Combination Chemotherapy, Radiation Therapy, and Surgery in Treating Patients With Primary or Recurrent Sarcoma
Overview[ - collapse ][ - ]
| Purpose | RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining chemotherapy, radiation therapy, and surgery may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy, radiation therapy, and surgery in treating patients who have primary or recurrent sarcoma. |
|---|---|
| Condition | Stage III Adult Soft Tissue Sarcoma Recurrent Adult Soft Tissue Sarcoma Stage IVA Adult Soft Tissue Sarcoma Stage IIB Adult Soft Tissue Sarcoma Stage IIC Adult Soft Tissue Sarcoma |
| Intervention | Drug: doxorubicin Drug: filgrastim Drug: ifosfamide Procedure: biological response modifier therapy Procedure: brachytherapy Procedure: chemotherapy Procedure: colony-stimulating factor therapy Procedure: conventional surgery Procedure: cytokine therapy Procedure: intraoperative radiotherapy Procedure: radiation therapy Procedure: surgery |
| Phase | Phase 2 |
| Sponsor | Radiation Therapy Oncology Group |
| Responsible Party | Radiation Therapy Oncology Group |
| ClinicalTrials.gov Identifier | NCT00017160 |
| First Received | June 6, 2001 |
| Last Updated | June 25, 2013 |
| Last verified | June 2013 |
Tracking Information[ + expand ][ + ]
| First Received Date | June 6, 2001 |
|---|---|
| Last Updated Date | June 25, 2013 |
| Start Date | Not Provided |
| Estimated Primary Completion Date | Not Provided |
| Current Primary Outcome Measures | Not Provided |
| Current Secondary Outcome Measures | Not Provided |
Descriptive Information[ + expand ][ + ]
| Brief Title | Combination Chemotherapy, Radiation Therapy, and Surgery in Treating Patients With Primary or Recurrent Sarcoma |
|---|---|
| Official Title | Phase II Study of Neoadjuvant Doxorubicin and Ifosfamide, Radiotherapy, and Surgical Resection in Patients With Primary or Recurrent Retroperitoneal Sarcoma |
| Brief Summary | RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining chemotherapy, radiation therapy, and surgery may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy, radiation therapy, and surgery in treating patients who have primary or recurrent sarcoma. |
| Detailed Description | OBJECTIVES: - Determine the overall survival of patients with primary or recurrent retroperitoneal sarcomas treated with neoadjuvant doxorubicin and ifosfamide, radiotherapy, and surgical resection. - Assess local-regional control in patients treated with this regimen. - Determine the disease-free survival of patients treated with this regimen. - Determine the pathologic response in patients treated with this regimen. - Determine the toxic effects of this regimen in these patients. - Determine the complications in patients treated with this regimen. OUTLINE: Patients receive doxorubicin IV continuously on days 1-3 and ifosfamide IV over 3 hours on days 1-4. Patients also receive filgrastim (G-CSF) beginning on day 5 and continuing until blood counts recover. Treatment repeats every 21 days for a maximum of 4 courses in the absence of unacceptable toxicity. Beginning 2-4 weeks after chemotherapy, patients undergo radiotherapy daily, 5 days a week, for 5-6 weeks. Beginning 4-7 weeks after radiotherapy, patients undergo complete surgical resection with intraoperative or postoperative radiotherapy or brachytherapy. Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 48 patients will be accrued for this study within 24 months. |
| Study Type | Interventional |
| Study Phase | Phase 2 |
| Study Design | Primary Purpose: Treatment |
| Condition |
|
| Intervention | Drug: doxorubicin Drug: filgrastim Drug: ifosfamide Procedure: biological response modifier therapy Procedure: brachytherapy Procedure: chemotherapy Procedure: colony-stimulating factor therapy Procedure: conventional surgery Procedure: cytokine therapy Procedure: intraoperative radiotherapy Procedure: radiation therapy Procedure: surgery |
