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Stråleterapi med eller uden cisplatin til behandling af patienter med tilbagevendende endometriecancer

3. marts 2023 opdateret af: GOG Foundation

Et randomiseret forsøg med bækkenbestråling med eller uden samtidig ugentlig cisplatin hos patienter med kun bækken-recidiver af karcinom i livmoderkroppen

Dette randomiserede fase II-forsøg studerer strålebehandling og cisplatin for at se, hvor godt de virker sammenlignet med strålebehandling alene ved behandling af patienter med endometriecancer, der er kommet tilbage. Strålebehandling bruger højenergi røntgenstråler og andre typer stråling til at dræbe tumorceller. Lægemidler, der bruges i kemoterapi, såsom cisplatin, virker på forskellige måder for at stoppe væksten af ​​tumorceller, enten ved at dræbe cellerne, ved at stoppe dem i at dele sig eller ved at stoppe dem i at sprede sig. Det vides endnu ikke, om det at give strålebehandling sammen med cisplatin er mere effektivt end strålebehandling alene til behandling af patienter med endometriecancer.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At vurdere om bækkenstrålebehandling med samtidig cisplatin er mere lovende med hensyn til progressionsfri overlevelse end bækkenstrålebehandling alene ved behandling af recidiverende livmoderkarcinom begrænset til bækken og skede.

SEKUNDÆRE MÅL:

I. At fange tilbagefaldsstederne efter behandling med bækkenbestråling med eller uden samtidig ugentlig cisplatin hos kvinder med recidiverende livmoderkarcinom.

II. At estimere den samlede overlevelse af patienter med recidiverende livmoderkarcinom behandlet med bækkenstrålebehandling med eller uden samtidig ugentlig cisplatin.

III. At estimere den prognostiske betydning af lokaliteten (central bækken versus vagina) og størrelsen af ​​recidiv, ud over den prognostiske betydning i redningsindstillingen af ​​den histologiske subtype, grad, patientens alder, race, præstationsstatus og tilstedeværelsen af ​​lymfe -vaskulær ruminvolvering af den oprindelige tumor på tidspunktet for initial hysterektomi.

IV. At evaluere toksicitet afledt af det kombinerede cisplatin og stråling sammenlignet med stråling alene i denne patientpopulation.

OVERSIGT: Patienterne randomiseres til 1 af 2 arme.

ARM I: Patienter gennemgår ekstern strålebehandling (EBRT) til bækkenet dagligt på dag 1-5 i 5 uger. Efter afslutning af EBRT gennemgår patienter intrakavitær lavdosis- eller højdosis-brachyterapi* eller lav-dosis interstitiel brachyterapi*.

ARM II: Patienter gennemgår EBRT som i arm I og får cisplatin intravenøst ​​(IV) over 1-2 timer på dag 1, 8, 15, 22 og 29. Patienterne gennemgår derefter brachyterapi* som i arm I.

BEMÆRK: *IMRT-boost er tilladt for patienter, der ikke er kandidater til brachyterapi. IMRT kan også bruges til hele terapiforløbet til behandling af hele bækkenet og/eller boost hos patienter, der ikke gennemgår brachyterapi. I begge arme fortsætter behandlingen i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afsluttet undersøgelsesbehandling følges patienterne hver måned i 3 måneder, 3 måneder i 2 år og derefter hver 6. måned i 3 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

