Hormone Therapy and Radiation Therapy in Treating Patients With Prostate Cancer
- Conditions
- Prostate Cancer
- Interventions
- Registration Number
- NCT00005044
- Lead Sponsor
- Radiation Therapy Oncology Group
- Brief Summary
RATIONALE: Hormones can stimulate the growth of prostate cancer cells. Hormone therapy may fight prostate cancer by reducing the production of androgens. Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which regimen of hormone therapy and radiation therapy is more effective for prostate cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of two different regimens of hormone therapy and radiation therapy in treating patients who have prostate cancer.
- Detailed Description
OBJECTIVES:
* Compare the efficacy of moderate-duration (28 weeks) neoadjuvant total androgen suppression (TAS) and radiotherapy (RT) with short-duration (8 weeks) neoadjuvant TAS and RT, as related to disease-specific survival, in patients with intermediate-risk adenocarcinoma of the prostate.
* Compare these regimens, in terms of overall survival, disease-free survival, time to local tumor progression or distant failure, time to first biochemical failure, hormone-refractory state, and treatment-induced morbidity, in this patient population.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prostate-specific antigen level (no greater than 10 ng/mL vs greater than 10 but no greater than 20 ng/mL vs greater than 20 ng/mL), tumor stage (T1b-2 vs T3-4), Gleason score (2-4 vs 5-6 vs 7-10), and prior hormonal therapy (yes vs no). Patients are randomized to one of two treatment arms.
* Arm I: Patients receive total androgen suppression for 8 weeks prior to the initiation of radiotherapy and throughout radiotherapy. A luteinizing hormone-releasing hormone (LHRH) agonist is administered every 1-3 months AND bicalutamide OR flutamide is given orally daily for a total duration of 16 weeks. Beginning with week 9, patients undergo radiotherapy 5 days a week for 8 weeks.
* Arm II: Patients receive total androgen suppression for 28 weeks prior to the initiation of radiotherapy and throughout radiotherapy. An LHRH agonist AND bicalutamide OR flutamide are administered as in arm I for a total duration of 36 weeks. Beginning with week 29, patients undergo radiotherapy as in arm I.
Patients are followed every 3 months for 1 year, every 6 months for 4 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 1,540 patients (770 per treatment arm) will be accrued for this study within 4 years.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 1579
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description TAS x 8 weeks Casodex Total Androgen Suppression (TAS) (LHRH agonist and Casodex or Eulexin) x 8 weeks followed by radiation therapy (RT) with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 28 weeks LHRH agonist TAS (LHRH agonist and Casodex or Eulexin) x 28 weeks followed by RT with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 8 weeks LHRH agonist Total Androgen Suppression (TAS) (LHRH agonist and Casodex or Eulexin) x 8 weeks followed by radiation therapy (RT) with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 8 weeks radiation therapy Total Androgen Suppression (TAS) (LHRH agonist and Casodex or Eulexin) x 8 weeks followed by radiation therapy (RT) with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 28 weeks Casodex TAS (LHRH agonist and Casodex or Eulexin) x 28 weeks followed by RT with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 28 weeks radiation therapy TAS (LHRH agonist and Casodex or Eulexin) x 28 weeks followed by RT with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 8 weeks Eulexin Total Androgen Suppression (TAS) (LHRH agonist and Casodex or Eulexin) x 8 weeks followed by radiation therapy (RT) with concurrent TAS (LHRH agonist and Casodex or Eulexin). TAS x 28 weeks Eulexin TAS (LHRH agonist and Casodex or Eulexin) x 28 weeks followed by RT with concurrent TAS (LHRH agonist and Casodex or Eulexin).
- Primary Outcome Measures
Name Time Method Disease-specific Survival (DSS) (10-year Rates Reported) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Disease-specific survival time is measured from date of randomization to death due to prostate cancer based on study chair review, with prostate-cancer death defined as (1) primary cause of death certified as due to prostate cancer, (2) complication of therapy, irrespective of disease status, (3) disease progression in the absence of any anti-tumor therapy, or (4) a 1.0 ng/ml-exceeding-rise in serum prostate-specific antigen (PSA) level on at least two consecutive occasions that occurs during or after salvage androgen suppression therapy. Death due to other causes is considered a competing risk. All others are censored. DSS is estimated using the cumulative incidence method. Ten-year rate is reported.