| Study Arm (s) | Not Provided |
Recruitment Information[ + expand ][ + ]
| Recruitment Status | Withdrawn |
|---|---|
| Estimated Enrollment | Not Provided |
| Estimated Completion Date | Not Provided |
| Estimated Primary Completion Date | Not Provided |
| Eligibility Criteria | DISEASE CHARACTERISTICS: - Histologically confirmed primary or recurrent soft tissue sarcoma of the retroperitoneum or pelvis - No rhabdomyosarcoma, extraosseous Ewing's sarcoma, primitive neuroectodermal tumor, osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or aggressive fibromatosis - No sarcoma that does not allow sparing of two-thirds of 1 kidney within planned irradiation field - Radiographically measurable disease greater than 5 cm (T2) by CT scan or MRI of the abdomen and pelvis - High-grade (grade 3/3, 3/4, 4/4) disease greater than 5 cm OR - Moderate-grade (grade 2/3, 2/4) recurrent disease greater than 10 cm - Eligible for gross total resection (R0 or R1) - No prior subtotal (R2) resection - Partial debulking OR subtotal tumor resection with residual gross disease - Fewer than 4 equivocal pulmonary lesions each less than 3 mm in diameter by CT scan - No multifocal disease suggestive of regional nodal involvement - No metastases PATIENT CHARACTERISTICS: Age: - Not specified Performance status: - Zubrod 0-2 Life expectancy: - At least 2 years Hematopoietic: - Absolute neutrophil count at least 1,500/mm^3 - Platelet count at least 100,000/mm^3 Hepatic: - Bilirubin no greater than 1.5 mg/dL - AST no greater than 3 times upper limit of normal - Albumin at least 3.5 g/dL Renal: - Creatinine no greater than 1.6 mg/dL - Two functional kidneys Cardiovascular: - No congestive heart failure - No myocardial infarction within the past 6 months - No New York Heart Association class III or IV heart disease - Ejection fraction at least 50% Other: - No other malignancy within the past 5 years except surgically treated carcinoma in situ of the cervix or basal cell or squamous cell skin cancer - No serious medical or psychiatric illness that would preclude study entry - No obvious bowel obstruction - No hypersensitivity to E. coli-derived products - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception - Oral caloric intake at least 1,500 kCal/day PRIOR CONCURRENT THERAPY: Biologic therapy: - Not specified Chemotherapy: - No prior doxorubicin or ifosfamide - No prior chemotherapy for sarcoma Endocrine therapy: - Not specified Radiotherapy: - No prior abdominal or pelvic irradiation Surgery: - See Disease Characteristics |
| Gender | Both |
| Ages | N/A |
| Accepts Healthy Volunteers | No |
| Contacts | Not Provided |
| Location Countries | United States, Canada |
Administrative Information[ + expand ][ + ]
| NCT Number | NCT00017160 |
|---|---|
| Other Study ID Numbers | RTOG-S-0124 |
| Has Data Monitoring Committee | Yes |
| Information Provided By | Radiation Therapy Oncology Group |
| Study Sponsor | Radiation Therapy Oncology Group |
| Collaborators | National Cancer Institute (NCI) |
| Investigators | Study Chair: Peter W. T. Pisters, MD M.D. Anderson Cancer Center |
| Verification Date | June 2013 |
Locations[ + expand ][ + ]
| University of Alabama at Birmingham Comprehensive Cancer Center | Birmingham, Alabama, United States, 35294-3300 |
|---|---|
| Comprehensive Cancer Institute of Huntsville | Huntsville, Alabama, United States, 35801 |
| Huntsville Hospital System | Huntsville, Alabama, United States, 35807 |
| MBCCOP - Gulf Coast | Mobile, Alabama, United States, 36688 |
| Alabama Oncology, LLC | Montgomery, Alabama, United States, 36106-3657 |
| DCH Cancer Treatment Center | Tuscaloosa, Alabama, United States, 35401 |