165

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Canada
    • Quebec
      • Montreal, Quebec, Canada, H2L 4M1
        • CHUM - Hopital Notre-Dame
      • Montreal, Quebec, Canada, H2X 3E4
        • CHUM - Centre Hospitalier de l'Universite de Montreal
  • Forenede Stater
    • California
      • Auburn, California, Forenede Stater, 95602
        • Sutter Auburn Faith Hospital
      • Auburn, California, Forenede Stater, 95603
        • Sutter Cancer Centers Radiation Oncology Services-Auburn
      • Berkeley, California, Forenede Stater, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Burbank, California, Forenede Stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Burlingame, California, Forenede Stater, 94010
        • Mills-Peninsula Medical Center
      • Cameron Park, California, Forenede Stater, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Forenede Stater, 94546
        • Eden Hospital Medical Center
      • Davis, California, Forenede Stater, 95616
        • Sutter Davis Hospital
      • La Jolla, California, Forenede Stater, 92093
        • UC San Diego Moores Cancer Center
      • Loma Linda, California, Forenede Stater, 92354
        • Loma Linda University Medical Center
      • Los Angeles, California, Forenede Stater, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Modesto, California, Forenede Stater, 95355
        • Memorial Medical Center
      • Mountain View, California, Forenede Stater, 94040
        • Palo Alto Medical Foundation-Camino Division
      • Mountain View, California, Forenede Stater, 94040
        • Palo Alto Medical Foundation-Gynecologic Oncology
      • Novato, California, Forenede Stater, 94945
        • Sutter Cancer Research Consortium
      • Orange, California, Forenede Stater, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Palo Alto, California, Forenede Stater, 94301
        • Palo Alto Medical Foundation Health Care
      • Roseville, California, Forenede Stater, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Roseville, California, Forenede Stater, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Forenede Stater, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Forenede Stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • San Diego, California, Forenede Stater, 92103
        • University of California San Diego
      • San Francisco, California, Forenede Stater, 94115
        • California Pacific Medical Center-Pacific Campus
      • Santa Cruz, California, Forenede Stater, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Santa Rosa, California, Forenede Stater, 95403
        • Sutter Pacific Medical Foundation
      • Sunnyvale, California, Forenede Stater, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Sylmar, California, Forenede Stater, 91342
        • Olive View-University of California Los Angeles Medical Center
      • Vacaville, California, Forenede Stater, 95687
        • Sutter Cancer Centers Radiation Oncology Services-Vacaville
      • Vallejo, California, Forenede Stater, 94589
        • Sutter Solano Medical Center/Cancer Center
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80045
        • University of Colorado Hospital
    • Connecticut
      • Hartford, Connecticut, Forenede Stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Hartford, Connecticut, Forenede Stater, 06102
        • Hartford Hospital
      • New Britain, Connecticut, Forenede Stater, 06050
        • The Hospital of Central Connecticut
    • Delaware
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forenede Stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forenede Stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forenede Stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Newark, Delaware, Forenede Stater, 19713
        • Christiana Gynecologic Oncology LLC
      • Rehoboth Beach, Delaware, Forenede Stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forenede Stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Forenede Stater, 19801
        • Christiana Care Health System-Wilmington Hospital
    • District of Columbia
      • Washington, District of Columbia, Forenede Stater, 20016
        • Sibley Memorial Hospital
    • Florida
      • Sarasota, Florida, Forenede Stater, 34239
        • Sarasota Memorial Hospital
    • Georgia
      • Atlanta, Georgia, Forenede Stater, 30342
        • Northside Hospital
      • Augusta, Georgia, Forenede Stater, 30912
        • Augusta University Medical Center
      • Gainesville, Georgia, Forenede Stater, 30501
        • Northeast Georgia Medical Center-Gainesville
      • Savannah, Georgia, Forenede Stater, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
      • Savannah, Georgia, Forenede Stater, 31404
        • Memorial Health University Medical Center
    • Idaho
      • Boise, Idaho, Forenede Stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Caldwell, Idaho, Forenede Stater, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Forenede Stater, 83814
        • Kootenai Health - Coeur d'Alene
      • Emmett, Idaho, Forenede Stater, 83617
        • Walter Knox Memorial Hospital
      • Meridian, Idaho, Forenede Stater, 83642
        • Idaho Urologic Institute-Meridian
      • Nampa, Idaho, Forenede Stater, 83686
        • Saint Alphonsus Medical Center-Nampa
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Forenede Stater, 83864
        • Kootenai Cancer Clinic
    • Illinois
      • Aurora, Illinois, Forenede Stater, 60504
        • Rush - Copley Medical Center
      • Bloomington, Illinois, Forenede Stater, 61704
        • Illinois CancerCare-Bloomington
      • Bloomington, Illinois, Forenede Stater, 61701
        • Saint Joseph Medical Center
      • Canton, Illinois, Forenede Stater, 61520
        • Illinois CancerCare-Canton
      • Carthage, Illinois, Forenede Stater, 62321
        • Illinois CancerCare-Carthage
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forenede Stater, 60612
        • Rush University Medical Center
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Eureka, Illinois, Forenede Stater, 61530
        • Illinois CancerCare-Eureka
      • Evanston, Illinois, Forenede Stater, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Galesburg, Illinois, Forenede Stater, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Forenede Stater, 61401
        • Illinois CancerCare-Galesburg
      • Geneva, Illinois, Forenede Stater, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Hinsdale, Illinois, Forenede Stater, 60521
        • Sudarshan K Sharma MD Limited-Gynecologic Oncology
      • Joliet, Illinois, Forenede Stater, 60435
        • Duly Health and Care Joliet
      • Kewanee, Illinois, Forenede Stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Forenede Stater, 61455
        • Illinois CancerCare-Macomb
      • Maywood, Illinois, Forenede Stater, 60153
        • Loyola University Medical Center
      • Moline, Illinois, Forenede Stater, 61265
        • Garneau, Stewart C MD (UIA Investigator)
      • Moline, Illinois, Forenede Stater, 61265
        • Spector, David MD (UIA Investigator)
      • Moline, Illinois, Forenede Stater, 61265
        • Trinity Medical Center
      • Monmouth, Illinois, Forenede Stater, 61462
        • Illinois CancerCare-Monmouth
      • Normal, Illinois, Forenede Stater, 61761
        • Carle Cancer Institute Normal
      • Normal, Illinois, Forenede Stater, 61761
        • Bromenn Regional Medical Center
      • Oak Lawn, Illinois, Forenede Stater, 60453-2699
        • Advocate Christ Medical Center
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Ottawa, Illinois, Forenede Stater, 61350
        • Ottawa Regional Hospital and Healthcare Center
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forenede Stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forenede Stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forenede Stater, 61356
        • Illinois CancerCare-Princeton
      • Warrenville, Illinois, Forenede Stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
    • Indiana
      • Fort Wayne, Indiana, Forenede Stater, 46805
        • Parkview Hospital Randallia
      • Fort Wayne, Indiana, Forenede Stater, 46845
        • Parkview Regional Medical Center
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Michigan City, Indiana, Forenede Stater, 46360
        • Franciscan Saint Anthony Health-Michigan City
      • Mishawaka, Indiana, Forenede Stater, 46545
        • Memorial Regional Cancer Center Day Road
      • South Bend, Indiana, Forenede Stater, 46601
        • Memorial Hospital of South Bend
    • Iowa
      • Bettendorf, Iowa, Forenede Stater, 52722
        • Constantinou, Costas L MD (UIA Investigator)
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Oncology Associates at Mercy Medical Center
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Medical Oncology and Hematology Associates-Des Moines
      • Des Moines, Iowa, Forenede Stater, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Forenede Stater, 50314
        • Medical Oncology and Hematology Associates-Laurel