- Secondary Outcome Measures
Name Time Method Overall Survival (OS) (10-year Rates Reported) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Survival time is defined as time from randomization to the date of death from any cause and is estimated by the Kaplan-Meier method. Patients last known to be alive are censored at the date of last contact. Ten-year rate is reported.
Time to First Biochemical Failure (BF) (10-year Rates Reported) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Protocol definition: Time to BF measured from date of randomization to first of (1) the midway date between the last non-rising PSA and the first rising PSA of three consecutive rises or (2) the date of the initiation of salvage hormone therapy; competing risks are LRP, DM, and death without BF; all others are censored.
Phoenix definition: Time to BF measured from date of randomization to first of (1) the date of documented rise of 2 ng/ml above the post-treatment(RT end date) nadir or (2) the date of the initiation of salvage hormone therapy; competing risks are LRP, DM, and death without BF; all others are censored. For both definitions BF is estimated using the cumulative incidence method. Ten year rates reported.Time to Second Biochemical Failure (SBF) (10-year Rates Reported) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Time to SBF measured from date of randomization to the date of PSA increase of ≥1.0 ng/mL (from the nadir PSA after completion of protocol-specified therapy) after salvage androgen suppression was started; competing risks LRP, DM, and death without SBF; all others are censored. SBF is estimated using the cumulative incidence method. Ten-year rates are reported.
Clinical Patterns of Tumor Recurrence: Time to Locoregional Progression (LRP) and Time to Distant Metastasis (DM) (10 Year Rates Reported) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Time to distant metastasis measured from date of randomization to date of documented distant metastasis; competing risks are BF, LRP, and death without DM; all others are censored. Time to locoregional progression measured from date of randomization to date of documented local or regional progression; competing risks are BF \[protocol definition- first of (1) the midway date between the last non-rising PSA and the first rising PSA of three consecutive rises or (2) the date of the initiation of salvage hormone therapy\], DM, and death without LRP; all others are censored. LRP and DM are estimated using the cumulative incidence method. Ten -year rates are reported.
Disease-free Survival (DFS) (10-year Rates Reported) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Disease-free survival time is defined as time from randomization to the date of disease progression or death from any cause and is estimated by the Kaplan-Meier method. Patients last known to be alive are censored at the date of last contact. Ten-year rate is reported.
Treatment-induced Morbidity (Highest Grade Toxicity Reported Per Patient) From randomization to 10 years. (Patients are followed until death or study termination, whichever occurs first.) Acute drug therapy and radiation (\<= 90 days from start of RT) toxicity was graded using the Common Toxicity Criteria (CTC) v.2.0 criteria; late toxicity was graded using the Radiation Therapy Oncology Group (RTOG)/European Organisation for Research and Treatment of Cancer (EORTC) Late Radiation Morbidity Scoring schema. Grade refers to the severity of the toxicity. The CTC v2.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each toxicity based on this general guideline: Grade 1 Mild toxicity, Grade 2 Moderate toxicity, Grade 3 Severe toxicity, Grade 4 Life-threatening or disabling toxicity, Grade 5 Death related to toxicity. The highest grade acute and late toxicity was determined for each patient.