| Foundation for Cancer Research and Education | Phoenix, Arizona, United States, 85013 |
| Mount Diablo Medical Center | Concord, California, United States, 94524-4110 |
| City of Hope Comprehensive Cancer Center | Duarte, California, United States, 91010-3000 |
| California Cancer Center | Fresno, California, United States, 93729-5100 |
| Saint Agnes Cancer Center | Fresno, California, United States, 93720 |
| Sutter Health West Cancer Research Group | Greenbrae, California, United States, 94904 |
| Loma Linda University Medical Center | Loma Linda, California, United States, 92354 |
| Veterans Affairs Medical Center - Long Beach | Long Beach, California, United States, 90822 |
| Jonsson Comprehensive Cancer Center, UCLA | Los Angeles, California, United States, 90025-1781 |
| USC/Norris Comprehensive Cancer Center and Hospital | Los Angeles, California, United States, 90033-0804 |
| CCOP - Bay Area Tumor Institute | Oakland, California, United States, 94609-3305 |
| Huntington Cancer Center | Pasadena, California, United States, 91105 |
| Robert and Beverly Lewis Family Cancer Care Center | Pomona, California, United States, 91767 |
| Radiation Oncology Center - Sacramento | Sacramento, California, United States, 95816 |
| Radiation Medical Group, Incorporated | San Diego, California, United States, 92101 |
| UCSF Comprehensive Cancer Center | San Francisco, California, United States, 94143-0128 |
| O'Connor Hospital | San Jose, California, United States, 95128 |
| CCOP - Santa Rosa Memorial Hospital | Santa Rosa, California, United States, 95403 |
| David Grant Medical Center | Travis Air Force Base, California, United States, 94535 |
| Memorial Hospital Cancer Center | Colorado Springs, Colorado, United States, 80909 |
| CCOP - Colorado Cancer Research Program, Incorporated | Denver, Colorado, United States, 80224 |
| University of Colorado Cancer Center | Denver, Colorado, United States, 80010 |
| Saint Mary's Hospital and Medical Center | Grand Junction, Colorado, United States, 81502-1628 |
| Hospital of St. Raphael | New Haven, Connecticut, United States, 06511 |
| CCOP - Christiana Care Health Services | Newark, Delaware, United States, 19713 |
| University of Florida Health Science Center | Gainesville, Florida, United States, 32610-0385 |
| Florida Radiation Oncology Group | Jacksonville, Florida, United States, 32207 |
| Holmes Regional Medical Center | Melbourne, Florida, United States, 32901-3276 |
| Baptist Hospital of Miami | Miami, Florida, United States, 33256-2110 |
| Sylvester Cancer Center, University of Miami | Miami, Florida, United States, 33136 |
| Veterans Affairs Medical Center - Miami | Miami, Florida, United States, 33125 |
| CCOP - Mount Sinai Medical Center | Miami Beach, Florida, United States, 33140 |
| MD Anderson Cancer Center Orlando | Orlando, Florida, United States, 32806-2134 |
| Gulf Coast Cancer Treatment Center | Panama City, Florida, United States, 32405-4587 |
| Bay Medical Center | Panama City, Florida, United States, 32401 |
| Sarasota Radiation and Medical Oncology Center | Sarasota, Florida, United States, 34233 |
| Tallahassee Memorial Healthcare | Tallahassee, Florida, United States, 32308 |
| H. Lee Moffitt Cancer Center and Research Institute | Tampa, Florida, United States, 33612-9497 |
| CCOP - Atlanta Regional | Atlanta, Georgia, United States, 30342-1701 |
| Emory University Hospital - Atlanta | Atlanta, Georgia, United States, 30322 |
| Medical Center/John B. Amos Community Cancer Center | Columbus, Georgia, United States, 31901 |
| Regional Radiation Oncology Center at Rome | Rome, Georgia, United States, 30165 |
| MBCCOP - Hawaii | Honolulu, Hawaii, United States, 96813 |
| Northwest Community Hospital | Arlington Heights, Illinois, United States, 60005 |
| Northwestern Memorial Hospital | Chicago, Illinois, United States, 60611 |
