United States

Green Bay Oncology Limited at Saint Mary's Hospital

🇺🇸

Green Bay, Wisconsin, United States

UW Cancer Center Johnson Creek

🇺🇸

Johnson Creek, Wisconsin, United States

Mayo Clinic Health System-Franciscan Healthcare

🇺🇸

La Crosse, Wisconsin, United States

Bay Area Medical Center

🇺🇸

Marinette, Wisconsin, United States

Gundersen Lutheran Medical Center

🇺🇸

La Crosse, Wisconsin, United States

Vince Lombardi Cancer Clinic-Marinette

🇺🇸

Marinette, Wisconsin, United States

Community Memorial Hospital

🇺🇸

Menomonee Falls, Wisconsin, United States

Columbia Saint Mary's Hospital - Ozaukee

🇺🇸

Mequon, Wisconsin, United States

Aurora Saint Luke's Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Wheaton Franciscan Cancer Care - All Saints

🇺🇸

Racine, Wisconsin, United States

Green Bay Oncology - Oconto Falls

🇺🇸

Oconto Falls, Wisconsin, United States

Door County Cancer Center

🇺🇸

Sturgeon Bay, Wisconsin, United States

Green Bay Oncology - Sturgeon Bay

🇺🇸

Sturgeon Bay, Wisconsin, United States

The Alyce and Elmore Kraemer Cancer Care Center

🇺🇸

West Bend, Wisconsin, United States

Aurora Medical Center in Summit

🇺🇸

Summit, Wisconsin, United States

Riverview Hospital

🇺🇸

Wisconsin Rapids, Wisconsin, United States

BCCA-Cancer Centre for the Southern Interior

🇨🇦

Kelowna, British Columbia, Canada

Juravinski Cancer Centre at Hamilton Health Sciences

🇨🇦

Hamilton, Ontario, Canada

London Regional Cancer Program

🇨🇦

London, Ontario, Canada

Ottawa Health Research Institute-General Division

🇨🇦

Ottawa, Ontario, Canada

Irving Greenberg Family Cancer Centre

🇨🇦

Ottawa, Ontario, Canada

Odette Cancer Centre- Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

Hopital Maisonneuve-Rosemont

🇨🇦

Montreal, Quebec, Canada

Thunder Bay Regional Health Science Centre

🇨🇦

Thunder Bay, Ontario, Canada

CHUM - Hopital Notre-Dame

🇨🇦

Montreal, Quebec, Canada

Saskatoon Cancer Centre

🇨🇦

Saskatoon, Saskatchewan, Canada

Saint Alphonsus Cancer Care Center-Boise

🇺🇸

Boise, Idaho, United States

Saint Agnes Medical Center

🇺🇸

Fresno, California, United States

Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

🇺🇸

Savannah, Georgia, United States

Broward Health Medical Center

🇺🇸

Fort Lauderdale, Florida, United States

Decatur Memorial Hospital

🇺🇸

Decatur, Illinois, United States

Cancer Research for the Ozarks NCORP

🇺🇸

Springfield, Missouri, United States

Spartanburg Medical Center

🇺🇸

Spartanburg, South Carolina, United States

Veterans Administration Long Beach Medical Center

🇺🇸

Long Beach, California, United States

Aurora BayCare Medical Center

🇺🇸

Green Bay, Wisconsin, United States

Green Bay Oncology at Saint Vincent Hospital

🇺🇸

Green Bay, Wisconsin, United States

Saint Vincent Hospital

🇺🇸

Green Bay, Wisconsin, United States

Saint Mary's Hospital

🇺🇸

Green Bay, Wisconsin, United States

Providence Saint Joseph Medical Center/Disney Family Cancer Center

🇺🇸

Burbank, California, United States

University of Miami Sylvester Comprehensive Cancer Center at Deerfield Beach

🇺🇸

Deerfield Beach, Florida, United States

Aurora West Allis Medical Center

🇺🇸

West Allis, Wisconsin, United States

McKay-Dee Hospital Center

🇺🇸

Ogden, Utah, United States

Rogue Valley Medical Center

🇺🇸

Medford, Oregon, United States

WellSpan Health-York Hospital

🇺🇸

York, Pennsylvania, United States