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Sioux City, Iowa, Forenede Stater, 51101
        • Siouxland Regional Cancer Center
      • Sioux City, Iowa, Forenede Stater, 51102
        • Mercy Medical Center-Sioux City
      • Sioux City, Iowa, Forenede Stater, 51104
        • Saint Luke's Regional Medical Center
      • West Des Moines, Iowa, Forenede Stater, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Forenede Stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Chanute, Kansas, Forenede Stater, 66720
        • Cancer Center of Kansas - Chanute
      • Dodge City, Kansas, Forenede Stater, 67801
        • Cancer Center of Kansas - Dodge City
      • El Dorado, Kansas, Forenede Stater, 67042
        • Cancer Center of Kansas - El Dorado
      • Fort Scott, Kansas, Forenede Stater, 66701
        • Cancer Center of Kansas - Fort Scott
      • Garden City, Kansas, Forenede Stater, 67846
        • Central Care Cancer Center - Garden City
      • Great Bend, Kansas, Forenede Stater, 67530
        • Central Care Cancer Center - Great Bend
      • Independence, Kansas, Forenede Stater, 67301
        • Cancer Center of Kansas-Independence
      • Kansas City, Kansas, Forenede Stater, 66112
        • Providence Medical Center
      • Kingman, Kansas, Forenede Stater, 67068
        • Cancer Center of Kansas-Kingman
      • Lawrence, Kansas, Forenede Stater, 66044
        • Lawrence Memorial Hospital
      • Lenexa, Kansas, Forenede Stater, 66219
        • Kansas Institute of Medicine Cancer and Blood Center
      • Lenexa, Kansas, Forenede Stater, 66219
        • Minimally Invasive Surgery Hospital
      • Liberal, Kansas, Forenede Stater, 67905
        • Cancer Center of Kansas-Liberal
      • Manhattan, Kansas, Forenede Stater, 66502
        • Cancer Center of Kansas-Manhattan
      • McPherson, Kansas, Forenede Stater, 67460
        • Cancer Center of Kansas - McPherson
      • Newton, Kansas, Forenede Stater, 67114
        • Cancer Center of Kansas - Newton
      • Overland Park, Kansas, Forenede Stater, 66209
        • Menorah Medical Center
      • Overland Park, Kansas, Forenede Stater, 66213
        • Saint Luke's South Hospital
      • Parsons, Kansas, Forenede Stater, 67357
        • Cancer Center of Kansas - Parsons
      • Pratt, Kansas, Forenede Stater, 67124
        • Cancer Center of Kansas - Pratt
      • Salina, Kansas, Forenede Stater, 67401
        • Cancer Center of Kansas - Salina
      • Wellington, Kansas, Forenede Stater, 67152
        • Cancer Center of Kansas - Wellington
      • Wichita, Kansas, Forenede Stater, 67214
        • Ascension Via Christi Hospitals Wichita
      • Wichita, Kansas, Forenede Stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forenede Stater, 67214
        • Cancer Center of Kansas - Wichita
      • Wichita, Kansas, Forenede Stater, 67208
        • Associates In Womens Health
      • Wichita, Kansas, Forenede Stater, 67214
        • Wesley Medical Center
      • Winfield, Kansas, Forenede Stater, 67156
        • Cancer Center of Kansas - Winfield
    • Kentucky
      • Edgewood, Kentucky, Forenede Stater, 41017
        • Saint Elizabeth Medical Center South
      • Lexington, Kentucky, Forenede Stater, 40536
        • University of Kentucky/Markey Cancer Center
    • Louisiana
      • Baton Rouge, Louisiana, Forenede Stater, 70817
        • Woman's Hospital
    • Maine
      • Portland, Maine, Forenede Stater, 04102
        • Maine Medical Center-Bramhall Campus
      • Scarborough, Maine, Forenede Stater, 04074
        • Maine Medical Center- Scarborough Campus
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21215
        • Sinai Hospital of Baltimore
      • Baltimore, Maryland, Forenede Stater, 21204
        • Greater Baltimore Medical Center
      • Elkton, Maryland, Forenede Stater, 21921
        • Christiana Care - Union Hospital
    • Massachusetts
      • Burlington, Massachusetts, Forenede Stater, 01805
        • Lahey Hospital and Medical Center
      • Springfield, Massachusetts, Forenede Stater, 01199
        • Baystate Medical Center
      • Worcester, Massachusetts, Forenede Stater, 01655
        • UMass Memorial Medical Center - University Campus
      • Worcester, Massachusetts, Forenede Stater, 01605
        • UMass Memorial Medical Center - Memorial Division
    • Michigan
      • Adrian, Michigan, Forenede Stater, 49221
        • Bixby Medical Center
      • Adrian, Michigan, Forenede Stater, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Saint Joseph Mercy Hospital
      • Bay City, Michigan, Forenede Stater, 48706
        • McLaren Cancer Institute-Bay City
      • Brighton, Michigan, Forenede Stater, 48114
        • Saint Joseph Mercy Brighton
      • Brighton, Michigan, Forenede Stater, 48114
        • IHA Hematology Oncology Consultants-Brighton
      • Canton, Michigan, Forenede Stater, 48188
        • Saint Joseph Mercy Canton
      • Canton, Michigan, Forenede Stater, 48188
        • IHA Hematology Oncology Consultants-Canton
      • Caro, Michigan, Forenede Stater, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Forenede Stater, 48118
        • Saint Joseph Mercy Chelsea
      • Chelsea, Michigan, Forenede Stater, 48118
        • IHA Hematology Oncology Consultants-Chelsea
      • Clarkston, Michigan, Forenede Stater, 48346
        • Hematology Oncology Consultants-Clarkston
      • Clarkston, Michigan, Forenede Stater, 48346
        • Newland Medical Associates-Clarkston
      • Dearborn, Michigan, Forenede Stater, 48124
        • Beaumont Hospital - Dearborn
      • Detroit, Michigan, Forenede Stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forenede Stater, 48236
        • Ascension Saint John Hospital
      • East China Township, Michigan, Forenede Stater, 48054
        • Great Lakes Cancer Management Specialists-Doctors Park
      • Farmington Hills, Michigan, Forenede Stater, 48334
        • Weisberg Cancer Treatment Center
      • Flint, Michigan, Forenede Stater, 48532
        • Genesys Regional Medical Center-West Flint Campus
      • Flint, Michigan, Forenede Stater, 48532
        • McLaren Cancer Institute-Flint
      • Flint, Michigan, Forenede Stater, 48532
        • Singh and Arora Hematology Oncology PC
      • Flint, Michigan, Forenede Stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesee Cancer and Blood Disease Treatment Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesee Hematology Oncology PC
      • Flint, Michigan, Forenede Stater, 48503
        • Genesys Hurley Cancer Institute
      • Grand Blanc, Michigan, Forenede Stater, 48439
        • Genesys Regional Medical Center
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Academic Hematology Oncology Specialists
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Michigan Breast Specialists-Grosse Pointe Woods
      • Jackson, Michigan, Forenede Stater, 49201
        • Allegiance Health
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Forenede Stater, 49048
        • Borgess Medical Center
      • Lansing, Michigan, Forenede Stater, 48912
        • Sparrow Hospital
      • Lapeer, Michigan, Forenede Stater, 48446
        • McLaren Cancer Institute-Lapeer Region
      • Livonia, Michigan, Forenede Stater, 48154
        • Saint Mary Mercy Hospital
      • Livonia, Michigan, Forenede Stater, 48154
        • Hope Cancer Clinic
      • Macomb, Michigan, Forenede Stater, 48044
        • Great Lakes Cancer Management Specialists-Macomb Medical Campus
      • Macomb, Michigan, Forenede Stater, 48044
        • Michigan Breast Specialists-Macomb Township
      • Marlette, Michigan, Forenede Stater, 48453
        • Saint Mary's Oncology/Hematology Associates of Marlette
      • Monroe, Michigan, Forenede Stater, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • Pontiac, Michigan, Forenede Stater, 48341
        • Saint Joseph Mercy Oakland
      • Pontiac, Michigan, Forenede Stater, 48341
        • 21st Century Oncology-Pontiac
      • Pontiac, Michigan, Forenede Stater, 48341
        • Hope Cancer Center
      • Pontiac, Michigan, Forenede Stater, 48341
        • Newland Medical Associates-Pontiac
      • Port Huron, Michigan, Forenede Stater, 48060
        • Lake Huron Medical Center
      • Rochester Hills, Michigan, Forenede Stater, 48309
        • Great Lakes Cancer Management Specialists-Rochester Hills
      • Saginaw, Michigan, Forenede Stater, 48601
        • Ascension Saint Mary's Hospital
      • Saginaw, Michigan, Forenede Stater, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Sterling Heights, Michigan, Forenede Stater, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Warren, Michigan, Forenede Stater, 48093
        • Saint John Macomb-Oakland Hospital
      • Warren, Michigan, Forenede Stater, 48088
        • Advanced Breast Care Center PLLC
      • Warren, Michigan, Forenede Stater, 48093
        • Great Lakes Cancer Management Specialists-Macomb Professional Building
      • Warren, Michigan, Forenede Stater, 48093
        • Macomb Hematology Oncology PC
      • Warren, Michigan, Forenede Stater, 48093
        • Michigan Breast Specialists-Warren