| CCOP - Central Illinois | Decatur, Illinois, United States, 62526 |
| Ingalls Memorial Hospital | Harvey, Illinois, United States, 60426 |
| Loyola University Medical Center | Maywood, Illinois, United States, 60153 |
| Lutheran General Cancer Care Center | Park Ridge, Illinois, United States, 60068 |
| Methodist Medical Center of Illinois | Peoria, Illinois, United States, 61636 |
| St. John's Medical Center | Anderson, Indiana, United States, 46016 |
| Bloomington Hospital | Bloomington, Indiana, United States, 47402 |
| Clarian Health Partners Inc. | Indianapolis, Indiana, United States, 46206-1367 |
| Community Regional Cancer Care | Indianapolis, Indiana, United States, 46219 |
| Veterans Affairs Medical Center - Indianapolis (Roudebush) | Indianapolis, Indiana, United States, 46202 |
| Ball Memorial Hospital | Muncie, Indiana, United States, 47303-3499 |
| CCOP - Northern Indiana CR Consortium | South Bend, Indiana, United States, 46601 |
| Wendt Regional Cancer Center of Finley Hospital | Dubuque, Iowa, United States, 52001 |
| Albert B. Chandler Medical Center, University of Kentucky | Lexington, Kentucky, United States, 40536-0084 |
| Central Baptist Hospital | Lexington, Kentucky, United States, 40503 |
| James Graham Brown Cancer Center | Louisville, Kentucky, United States, 40202 |
| Louisville Radiation Oncology | Louisville, Kentucky, United States, 40215 |
| Merle M. Mahr Cancer Center | Madisonville, Kentucky, United States, 42431 |
| Mary Bird Perkins Cancer Center | Baton Rouge, Louisiana, United States, 70809 |
| CCOP - Ochsner | New Orleans, Louisiana, United States, 70121 |
| MBCCOP - LSU Health Sciences Center | New Orleans, Louisiana, United States, 70112 |
| Tulane University School of Medicine | New Orleans, Louisiana, United States, 70112-2699 |
| Maine Medical Center | Portland, Maine, United States, 04102 |
| Anne Arundel Oncology Center | Annapolis, Maryland, United States, 21401 |
| Greater Baltimore Medical Center and Cancer Center | Baltimore, Maryland, United States, 21204 |
| Harbor Hospital Center | Baltimore, Maryland, United States, 21215-1290 |
| Marlene and Stewart Greenebaum Cancer Center, University of Maryland | Baltimore, Maryland, United States, 21201 |
| Sinai Hospital of Baltimore | Baltimore, Maryland, United States, 21215 |
| Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore, Maryland, United States, 21231-2410 |
| Peninsula Regional Medical Center | Salisbury, Maryland, United States, 21801 |
| Dana-Farber Cancer Institute | Boston, Massachusetts, United States, 02115 |
| Cape Cod Hospital | Hyannis, Massachusetts, United States, 02601 |
| Veterans Affairs Medical Center - Boston (Jamaica Plain) | Jamaica Plain, Massachusetts, United States, 02130 |
| University of Michigan Comprehensive Cancer Center | Ann Arbor, Michigan, United States, 48109-0010 |
| CCOP - Michigan Cancer Research Consortium | Ann Arbor, Michigan, United States, 48106 |
| Barbara Ann Karmanos Cancer Institute | Detroit, Michigan, United States, 48201-1379 |
| Henry Ford Hospital | Detroit, Michigan, United States, 48202 |
| Hurley Medical Center | Flint, Michigan, United States, 48503 |
| McLaren Regional Cancer Center | Flint, Michigan, United States, 48532-3685 |
| CCOP - Kalamazoo | Kalamazoo, Michigan, United States, 49007-3731 |
| Marquette General Hospital | Marquette, Michigan, United States, 49855 |
| MidMichigan Medical Center - Midland | Midland, Michigan, United States, 48670 |
| CCOP - Beaumont | Royal Oak, Michigan, United States, 48073-6769 |
| William Beaumont Hospital | Royal Oak, Michigan, United States, 48073 |
| William Beaumont Hospital - Troy | Troy, Michigan, United States, 48098 |
| Mayo Clinic Cancer Center | Rochester, Minnesota, United States, 55905 |
| CCOP - Metro-Minnesota | Saint Louis Park, Minnesota, United States, 55416 |