Trial Locations
- Locations (261)
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Veterans Affairs Medical Center - Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
Mercy Hospital of Pittsburgh
🇺🇸Pittsburgh, Pennsylvania, United States
Huntsville Hospital
🇺🇸Huntsville, Alabama, United States
Comprehensive Cancer Institute
🇺🇸Huntsville, Alabama, United States
MBCCOP - Gulf Coast
🇺🇸Mobile, Alabama, United States
Montgomery Cancer Center
🇺🇸Montgomery, Alabama, United States
DCH Cancer Treatment Center
🇺🇸Tuscaloosa, Alabama, United States
Providence Saint Joseph Medical Center - Burbank
🇺🇸Burbank, California, United States
Mount Diablo Medical Center
🇺🇸Concord, California, United States
City of Hope Comprehensive Cancer Center
🇺🇸Duarte, California, United States
California Cancer Center
🇺🇸Fresno, California, United States
Sutter Health Western Division Cancer Research Group
🇺🇸Greenbrae, California, United States
Loma Linda University Cancer Institute at Loma Linda University Medical Center
🇺🇸Loma Linda, California, United States
Saint Agnes Cancer Center
🇺🇸Fresno, California, United States
Veterans Affairs Medical Center - Long Beach
🇺🇸Long Beach, California, United States
USC/Norris Comprehensive Cancer Center and Hospital
🇺🇸Los Angeles, California, United States
Jonsson Comprehensive Cancer Center, UCLA
🇺🇸Los Angeles, California, United States
CCOP - Bay Area Tumor Institute
🇺🇸Oakland, California, United States
Robert and Beverly Lewis Family Cancer Care Center
🇺🇸Pomona, California, United States
Huntington Cancer Center at Huntington Hospital
🇺🇸Pasadena, California, United States
O'Connor Hospital
🇺🇸San Jose, California, United States
CCOP - Santa Rosa Memorial Hospital
🇺🇸Santa Rosa, California, United States
Torrance Memorial Medical Center
🇺🇸Torrance, California, United States
David Grant Medical Center
🇺🇸Travis Air Force Base, California, United States
Memorial Hospital Cancer Center
🇺🇸Colorado Springs, Colorado, United States
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
🇺🇸Grand Junction, Colorado, United States
Cancer Research Center at Boston Medical Center
🇺🇸Boston, Massachusetts, United States
CCOP - Christiana Care Health Services
🇺🇸Newark, Delaware, United States
Sibley Memorial Hospital
🇺🇸Washington, District of Columbia, United States
Shands Cancer Center at the University of Florida Health Science Center
🇺🇸Gainesville, Florida, United States
Florida Radiation Oncology Group
🇺🇸Jacksonville, Florida, United States
21st Century Oncology - Fort Myers
🇺🇸Fort Myers, Florida, United States
Holmes Regional Medical Center
🇺🇸Melbourne, Florida, United States
CCOP - Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States
Bay Medical Center
🇺🇸Panama City, Florida, United States
Sarasota Radiation and Medical Oncology Center
🇺🇸Sarasota, Florida, United States
Gulf Coast Cancer Treatment Center
🇺🇸Panama City, Florida, United States
Tallahassee Memorial Hospital
🇺🇸Tallahassee, Florida, United States
Winship Cancer Institute of Emory University
🇺🇸Atlanta, Georgia, United States
CCOP - Atlanta Regional
🇺🇸Atlanta, Georgia, United States
Medical Center/John B. Amos Community Cancer Center
🇺🇸Columbus, Georgia, United States
Regional Radiation Oncology Center at Rome
🇺🇸Rome, Georgia, United States
CCOP - Central Illinois
🇺🇸Decatur, Illinois, United States
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
🇺🇸Chicago, Illinois, United States
Northwest Community Hospital
🇺🇸Arlington Heights, Illinois, United States
Lutheran General Cancer Care Center
🇺🇸Park Ridge, Illinois, United States
Ingalls Memorial Hospital