      • West Branch, Michigan, Forenede Stater, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Ypsilanti, Michigan, Forenede Stater, 48106
        • Huron Gastroenterology PC
      • Ypsilanti, Michigan, Forenede Stater, 48197
        • IHA Hematology Oncology Consultants-Ann Arbor
    • Minnesota
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Forenede Stater, 55433
        • Mercy Hospital
      • Edina, Minnesota, Forenede Stater, 55435
        • Fairview Southdale Hospital
      • Fridley, Minnesota, Forenede Stater, 55432
        • Unity Hospital
      • Hutchinson, Minnesota, Forenede Stater, 55350
        • Hutchinson Area Health Care
      • Maplewood, Minnesota, Forenede Stater, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Forenede Stater, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Forenede Stater, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Forenede Stater, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Forenede Stater, 55454
        • Health Partners Inc
      • New Ulm, Minnesota, Forenede Stater, 56073
        • New Ulm Medical Center
      • Robbinsdale, Minnesota, Forenede Stater, 55422
        • North Memorial Medical Health Center
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Forenede Stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forenede Stater, 55102
        • United Hospital
      • Shakopee, Minnesota, Forenede Stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forenede Stater, 55082
        • Lakeview Hospital
      • Waconia, Minnesota, Forenede Stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forenede Stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forenede Stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Jackson, Mississippi, Forenede Stater, 39216
        • University of Mississippi Medical Center
      • Pascagoula, Mississippi, Forenede Stater, 39581
        • Singing River Hospital
    • Missouri
      • Bolivar, Missouri, Forenede Stater, 65613
        • Central Care Cancer Center - Bolivar
      • Columbia, Missouri, Forenede Stater, 65212
        • University of Missouri - Ellis Fischel
      • Independence, Missouri, Forenede Stater, 64057
        • Centerpoint Medical Center LLC
      • Joplin, Missouri, Forenede Stater, 64804
        • Freeman Health System
      • Kansas City, Missouri, Forenede Stater, 64111
        • Saint Luke's Hospital of Kansas City
      • Kansas City, Missouri, Forenede Stater, 64132
        • Research Medical Center
      • Kansas City, Missouri, Forenede Stater, 64118
        • Heartland Hematology and Oncology Associates Incorporated
      • Lee's Summit, Missouri, Forenede Stater, 64086
        • Saint Luke's East - Lee's Summit
      • Liberty, Missouri, Forenede Stater, 64068
        • Liberty Radiation Oncology Center
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Saint Joseph, Missouri, Forenede Stater, 64506
        • Heartland Regional Medical Center
      • Saint Joseph, Missouri, Forenede Stater, 64507
        • Saint Joseph Oncology Inc
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Barnes-Jewish Hospital
      • Springfield, Missouri, Forenede Stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forenede Stater, 65804
        • Mercy Hospital Springfield
    • Montana
      • Anaconda, Montana, Forenede Stater, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Forenede Stater, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Forenede Stater, 59101
        • Saint Vincent Healthcare
      • Bozeman, Montana, Forenede Stater, 59715
        • Bozeman Deaconess Hospital
      • Butte, Montana, Forenede Stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forenede Stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Healthcare- Sletten Cancer Institute
      • Helena, Montana, Forenede Stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forenede Stater, 59901
        • Kalispell Regional Medical Center
      • Missoula, Montana, Forenede Stater, 59804
        • Community Medical Hospital
      • Missoula, Montana, Forenede Stater, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Omaha, Nebraska, Forenede Stater, 68114
        • Nebraska Methodist Hospital
    • Nevada
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Forenede Stater, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Forenede Stater, 89074
        • 21st Century Oncology-Henderson
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Forenede Stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Forenede Stater, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Forenede Stater, 89148
        • OptumCare Cancer Care at Fort Apache
      • Las Vegas, Nevada, Forenede Stater, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Forenede Stater, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Cancer and Blood Specialists-Shadow
      • Las Vegas, Nevada, Forenede Stater, 89109
        • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
      • Las Vegas, Nevada, Forenede Stater, 89113
        • HealthCare Partners Medical Group Oncology/Hematology-San Martin
      • Las Vegas, Nevada, Forenede Stater, 89121
        • Cancer Therapy and Integrative Medicine
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Cancer and Blood Specialists-Tenaya
      • Las Vegas, Nevada, Forenede Stater, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
      • Las Vegas, Nevada, Forenede Stater, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Forenede Stater, 89149
        • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
      • Las Vegas, Nevada, Forenede Stater, 89109
        • 21st Century Oncology
      • Las Vegas, Nevada, Forenede Stater, 89128
        • 21st Century Oncology-Vegas Tenaya
      • Las Vegas, Nevada, Forenede Stater, 89148
        • 21st Century Oncology-Fort Apache
      • Las Vegas, Nevada, Forenede Stater, 89169
        • Women's Cancer Center of Nevada
    • New Hampshire
      • Dover, New Hampshire, Forenede Stater, 03820
        • Wentworth-Douglass Hospital
      • Lebanon, New Hampshire, Forenede Stater, 03756
        • Dartmouth Hitchcock Medical Center
      • Manchester, New Hampshire, Forenede Stater, 03103
        • Elliot Hospital
    • New Jersey
      • Camden, New Jersey, Forenede Stater, 08103
        • Cooper Hospital University Medical Center
      • Mount Holly, New Jersey, Forenede Stater, 08060
        • Virtua Memorial
      • Neptune, New Jersey, Forenede Stater, 07753
        • Jersey Shore Medical Center
      • Newark, New Jersey, Forenede Stater, 07101
        • Rutgers New Jersey Medical School
      • Paramus, New Jersey, Forenede Stater, 07652
        • The Valley Hospital-Luckow Pavilion
      • Ridgewood, New Jersey, Forenede Stater, 07450
        • Valley Hospital
      • Toms River, New Jersey, Forenede Stater, 08755
        • Community Medical Center
      • Voorhees, New Jersey, Forenede Stater, 08043
        • Virtua Voorhees
      • Voorhees, New Jersey, Forenede Stater, 08043
        • MD Anderson Cancer Center at Cooper-Voorhees
      • Westwood, New Jersey, Forenede Stater, 07675
        • Valley Health System-Hematology/Oncology
    • New Mexico
      • Albuquerque, New Mexico, Forenede Stater, 87102
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Forenede Stater, 87106
        • Southwest Gynecologic Oncology Associates Inc
    • New York
      • Brooklyn, New York, Forenede Stater, 11203
        • State University of New York Downstate Medical Center
      • Lake Success, New York, Forenede Stater, 11042
        • Northwell Health/Center for Advanced Medicine
      • Manhasset, New York, Forenede Stater, 11030
        • North Shore University Hospital
      • New Hyde Park, New York, Forenede Stater, 11040
        • Long Island Jewish Medical Center
      • Rochester, New York, Forenede Stater, 14642
        • University of Rochester
      • Rochester, New York, Forenede Stater, 14620
        • Highland Hospital
      • Stony Brook, New York, Forenede Stater, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Forenede Stater, 13210
        • State University of New York Upstate Medical University
    • North Carolina
      • Charlotte, North Carolina, Forenede Stater, 28204
        • Novant Health Presbyterian Medical Center
      • Clinton, North Carolina, Forenede Stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Wayne Memorial Hospital
      • Huntersville, North Carolina, Forenede Stater, 28078
        • Novant Health Presbyterian Medical Center Huntersville
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Winston-Salem, North Carolina, Forenede Stater, 27157
        • Wake Forest University Health Sciences
    • Ohio
      • Akron, Ohio, Forenede Stater, 44304
        • Summa Health System - Akron Campus
      • Beachwood, Ohio, Forenede Stater, 44122
        • UHHS-Chagrin Highlands Medical Center
      • Belpre, Ohio, Forenede Stater, 45714
        • Strecker Cancer Center-Belpre
      • Canton, Ohio, Forenede Stater, 44710
        • Aultman Health Foundation
      • Centerville, Ohio, Forenede Stater, 45459
        • Miami Valley Hospital South