| Ellis Fischel Cancer Center - Columbia | Columbia, Missouri, United States, 65203 |
| CCOP - Kansas City | Kansas City, Missouri, United States, 64131 |
| Mallinckrodt Institute of Radiology | Saint Louis, Missouri, United States, 63108 |
| St. Louis University Health Sciences Center | Saint Louis, Missouri, United States, 63110-0250 |
| Cancer Research for the Ozarks | Springfield, Missouri, United States, 65807 |
| CCOP - Cancer Research for the Ozarks | Springfield, Missouri, United States, 65807 |
| CCOP - Montana Cancer Consortium | Billings, Montana, United States, 59101 |
| CCOP - Missouri Valley Cancer Consortium | Omaha, Nebraska, United States, 68106 |
| Methodist Hospital Cancer Center - Omaha | Omaha, Nebraska, United States, 68114 |
| Nebraska Health System | Omaha, Nebraska, United States, 68198-7460 |
| CCOP - Southern Nevada Cancer Research Foundation | Las Vegas, Nevada, United States, 89106 |
| Norris Cotton Cancer Center | Lebanon, New Hampshire, United States, 03756-0002 |
| Elliot Regional Cancer Center | Manchester, New Hampshire, United States, 03103 |
| Veterans Affairs Medical Center - East Orange | East Orange, New Jersey, United States, 07019 |
| John F. Kennedy Medical Center | Edison, New Jersey, United States, 08818 |
| Trinitas Hospital - Jersey Street Campus | Elizabeth, New Jersey, United States, 07201 |
| Monmouth Medical Center | Long Branch, New Jersey, United States, 07740-6395 |
| South Jersey Regional Cancer Center | Millville, New Jersey, United States, 08332 |
| Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital | Mount Holly, New Jersey, United States, 08060 |
| Cancer Institute of New Jersey | New Brunswick, New Jersey, United States, 38103-2807 |
| Newark Beth Israel Medical Center | Newark, New Jersey, United States, 07112 |
| Atlantic City Medical Center | Pomona, New Jersey, United States, 08240 |
| Valley Hospital | Ridgewood, New Jersey, United States, 07450 |
| Community Medical Center | Toms River, New Jersey, United States, 08755 |
| St. Francis Medical Center | Trenton, New Jersey, United States, 08629 |
| Associated Radiologists, P.A. | Warren, New Jersey, United States, 07059 |
| Radiation Oncology Associates of Albuquerque | Albuquerque, New Mexico, United States, 87109 |
| Cancer Center of Albany Medical Center | Albany, New York, United States, 12208 |
| State University of New York Health Science Center at Brooklyn | Brooklyn, New York, United States, 11203 |
| New York Methodist Hospital | Brooklyn, New York, United States, 11215 |
| Roswell Park Cancer Institute | Buffalo, New York, United States, 14263-0001 |
| Finger Lakes Radiation Oncology Center | Clifton Springs, New York, United States, 14432 |
| CCOP - North Shore University Hospital | Manhasset, New York, United States, 11030 |
| Herbert Irving Comprehensive Cancer Center | New York, New York, United States, 10032 |
| Champlain Valley Physicians Hospital Medical Center | Plattsburgh, New York, United States, 12901 |
| Vassar Brothers Medical Center | Poughkeepsie, New York, United States, 12601 |
| James P. Wilmot Cancer Center | Rochester, New York, United States, 14642 |
| CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C. | Syracuse, New York, United States, 13217 |
| Riverhill Radiation Oncology | Yonkers, New York, United States, 10701 |
| Lineberger Comprehensive Cancer Center, UNC | Chapel Hill, North Carolina, United States, 27599-7295 |
| Northeast Medical Center | Concord, North Carolina, United States, 28025 |
| East Carolina University School of Medicine | Greenville, North Carolina, United States, 27858-4354 |
| CCOP - Southeast Cancer Control Consortium | Winston-Salem, North Carolina, United States, 27104-4241 |
| Comprehensive Cancer Center at Wake Forest University | Winston-Salem, North Carolina, United States, 27157-1082 |