🇺🇸Harvey, Illinois, United States
CCOP - Scott and White Hospital
🇺🇸Peoria, Illinois, United States
Cardinal Bernardin Cancer Center at Loyola University Medical Center
🇺🇸Maywood, Illinois, United States
St. John's Medical Center
🇺🇸Anderson, Indiana, United States
Ball Memorial Hospital Cancer Center
🇺🇸Muncie, Indiana, United States
Bloomington Hospital
🇺🇸Bloomington, Indiana, United States
CCOP - Northern Indiana CR Consortium
🇺🇸South Bend, Indiana, United States
Wendt Regional Cancer Center of Finley Hospital
🇺🇸Dubuque, Iowa, United States
St. Elizabeth Medical Center
🇺🇸Edgewood, Kentucky, United States
Central Baptist Hospital
🇺🇸Lexington, Kentucky, United States
Markey Cancer Center at University of Kentucky Chandler Medical Center
🇺🇸Lexington, Kentucky, United States
Mary Bird Perkins Cancer Center
🇺🇸Baton Rouge, Louisiana, United States
Merle M. Mahr Cancer Center
🇺🇸Madisonville, Kentucky, United States
Tulane University School of Medicine
🇺🇸New Orleans, Louisiana, United States
MBCCOP - LSU Health Sciences Center
🇺🇸New Orleans, Louisiana, United States
CCOP - Ochsner
🇺🇸New Orleans, Louisiana, United States
Maine Medical Center
🇺🇸Portland, Maine, United States
Anne Arundel Oncology Center
🇺🇸Annapolis, Maryland, United States
Marlene and Stewart Greenebaum Cancer Center, University of Maryland
🇺🇸Baltimore, Maryland, United States
Greater Baltimore Medical Center and Cancer Center
🇺🇸Baltimore, Maryland, United States
Harbor Hospital Center
🇺🇸Baltimore, Maryland, United States
Sinai Hospital of Baltimore
🇺🇸Baltimore, Maryland, United States
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
🇺🇸Baltimore, Maryland, United States
St. Agnes Cancer Center
🇺🇸Baltimore, Maryland, United States
Peninsula Regional Medical Center
🇺🇸Salisbury, Maryland, United States
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Cape Cod Hospital
🇺🇸Hyannis, Massachusetts, United States
NSMC Cancer Center
🇺🇸Peabody, Massachusetts, United States
Hurley Medical Center
🇺🇸Flint, Michigan, United States
McLaren Regional Cancer Center
🇺🇸Flint, Michigan, United States
CCOP - Kalamazoo
🇺🇸Kalamazoo, Michigan, United States
Marquette General Hospital
🇺🇸Marquette, Michigan, United States
MidMichigan Medical Center - Midland
🇺🇸Midland, Michigan, United States
CCOP - Beaumont
🇺🇸Royal Oak, Michigan, United States
William Beaumont Hospital - Royal Oak
🇺🇸Royal Oak, Michigan, United States
William Beaumont Hospital - Troy
🇺🇸Troy, Michigan, United States
CCOP - Metro-Minnesota
🇺🇸Saint Louis Park, Minnesota, United States
Ellis Fischel Cancer Center at University of Missouri - Columbia
🇺🇸Columbia, Missouri, United States
Mallinckrodt Institute of Radiology
🇺🇸Saint Louis, Missouri, United States
St. Louis University Hospital Cancer Center
🇺🇸Saint Louis, Missouri, United States
Cancer Research for the Ozarks
🇺🇸Springfield, Missouri, United States
CCOP - Cancer Research for the Ozarks
🇺🇸Springfield, Missouri, United States
CCOP - Montana Cancer Consortium
🇺🇸Billings, Montana, United States
Norris Cotton Cancer Center at Dartmouth Medical School
🇺🇸Lebanon, New Hampshire, United States
John F. Kennedy Medical Center
🇺🇸Edison, New Jersey, United States
Cooper Cancer Institute
🇺🇸Camden, New Jersey, United States
Elliot Regional Cancer Center
🇺🇸Manchester, New Hampshire, United States
Monmouth Medical Center
🇺🇸Long Branch, New Jersey, United States
Trinitas Hospital - Jersey Street Campus
🇺🇸Elizabeth, New Jersey, United States
Cancer Institute of New Jersey
🇺🇸New Brunswick, New Jersey, United States
Medical Center of Princeton
🇺🇸Princeton, New Jersey, United States
Associated Radiologists, P.A.