Vince Lombardi Cancer Clinic - Oshkosh

🇺🇸

Oshkosh, Wisconsin, United States

Centre Hospitalier Universitaire de Sherbrooke-Fleurimont

🇨🇦

Sherbrooke, Quebec, Canada

AnMed Health Hospital

🇺🇸

Anderson, South Carolina, United States

Texas Oncology-Arlington South

🇺🇸

Arlington, Texas, United States

BCCA-Vancouver Island Cancer Centre

🇨🇦

Victoria, British Columbia, Canada

Atlantic Health Sciences Corporation-Saint John Regional Hospital

🇨🇦

Saint John, New Brunswick, Canada

Allan Blair Cancer Centre

🇨🇦

Regina, Saskatchewan, Canada

Mary Bird Perkins Cancer Center

🇺🇸

Baton Rouge, Louisiana, United States

Penn State Milton S Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Wesley Medical Center

🇺🇸

Wichita, Kansas, United States

Atlanta VA Medical Center

🇺🇸

Decatur, Georgia, United States

VA Pittsburgh Healthcare System

🇺🇸

Pittsburgh, Pennsylvania, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Texas Oncology-Austin Midtown

🇺🇸

Austin, Texas, United States

Texas Oncology - Central Austin Cancer Center

🇺🇸

Austin, Texas, United States

Texas Oncology - South Austin Cancer Center

🇺🇸

Austin, Texas, United States

Queen's Medical Center

🇺🇸

Honolulu, Hawaii, United States

University of Hawaii Cancer Center

🇺🇸

Honolulu, Hawaii, United States

The Cancer Center of Hawaii-Liliha

🇺🇸

Honolulu, Hawaii, United States

Tulane University Health Sciences Center

🇺🇸

New Orleans, Louisiana, United States

Ochsner Medical Center Jefferson

🇺🇸

New Orleans, Louisiana, United States

Kansas City Cancer Center - South

🇺🇸

Kansas City, Missouri, United States

Kansas City Cancer Centers - North

🇺🇸

Kansas City, Missouri, United States

University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Iowa Methodist Medical Center

🇺🇸

Des Moines, Iowa, United States

Iowa Oncology Research Association CCOP

🇺🇸

Des Moines, Iowa, United States

Medical Oncology and Hematology Associates-Des Moines

🇺🇸

Des Moines, Iowa, United States

Medical Oncology and Hematology Associates-Laurel

🇺🇸

Des Moines, Iowa, United States

Mercy Medical Center - Des Moines

🇺🇸

Des Moines, Iowa, United States

Iowa Lutheran Hospital

🇺🇸

Des Moines, Iowa, United States

Baptist Health Lexington

🇺🇸

Lexington, Kentucky, United States

University of Kentucky/Markey Cancer Center

🇺🇸

Lexington, Kentucky, United States

Lovelace Medical Center-Downtown

🇺🇸

Albuquerque, New Mexico, United States

University of New Mexico

🇺🇸

Albuquerque, New Mexico, United States

University of New Mexico Cancer Center

🇺🇸

Albuquerque, New Mexico, United States

Radiation Oncology Associates

🇺🇸

Albuquerque, New Mexico, United States

Highland Hospital

🇺🇸

Rochester, New York, United States

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

University Radiation Oncology

🇺🇸

Rochester, New York, United States

University of Rochester

🇺🇸

Rochester, New York, United States

Mayo Clinic in Florida

🇺🇸

Jacksonville, Florida, United States

Kaiser Permanente-Santa Rosa

🇺🇸

Santa Rosa, California, United States

Rocky Mountain Cancer Centers-Littleton

🇺🇸

Littleton, Colorado, United States

Sutter Cancer Centers Radiation Oncology Services-Vacaville

🇺🇸

Vacaville, California, United States

CentraState Medical Center

🇺🇸

Freehold, New Jersey, United States

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