| Trinity Cancer Care Center | Minot, North Dakota, United States, 58701 |
| Akron City Hospital | Akron, Ohio, United States, 44304 |
| Akron General Medical Center | Akron, Ohio, United States, 44302 |
| Christ Hospital | Cincinnati, Ohio, United States, 45219 |
| Barrett Cancer Center | Cincinnati, Ohio, United States, 45267-0502 |
| Cleveland Clinic Taussig Cancer Center | Cleveland, Ohio, United States, 44195 |
| Ireland Cancer Center | Cleveland, Ohio, United States, 44106-5065 |
| University Hospitals of Cleveland | Cleveland, Ohio, United States, 44106 |
| Arthur G. James Cancer Hospital - Ohio State University | Columbus, Ohio, United States, 43210-1240 |
| CCOP - Columbus | Columbus, Ohio, United States, 43206 |
| CCOP - Dayton | Dayton, Ohio, United States, 45429 |
| CCOP - Toledo Community Hospital | Toledo, Ohio, United States, 43623-3456 |
| St. Anthony Hospital | Oklahoma City, Oklahoma, United States, 73101 |
| University of Oklahoma Health Sciences Center | Oklahoma City, Oklahoma, United States, 73104 |
| St. John Health System | Tulsa, Oklahoma, United States, 74104 |
| CCOP - Oklahoma | Tulsa, Oklahoma, United States, 74136 |
| CCOP - Columbia River Program | Portland, Oregon, United States, 97225 |
| Lehigh Valley Hospital | Allentown, Pennsylvania, United States, 18105 |
| St. Luke's Hospital Cancer Center | Bethlehem, Pennsylvania, United States, 18015 |
| Geisinger Medical Center | Danville, Pennsylvania, United States, 17822-2001 |
| Mercy Fitzgerald Hospital | Darby, Pennsylvania, United States, 19023 |
| Delaware County Memorial Hospital | Drexel Hill, Pennsylvania, United States, 19026 |
| Pocono Cancer Center | East Stroudsburg, Pennsylvania, United States, 18301 |
| Milton S. Hershey Medical Center | Hershey, Pennsylvania, United States, 17033-0850 |
| Kimmel Cancer Center of Thomas Jefferson University - Philadelphia | Philadelphia, Pennsylvania, United States, 19107-5541 |
| Fox Chase Cancer Center | Philadelphia, Pennsylvania, United States, 19111 |
| Abramson Cancer Center of the University of Pennsylvania | Philadelphia, Pennsylvania, United States, 19104-4283 |
| Albert Einstein Cancer Center | Philadelphia, Pennsylvania, United States, 19141-3098 |
| Veterans Affairs Medical Center - Philadelphia | Philadelphia, Pennsylvania, United States, 19104 |
| Mercy Hospital of Pittsburgh | Pittsburgh, Pennsylvania, United States, 15219 |
| Western Pennsylvania Hospital | Pittsburgh, Pennsylvania, United States, 15224 |
| University of Pittsburgh Cancer Institute | Pittsburgh, Pennsylvania, United States, 15236 |
| Reading Hospital and Medical Center | Reading, Pennsylvania, United States, 19612-6052 |
| Mercy Hospital Cancer Center - Scranton | Scranton, Pennsylvania, United States, 18501 |
| Wilkes Barre General Hospital | Wilkes-Barre, Pennsylvania, United States, 18764 |
| York Cancer Center | York, Pennsylvania, United States, 17403 |
| Roger Williams Medical Center/BUSM | Providence, Rhode Island, United States, 02908-4735 |
| CCOP - Greenville | Greenville, South Carolina, United States, 29615 |
| CCOP - Upstate Carolina | Spartanburg, South Carolina, United States, 29303 |
| Rapid City Regional Hospital | Rapid City, South Dakota, United States, 57709 |
| Jackson-Madison County General Hospital | Jackson, Tennessee, United States, 38301-3956 |
| University of Tennessee Cancer Institute | Memphis, Tennessee, United States, 38103 |
| Vanderbilt-Ingram Cancer Center | Nashville, Tennessee, United States, 37232-5671 |
| Harrington Cancer Center | Amarillo, Texas, United States, 79106 |
| University of Texas Medical Branch | Galveston, Texas, United States, 77555-0209 |
| University of Texas - MD Anderson Cancer Center | Houston, Texas, United States, 77030-4009 |