🇺🇸Warren, New Jersey, United States
Radiation Oncology Associates of Albuquerque
🇺🇸Albuquerque, New Mexico, United States
Cancer Center of Albany Medical Center
🇺🇸Albany, New York, United States
New York Methodist Hospital
🇺🇸Brooklyn, New York, United States
State University of New York Health Science Center at Brooklyn
🇺🇸Brooklyn, New York, United States
CCOP - North Shore University Hospital
🇺🇸Manhasset, New York, United States
Roswell Park Cancer Institute
🇺🇸Buffalo, New York, United States
Beth Israel Medical Center - Philipps Ambulatory Care Center
🇺🇸New York, New York, United States
Herbert Irving Comprehensive Cancer Center at Columbia University
🇺🇸New York, New York, United States
Champlain Valley Physicians Hospital Medical Center
🇺🇸Plattsburgh, New York, United States
James P. Wilmot Cancer Center at University of Rochester Medical Center
🇺🇸Rochester, New York, United States
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
🇺🇸Syracuse, New York, United States
Riverhill Radiation Oncology
🇺🇸Yonkers, New York, United States
Batte Cancer Center at Northeast Medical Center
🇺🇸Concord, North Carolina, United States
Leo W. Jenkins Cancer Center of University Health Systems of Eastern Carolina
🇺🇸Greenville, North Carolina, United States
Akron General Medical Center
🇺🇸Akron, Ohio, United States
Trinity Cancer Care Center
🇺🇸Minot, North Dakota, United States
Akron City Hospital
🇺🇸Akron, Ohio, United States
Ireland Cancer Center
🇺🇸Cleveland, Ohio, United States
CCOP - Columbus
🇺🇸Columbus, Ohio, United States
Cleveland Clinic Taussig Cancer Center
🇺🇸Cleveland, Ohio, United States
Arthur G. James Cancer Hospital - Ohio State University
🇺🇸Columbus, Ohio, United States
CCOP - Toledo Community Hospital
🇺🇸Toledo, Ohio, United States
CCOP - Dayton
🇺🇸Dayton, Ohio, United States
Parma Community General Hospital
🇺🇸Parma, Ohio, United States
CCOP - Oklahoma
🇺🇸Tulsa, Oklahoma, United States
St. John Health System
🇺🇸Tulsa, Oklahoma, United States
Abington Memorial Hospital
🇺🇸Abington, Pennsylvania, United States
John and Dorothy Morgan Cancer Center at Lehigh Valley Hospital
🇺🇸Allentown, Pennsylvania, United States
St. Luke's Hospital Cancer Center
🇺🇸Bethlehem, Pennsylvania, United States
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
Mercy Fitzgerald Hospital
🇺🇸Darby, Pennsylvania, United States
Delaware County Memorial Hospital
🇺🇸Drexel Hill, Pennsylvania, United States
Pocono Cancer Center
🇺🇸East Stroudsburg, Pennsylvania, United States
Penn State Cancer Institute at Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
Abramson Cancer Center at University of Pennsylvania Medical Center
🇺🇸Philadelphia, Pennsylvania, United States
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
Albert Einstein Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Hillman Cancer Center at University of Pittsburgh Cancer Institute
🇺🇸Pittsburgh, Pennsylvania, United States
Allegheny General Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Western Pennsylvania Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
CCOP - MainLine Health
🇺🇸Wynnewood, Pennsylvania, United States
Reading Hospital and Medical Center
🇺🇸Reading, Pennsylvania, United States
Wilkes-Barre General Hospital
🇺🇸Wilkes-Barre, Pennsylvania, United States
Mercy Hospital Cancer Center - Scranton
🇺🇸Scranton, Pennsylvania, United States
Wellspan Health - York Cancer Center
🇺🇸York, Pennsylvania, United States
Roger Williams Medical Center
🇺🇸Providence, Rhode Island, United States
CCOP - Upstate Carolina
🇺🇸Spartanburg, South Carolina, United States
Rapid City Regional Hospital
🇺🇸Rapid City, South Dakota, United States
West Tennessee Cancer Center at Jackson-Madison County General Hospital
🇺🇸Jackson, Tennessee, United States
Harrington Cancer Center
🇺🇸Amarillo, Texas, United States
Arlington Cancer Center
🇺🇸Arlington, Texas, United States
University of Texas Medical Branch
🇺🇸Galveston, Texas, United States
Wilford Hall Medical Center
🇺🇸Lackland Air Force Base, Texas, United States
Joe Arrington Cancer Research and Treatment Center