      • Chillicothe, Ohio, Forenede Stater, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Forenede Stater, 45242
        • Bethesda North Hospital
      • Cleveland, Ohio, Forenede Stater, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Forenede Stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forenede Stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forenede Stater, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Forenede Stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Forenede Stater, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Forenede Stater, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Forenede Stater, 43228
        • Doctors Hospital
      • Columbus, Ohio, Forenede Stater, 43213
        • Mount Carmel East Hospital
      • Columbus, Ohio, Forenede Stater, 43215
        • Grant Medical Center
      • Columbus, Ohio, Forenede Stater, 43222
        • Mount Carmel Health Center West
      • Dayton, Ohio, Forenede Stater, 45405
        • Grandview Hospital
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Radiation Oncology
      • Delaware, Ohio, Forenede Stater, 43015
        • Grady Memorial Hospital
      • Dublin, Ohio, Forenede Stater, 43016
        • Dublin Methodist Hospital
      • Grove City, Ohio, Forenede Stater, 43123
        • Mount Carmel Grove City Hospital
      • Kettering, Ohio, Forenede Stater, 45429
        • Kettering Medical Center
      • Lancaster, Ohio, Forenede Stater, 43130
        • Fairfield Medical Center
      • Lancaster, Ohio, Forenede Stater, 43130
        • Lancaster Radiation Oncology
      • Mansfield, Ohio, Forenede Stater, 44903
        • OhioHealth Mansfield Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Marion, Ohio, Forenede Stater, 43302
        • OhioHealth Marion General Hospital
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
      • Mayfield Heights, Ohio, Forenede Stater, 44124
        • Hillcrest Hospital Cancer Center
      • Mayfield Heights, Ohio, Forenede Stater, 44124
        • UH Seidman Cancer Center at Landerbrook Health Center
      • Mentor, Ohio, Forenede Stater, 44060
        • UH Seidman Cancer Center at Lake Health Mentor Campus
      • Mount Vernon, Ohio, Forenede Stater, 43050
        • Knox Community Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Newark Radiation Oncology
      • Oregon, Ohio, Forenede Stater, 43616
        • Saint Charles Hospital
      • Portsmouth, Ohio, Forenede Stater, 45662
        • Southern Ohio Medical Center
      • Springfield, Ohio, Forenede Stater, 45505
        • Springfield Regional Medical Center
      • Sylvania, Ohio, Forenede Stater, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Forenede Stater, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forenede Stater, 43614
        • University of Toledo
      • Toledo, Ohio, Forenede Stater, 43617
        • Toledo Community Hospital Oncology Program CCOP
      • Wadsworth, Ohio, Forenede Stater, 44281
        • University Hospitals Sharon Health Center
      • West Chester, Ohio, Forenede Stater, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Westerville, Ohio, Forenede Stater, 43081
        • Saint Ann's Hospital
      • Westlake, Ohio, Forenede Stater, 44145
        • UHHS-Westlake Medical Center
      • Zanesville, Ohio, Forenede Stater, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Oklahoma City, Oklahoma, Forenede Stater, 73104
        • University of Oklahoma Health Sciences Center
      • Tulsa, Oklahoma, Forenede Stater, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Baker City, Oregon, Forenede Stater, 97814
        • Saint Alphonsus Medical Center-Baker City
      • Gresham, Oregon, Forenede Stater, 97030
        • Legacy Mount Hood Medical Center
      • Ontario, Oregon, Forenede Stater, 97914
        • Saint Alphonsus Medical Center-Ontario
      • Portland, Oregon, Forenede Stater, 97210
        • Legacy Good Samaritan Hospital and Medical Center
      • Portland, Oregon, Forenede Stater, 97213
        • Providence Portland Medical Center
      • Tualatin, Oregon, Forenede Stater, 97062
        • Legacy Meridian Park Hospital
    • Pennsylvania
      • Abington, Pennsylvania, Forenede Stater, 19001
        • Jefferson Abington Hospital
      • Allentown, Pennsylvania, Forenede Stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bethlehem, Pennsylvania, Forenede Stater, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Bethlehem, Pennsylvania, Forenede Stater, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Bryn Mawr, Pennsylvania, Forenede Stater, 19010
        • Bryn Mawr Hospital
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • Drexel Hill, Pennsylvania, Forenede Stater, 19026
        • Delaware County Memorial Hospital
      • East Stroudsburg, Pennsylvania, Forenede Stater, 18301
        • Pocono Medical Center
      • Gettysburg, Pennsylvania, Forenede Stater, 17325
        • Adams Cancer Center
      • Hanover, Pennsylvania, Forenede Stater, 17331
        • Cherry Tree Cancer Center
      • Lewisburg, Pennsylvania, Forenede Stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Forenede Stater, 17044
        • Lewistown Hospital
      • Paoli, Pennsylvania, Forenede Stater, 19301
        • Paoli Memorial Hospital
      • Philadelphia, Pennsylvania, Forenede Stater, 19111
        • Fox Chase Cancer Center
      • West Reading, Pennsylvania, Forenede Stater, 19611
        • Reading Hospital
      • Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Wynnewood, Pennsylvania, Forenede Stater, 19096
        • Lankenau Medical Center
      • York, Pennsylvania, Forenede Stater, 17403
        • WellSpan Health-York Cancer Center
      • York, Pennsylvania, Forenede Stater, 17403
        • WellSpan Health-York Hospital
    • South Carolina
      • Boiling Springs, South Carolina, Forenede Stater, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Easley, South Carolina, Forenede Stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forenede Stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greenville, South Carolina, Forenede Stater, 29601
        • Greenville Health System Cancer Institute-Andrews
      • Greer, South Carolina, Forenede Stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Seneca, South Carolina, Forenede Stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forenede Stater, 29303
        • Spartanburg Medical Center
    • South Dakota
      • Sioux Falls, South Dakota, Forenede Stater, 57105
        • Avera Cancer Institute
    • Tennessee
      • Chattanooga, Tennessee, Forenede Stater, 37403
        • Chattanooga Gynecological Oncology
      • Knoxville, Tennessee, Forenede Stater, 37920
        • University of Tennessee - Knoxville
    • Texas
      • Dallas, Texas, Forenede Stater, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Forenede Stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Houston, Texas, Forenede Stater, 77030
        • M D Anderson Cancer Center
      • Houston, Texas, Forenede Stater, 77030
        • Houston Methodist Hospital
      • Houston, Texas, Forenede Stater, 77030
        • Memorial Hermann Texas Medical Center
      • Houston, Texas, Forenede Stater, 77070
        • Methodist Willowbrook Hospital
      • Sugar Land, Texas, Forenede Stater, 77479
        • Houston Methodist Sugar Land Hospital
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84112
        • Huntsman Cancer Institute/University of Utah
      • South Jordan, Utah, Forenede Stater, 84009
        • South Jordan Health Center
    • Vermont
      • Burlington, Vermont, Forenede Stater, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Forenede Stater, 05405
        • University of Vermont and State Agricultural College
    • Washington
      • Vancouver, Washington, Forenede Stater, 98686
        • Legacy Salmon Creek Hospital
    • West Virginia
      • Morgantown, West Virginia, Forenede Stater, 26506
        • West Virginia University Healthcare
    • Wisconsin
      • Green Bay, Wisconsin, Forenede Stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Green Bay Oncology Limited at Saint Mary's Hospital
      • Green Bay, Wisconsin, Forenede Stater, 54301-3526
        • Green Bay Oncology at Saint Vincent Hospital
      • La Crosse, Wisconsin, Forenede Stater, 54601
        • Gundersen Lutheran Medical Center
      • Madison, Wisconsin, Forenede Stater, 53792
        • University of Wisconsin Hospital and Clinics
      • Milwaukee, Wisconsin, Forenede Stater, 53215
        • Aurora Saint Luke's Medical Center
      • New Richmond, Wisconsin, Forenede Stater, 54017
        • Cancer Center of Western Wisconsin
      • West Allis, Wisconsin, Forenede Stater, 53227
        • Aurora West Allis Medical Center
    • Wyoming
      • Casper, Wyoming, Forenede Stater, 82609
        • Rocky Mountain Oncology
      • Cody, Wyoming, Forenede Stater, 82414
        • Big Horn Basin Cancer Center
      • Cody, Wyoming, Forenede Stater, 82414
        • Billings Clinic-Cody
      • Sheridan, Wyoming, Forenede Stater, 82801
        • Welch Cancer Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