| Wilford Hall Medical Center | Lackland Air Force Base, Texas, United States, 78236-5300 |
| Joe Arrington Cancer Research and Treatment Center | Lubbock, Texas, United States, 79410-1894 |
| Dixie Regional Medical Center | Saint George, Utah, United States, 84770 |
| Latter Day Saints Hospital | Salt Lake City, Utah, United States, 84143 |
| University of Utah Health Sciences Center | Salt Lake City, Utah, United States, 84132 |
| Vermont Cancer Center | Burlington, Vermont, United States, 05405-0075 |
| Cancer Center at the University of Virginia | Charlottesville, Virginia, United States, 22908 |
| RMH Regional Cancer Center | Harrisonburg, Virginia, United States, 22801 |
| Naval Medical Center, Portsmouth | Portsmouth, Virginia, United States, 23708-2197 |
| Massey Cancer Center | Richmond, Virginia, United States, 23298-0058 |
| Bon Secours - St. Mary's Hospital | Richmond, Virginia, United States, 23226 |
| Virginia Mason Medical Center | Seattle, Washington, United States, 98111 |
| Deaconess Medical Center | Spokane, Washington, United States, 99204 |
| Yakima Valley Memorial Hospital | Yakima, Washington, United States, 98902 |
| Schiffler Cancer Center | Wheeling, West Virginia, United States, 26003 |
| CCOP - St. Vincent Hospital Cancer Center, Green Bay | Green Bay, Wisconsin, United States, 54301 |
| St. Vincent Hospital | Green Bay, Wisconsin, United States, 54307-3508 |
| Gundersen Lutheran Medical Foundation | La Crosse, Wisconsin, United States, 54601 |
| University of Wisconsin Comprehensive Cancer Center | Madison, Wisconsin, United States, 53792 |
| Southern Wisconsin Radiotherapy Center | Madison, Wisconsin, United States, 53713 |
| Marshfield Clinic | Marshfield, Wisconsin, United States, 54449 |
| Community Memorial Hospital | Menomonee Falls, Wisconsin, United States, 53051 |
| Medical College of Wisconsin Cancer Center | Milwaukee, Wisconsin, United States, 53226 |
| Columbia Hospital | Milwaukee, Wisconsin, United States, 53211 |
| St. Luke's Medical Center | Milwaukee, Wisconsin, United States, 53215 |
| Veterans Affairs Medical Center - Milwaukee (Zablocki) | Milwaukee, Wisconsin, United States, 53295 |
| All Saints Cancer Center | Racine, Wisconsin, United States, 53405 |
| Waukesha Memorial Hospital Regional Cancer Center | Waukesha, Wisconsin, United States, 53188 |
| Tom Baker Cancer Center - Calgary | Calgary, Alberta, Canada, T2N 4N2 |
| Cross Cancer Institute | Edmonton, Alberta, Canada, T6G 1Z2 |
| Saint John Regional Hospital | Saint John, New Brunswick, Canada, E2L 4L2 |
| Newfoundland Cancer Treatment and Research Foundation | St. Johns, Newfoundland and Labrador, Canada, A1B 3V6 |
| Nova Scotia Cancer Centre | Halifax, Nova Scotia, Canada, B3H 1V7 |
| Cancer Care Ontario-Hamilton Regional Cancer Centre | Hamilton, Ontario, Canada, L8V 5C2 |
| Kingston Regional Cancer Centre | Kingston, Ontario, Canada, K7L 5P9 |
| Cancer Care Ontario-London Regional Cancer Centre | London, Ontario, Canada, N6A 4L6 |
| Ottawa Regional Cancer Centre | Ottawa, Ontario, Canada, K1H 1C4 |
| Northeastern Ontario Regional Cancer Centre, Sudbury | Sudbury, Ontario, Canada, P3E 5J1 |
| Northwestern Ontario Regional Cancer Centre, Thunder Bay | Thunder Bay, Ontario, Canada, P7A 7T1 |
| Princess Margaret Hospital | Toronto, Ontario, Canada, M5G 2M9 |
| Toronto Sunnybrook Regional Cancer Centre | Toronto, Ontario, Canada, M4N 3M5 |
| CHUS-Hopital Fleurimont | Fleurimont, Quebec, Canada, J1H 5N4 |
| Centre Hospitalier de l'Universite de Montreal | Montreal, Quebec, Canada, H2L 4MI |
| McGill University | Montreal, Quebec, Canada, H2W 1S6 |
| Centre Hospitalier Universitaire de Quebec | Quebec City, Quebec, Canada, G1R 2J6 |
| Allan Blair Cancer Centre | Regina, Saskatchewan, Canada, S4T 7T1 |
| Saskatoon Cancer Centre | Saskatoon, Saskatchewan, Canada, S7N 4H4 |