🇺🇸Lubbock, Texas, United States
Bayshore Medical Center
🇺🇸Pasadena, Texas, United States
Utah Valley Regional Medical Center - Provo
🇺🇸Provo, Utah, United States
Dixie Regional Medical Center
🇺🇸Saint George, Utah, United States
Cancer Center at the University of Virginia
🇺🇸Charlottesville, Virginia, United States
RMH Regional Cancer Center
🇺🇸Harrisonburg, Virginia, United States
Naval Medical Center, Portsmouth
🇺🇸Portsmouth, Virginia, United States
Bon Secours - St. Mary's Hospital
🇺🇸Richmond, Virginia, United States
Massey Cancer Center at Virginia Commonwealth University
🇺🇸Richmond, Virginia, United States
Deaconess Medical Center
🇺🇸Spokane, Washington, United States
Yakima Valley Memorial Hospital
🇺🇸Yakima, Washington, United States
CCOP - St. Vincent Hospital Cancer Center, Green Bay
🇺🇸Green Bay, Wisconsin, United States
St. Vincent Hospital
🇺🇸Green Bay, Wisconsin, United States
Schiffler Cancer Center
🇺🇸Wheeling, West Virginia, United States
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
🇺🇸La Crosse, Wisconsin, United States
Southern Wisconsin Radiotherapy Center
🇺🇸Madison, Wisconsin, United States
University of Wisconsin Comprehensive Cancer Center
🇺🇸Madison, Wisconsin, United States
Marshfield Clinic
🇺🇸Marshfield, Wisconsin, United States
CCOP - Marshfield Clinic Research Foundation
🇺🇸Marshfield, Wisconsin, United States
Community Memorial Hospital
🇺🇸Menomonee Falls, Wisconsin, United States
All Saints Cancer Center at All Saints Healthcare
🇺🇸Racine, Wisconsin, United States
Waukesha Memorial Hospital Regional Cancer Center
🇺🇸Waukesha, Wisconsin, United States
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
Tom Baker Cancer Center - Calgary
🇨🇦Calgary, Alberta, Canada
Doctor Leon Richard Oncology Centre
🇨🇦Moncton, New Brunswick, Canada
Saint John Regional Hospital
🇨🇦Saint John, New Brunswick, Canada
Margaret and Charles Juravinski Cancer Centre
🇨🇦Hamilton, Ontario, Canada
Newfoundland Cancer Treatment and Research Foundation
🇨🇦St. Johns, Newfoundland and Labrador, Canada
Nova Scotia Cancer Centre
🇨🇦Halifax, Nova Scotia, Canada
Kingston Regional Cancer Centre
🇨🇦Kingston, Ontario, Canada
Cancer Care Ontario-London Regional Cancer Centre
🇨🇦London, Ontario, Canada
Northeastern Ontario Regional Cancer Centre - Sudbury
🇨🇦Sudbury, Ontario, Canada
Northwestern Ontario Regional Cancer Care
🇨🇦Thunder Bay, Ontario, Canada
Toronto Sunnybrook Regional Cancer Centre
🇨🇦Toronto, Ontario, Canada
Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
Saskatoon Cancer Centre
🇨🇦Saskatoon, Saskatchewan, Canada
Allan Blair Cancer Centre
🇨🇦Regina, Saskatchewan, Canada
University of Texas - MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
Cancer Institute at Virginia Mason Medical Center
🇺🇸Seattle, Washington, United States
University Cancer Center at University of Washington Medical Center
🇺🇸Seattle, Washington, United States
CCOP - Southern Nevada Cancer Research Foundation
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
University of Miami Sylvester Cancer Center
🇺🇸Miami, Florida, United States
Baptist Hospital of Miami
🇺🇸Miami, Florida, United States
Methodist Cancer Center at Methodist Hospital
🇺🇸Indianapolis, Indiana, United States
Veterans Affairs Medical Center - Indianapolis (Roudebush)
🇺🇸Indianapolis, Indiana, United States
Community Regional Cancer Care
🇺🇸Indianapolis, Indiana, United States
Radiation Medical Group, Incorporated
🇺🇸San Diego, California, United States
Naval Medical Center - San Diego
🇺🇸San Diego, California, United States
Cancer Center at Christ Hospital
🇺🇸Cincinnati, Ohio, United States
Charles M. Barrett Cancer Center at University Hospital
🇺🇸Cincinnati, Ohio, United States
Fairview University Medical Center - University Campus
🇺🇸Minneapolis, Minnesota, United States
University of Texas Health Science Center at San Antonio
🇺🇸San Antonio, Texas, United States
UCSF Comprehensive Cancer Center
🇺🇸San Francisco, California, United States
Vanderbilt-Ingram Cancer Center at Vanderbilt Medical Center
🇺🇸Nashville, Tennessee, United States
LDS Hospital