Inklusionskriterier:

  • Alle patienter skal have gennemgået fuldstændig hysterektomi og bilateral salpingo-ooforektomi på tidspunktet for den oprindelige behandling for deres livmoderkarcinom
  • Patienter skal have en biopsi med histologisk bekræftet diagnose af tilbagevendende endometriecancer begrænset til bækkenet og/eller skeden og ingen tegn på ekstrapelvis sygdom
  • Patienter skal have endometriekarcinom, herunder endometrioid adenokarcinom, adenokarcinom med pladeeplade differentiering, mucinøst adenokarcinom, pladecellekræft, blandet karcinom, udifferentieret karcinom, klarcellet adenokarcinom og serøst adenokarcinom histologier
  • Patienter må ikke have tegn på ekstrapelvis sygdom; fuldstændig oparbejdningsstadie skal udføres før påbegyndelse af behandling for at udelukke tilstedeværelse af metastatisk sygdom; dette bør omfatte: computertomografi (CT) scanning af thorax med IV kontrast, samt en CT af bækken og abdomen med IV og oral (PO) kontrast udført ved hjælp af multi-detektor CT og lig med eller mindre end 5 mm skivetykkelse ; hvis patienten ikke er i stand til at tolerere kontrast, skal der udføres magnetisk resonansbilleddannelse (MRI) med IV gadolinium; en røntgen af ​​thorax skal først foretages, og hvis unormalt, skal der foretages en CT-scanning af brystet