🇺🇸Salt Lake City, Utah, United States
University of Utah Health Sciences Center
🇺🇸Salt Lake City, Utah, United States
Foundation for Cancer Research and Education
🇺🇸Phoenix, Arizona, United States
MBCCOP - Hawaii
🇺🇸Honolulu, Hawaii, United States
Newark Beth Israel Medical Center
🇺🇸Newark, New Jersey, United States
University of Alabama at Birmingham Comprehensive Cancer Center
🇺🇸Birmingham, Alabama, United States
University of Colorado Cancer Center at University of Colorado Health Sciences Center
🇺🇸Denver, Colorado, United States
CCOP - Colorado Cancer Research Program, Incorporated
🇺🇸Denver, Colorado, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Josephine Ford Cancer Center at Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Frank C. Love Cancer Institute at St. Anthony Hospital
🇺🇸Oklahoma City, Oklahoma, United States
Oklahoma University Medical Center at University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
CCOP - Columbia River Oncology Program
🇺🇸Portland, Oregon, United States
Mayo Clinic Cancer Center
🇺🇸Rochester, Minnesota, United States
Centre Hospitalier de l'Universite de Montreal
🇨🇦Montreal, Quebec, Canada
Green Mountain Oncology Group
🇺🇸Bennington, Vermont, United States
Valley Hospital
🇺🇸Ridgewood, New Jersey, United States
Vermont Cancer Center at University of Vermont
🇺🇸Burlington, Vermont, United States
University Hospitals of Cleveland
🇺🇸Cleveland, Ohio, United States
CCOP - Greenville
🇺🇸Greenville, South Carolina, United States
Atlantic City Medical Center
🇺🇸Pomona, New Jersey, United States
Veterans Affairs Medical Center - East Orange
🇺🇸East Orange, New Jersey, United States
Somerset Medical Center
🇺🇸Somerville, New Jersey, United States
Community Medical Center
🇺🇸Toms River, New Jersey, United States
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital
🇺🇸Mount Holly, New Jersey, United States
Fox Chase Cancer Center at St. Francis Medical Center
🇺🇸Trenton, New Jersey, United States
South Jersey Regional Cancer Center
🇺🇸Millville, New Jersey, United States
CHUS-Hopital Fleurimont
🇨🇦Fleurimont, Quebec, Canada
Centre Hospitalier Universitaire de Quebec
🇨🇦Quebec City, Quebec, Canada
McGill University
🇨🇦Montreal, Quebec, Canada
H. Lee Moffitt Cancer Center and Research Institute
🇺🇸Tampa, Florida, United States
CCOP - Missouri Valley Cancer Consortium
🇺🇸Omaha, Nebraska, United States
Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha
🇺🇸Omaha, Nebraska, United States
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Columbia Hospital
🇺🇸Milwaukee, Wisconsin, United States
St. Luke's Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Medical College of Wisconsin Cancer Center
🇺🇸Milwaukee, Wisconsin, United States
Veterans Affairs Medical Center - Milwaukee (Zablocki)
🇺🇸Milwaukee, Wisconsin, United States
Veterans Affairs Medical Center - Boston (Jamaica Plain)
🇺🇸Jamaica Plain, Massachusetts, United States
Radiation Oncology Center - Sacramento
🇺🇸Sacramento, California, United States
CCOP - Michigan Cancer Research Consortium
🇺🇸Ann Arbor, Michigan, United States
University of Michigan Comprehensive Cancer Center
🇺🇸Ann Arbor, Michigan, United States
CCOP - Southeast Cancer Control Consortium
🇺🇸Winston-Salem, North Carolina, United States
Comprehensive Cancer Center at Wake Forest University
🇺🇸Winston-Salem, North Carolina, United States
Hospital of St. Raphael
🇺🇸New Haven, Connecticut, United States
MD Anderson Cancer Center Orlando
🇺🇸Orlando, Florida, United States
Yale Comprehensive Cancer Center
🇺🇸New Haven, Connecticut, United States
James Graham Brown Cancer Center at University of Louisville
🇺🇸Louisville, Kentucky, United States
CCOP - Kansas City
🇺🇸Kansas City, Missouri, United States
Louisville Radiation Oncology Center at Caritas Regional Cancer Center
🇺🇸Louisville, Kentucky, United States
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
Methodist Medical Center of Illinois
🇺🇸Peoria, Illinois, United States
Finger Lakes Radiation Oncology Center
🇺🇸Clifton Springs, New York, United States
Ottawa Regional Cancer Centre
🇨🇦Ottawa, Ontario, Canada