  • Primær kirurgisk debulking før protokolbehandling er tilladt; dette vil omfatte fjernelse af grov symptomatisk sygdom i bækkenet og/eller skeden

    • Eksenterativ kirurgi er ikke tilladt; patienter med fuldstændig resektion af alvorlig tilbagevendende sygdom er berettigede
  • Patienter kan have modtaget tidligere hormonbehandling og/eller systemisk kemoterapi; sådan terapi skal være afsluttet mindst 6 måneder før studiestart, og patienten har klare tegn på sygdom efter sådan terapi; patienter må ikke have modtaget neoadjuverende kemoterapi for den nuværende tilbagevendende sygdom
  • Patienter skal have Gynecologic Oncology Group (GOG) præstationsstatus 0, 1 eller 2
  • Patienter skal have en estimeret overlevelse større eller lig med 3 måneder
  • Absolut neutrofiltal (ANC) >= 1.500/mm^3, svarende til almindelige toksicitetskriterier (fælles terminologikriterier for bivirkninger [CTCAE] version [v] 3.0) grad 1
  • Blodplader >= 100.000/mm^3 (CTCAE v 3.0 grad 0-1)
  • Kreatinin =< institutionel øvre grænse normal (ULN), CTCAE v 3.0 grad 0; BEMÆRK: hvis kreatinin > ULN, skal kreatininclearance være > 50 ml/min.
  • Bilirubin =< 1,5 x ULN (CTCAE v 3.0 grad 1)
  • Serumglutamin-oxaloeddikesyretransaminase (SGOT) =< 2,5 x ULN (CTCAE v 3.0 grad 0-1)
  • Alkalisk fosfatase =< 2,5 x ULN (CTCAE v 3.0 grad 0-1)
  • Neuropati (sensorisk og motorisk) =< CTCAE v 3.0 grad 1
  • Patienter med ureteral obstruktion skal gennemgå stent- eller nefrostomirørsplacering før studiestart
  • Patienter, der har opfyldt før-adgangskravene
  • Patienter skal have underskrevet et godkendt informeret samtykke og godkendelse fra Health Insurance Portability and Accountability Act (HIPAA)

Ekskluderingskriterier:

  • Patienter med tegn på sygdom uden for bækkenet, herunder tilstedeværelse af positive periaortiske eller inguino-femorale noder
  • Patienter, der tidligere har modtaget vaginal, bækken- eller abdominal bestråling
  • Patienter, der modtog kemoterapi rettet mod det nuværende tilbagefald
  • Patienter med septikæmi eller alvorlig infektion
  • Patienter, der har omstændigheder, der ikke tillader fuldførelse af denne undersøgelse eller den nødvendige opfølgning
  • Patienter med nyreabnormiteter, såsom bækkennyre, hestesko-nyre eller nyretransplantation, som ville kræve modifikation af strålingsfelter
  • Patienter med en anamnese med andre invasive maligniteter, med undtagelse af non-melanom hudcancer, udelukkes, hvis der er tegn på, at andre maligne sygdomme er til stede inden for de sidste fem år; patienter er også udelukket, hvis deres tidligere kræftbehandling kontraindicerer denne protokolbehandling
  • Patienter, der har gennemgået fuldstændig kirurgisk resektion af den tilbagevendende tumor og ikke har tegn på resterende sygdom, der kan vurderes klinisk og ved CT- eller MR-billeddannelse efter resektion
  • Patienter, der har en betydelig historie med hjertesygdom, dvs. ukontrolleret hypertension, ustabil angina, kongestiv hjertesvigt eller ukontrollerede arytmier inden for 6 måneder efter registreringen
  • Patienter med en historie med aktiv kollagen vaskulær sygdom
  • Patienter med GOG præstationsgrad på 3 eller 4

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Arm I (brachyterapi, strålebehandling)
Patienter gennemgår EBRT til bækkenet dagligt på dag 1-5 i 5 uger. Efter afslutning af EBRT gennemgår patienter intrakavitær lavdosis- eller højdosis-brachyterapi eller interstitiel brachyterapi med lav dosis.
Stråling: Intensitetsmoduleret strålebehandling
Gennemgå IMRT
Andre navne:
  • IMRT
  • Intensitetsmoduleret RT
  • Intensitetsmoduleret strålebehandling
  • Stråling, intensitetsmoduleret strålebehandling
Stråling: 3-dimensionel konform strålebehandling
Gennemgå 3-dimensionel konform strålebehandling
Andre navne:
  • 3-dimensionel strålebehandling
  • 3D KONFORMAL STRÅLETERAPI
  • 3D CRT
  • 3D-CRT
  • Konform terapi
  • Stråling konform terapi
  • 3D konform
  • Stråling, 3D-konform
Stråling: Intern Stråleterapi
Gives intrakavitært eller interstitielt
Andre navne:
  • Brachyterapi, NOS
  • Intern stråling
  • Intern strålings brachyterapi
  • Strålingsbrachyterapi
  • Stråling, indre
  • Brachyterapi
Eksperimentel: Arm II (brachyterapi, strålebehandling, cisplatin)
Patienter gennemgår EBRT som i arm I og får cisplatin IV over 1-2 timer på dag 1, 8, 15, 22 og 29. Patienterne gennemgår derefter brachyterapi som i arm I.
Medicin: Cisplatin
Givet IV
Andre navne:
  • CDDP
  • Cis-diammindichloridoplatin
  • Cismaplat
  • Cisplatin
  • Neoplatin
  • Platinol
  • Abiplatin
  • Blastolem
  • Briplatin
  • Cis-diammin-dichlorplatin
  • Cis-diammindichlor platin (II)
  • Cis-diamindichlorplatin
  • Cis-dichloramin Platin (II)
  • Cis-platinøst diamin dichlorid
  • Cis-platin
  • Cis-platin II
  • Cis-platin II diamin dichlorid
  • Cisplatina
  • Cisplatyl
  • Citoplatino
  • Citosin
  • Cysplatyna
  • DDP
  • Lederplatin
  • Metaplatin
  • Placis
  • Plastistil
  • Platamin
  • Platiblastin
  • Platiblastin-S
  • Platinex
  • Platinol-AQ
  • Platinol-AQ VHA Plus
  • Platinoxan
  • Platin
  • Platindiaminodichlorid
  • Platiran
  • Platistin
  • Platosin
  • Peyrones klorid
  • Peyrones salt
Stråling: Intensitetsmoduleret strålebehandling
Gennemgå IMRT
Andre navne:
  • IMRT
  • Intensitetsmoduleret RT
  • Intensitetsmoduleret strålebehandling
  • Stråling, intensitetsmoduleret strålebehandling
Stråling: 3-dimensionel konform strålebehandling
Gennemgå 3-dimensionel konform strålebehandling
Andre navne:
  • 3-dimensionel strålebehandling
  • 3D KONFORMAL STRÅLETERAPI
  • 3D CRT
  • 3D-CRT
  • Konform terapi
  • Stråling konform terapi
  • 3D konform
  • Stråling, 3D-konform
Stråling: Intern Stråleterapi
Gives intrakavitært eller interstitielt
Andre navne:
  • Brachyterapi, NOS
  • Intern stråling
  • Intern strålings brachyterapi
  • Strålingsbrachyterapi
  • Stråling, indre
  • Brachyterapi

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Antal deltagere med sygdomsprogression eller død.
Tidsramme: Median opfølgning for progressionsfri overlevelse var 62 måneder med et maksimum på 128 måneder. Patienterne blev fulgt fra studiestart til sygdomsprogression, død eller dato for sidste kontakt
Antallet af deltagere med sygdomsprogression eller død fra studiestart til progression eller død. Deltagere, der oplevede progression eller død, blev rapporteret af behandlingsarmen.
Median opfølgning for progressionsfri overlevelse var 62 måneder med et maksimum på 128 måneder. Patienterne blev fulgt fra studiestart til sygdomsprogression, død eller dato for sidste kontakt

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Antal deltagere, der oplevede død ved undersøgelse
Tidsramme: Deltagerne blev fulgt fra studiestart til død eller dato for sidste kontakt. Median opfølgning for den samlede overlevelse var 62 måneder med et maksimum på 128 måneder.
Samlet overlevelse er perioden fra studiestart til død eller dato for sidste kontakt. Behandlingsregimerne blev sammenlignet med hensyn til den samlede overlevelse.
Deltagerne blev fulgt fra studiestart til død eller dato for sidste kontakt. Median opfølgning for den samlede overlevelse var 62 måneder med et maksimum på 128 måneder.
Antal deltagere i udvalgte prognostiske grupper, der oplevede progression eller død ved undersøgelse.
Tidsramme: Median opfølgning for progressionsfri overlevelse var 62 måneder med et maksimum på 128 måneder.
Deltagerne blev sat i prognostiske grupper, herunder basislinjefaktorer for tumorplacering (kun vagina vs. alle andre) og histologi (alvorlige og klare celler vs. alle andre). De blev vurderet for prognostiske sammenhænge med progressionsfri overlevelse. Deltagerfaktorer blev indsamlet ved baseline. Deltagerne blev fulgt fra studiestart til sygdomsprogression, død eller dato for sidste kontakt for progressionsfri overlevelse.
Median opfølgning for progressionsfri overlevelse var 62 måneder med et maksimum på 128 måneder.
Antal deltagere, der oplevede bivirkninger, grad 3 eller højere
Tidsramme: Maksimal opfølgning for bivirkninger var 61 måneder.
Antal behandlede deltagere med bivirkninger af grad 3 eller højere. Bedømt efter Common Terminology Criteria for Adverse Events version 3.0. Behandlede patienter blev evalueret for uønskede hændelser i behandlingsperioden, hver måned i de første tre måneder efter afslutning af behandlingen op til 2 år og derefter hver sjette måned i de næste 3 år.
Maksimal opfølgning for bivirkninger var 61 måneder.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

GOG Foundation

Samarbejdspartnere

National Cancer Institute (NCI)

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

25. februar 2008

Primær færdiggørelse (Faktiske)

15. december 2021

Datoer for studieregistrering

Først indsendt

25. juni 2007

Først indsendt, der opfyldte QC-kriterier

25. juni 2007

Først opslået (Skøn)

27. juni 2007

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. marts 2023

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. marts 2023

Sidst verificeret

1. marts 2023

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • GOG-0238 (Anden identifikator: CTEP)
  • U10CA180868 (U.S. NIH-bevilling/kontrakt)
  • U10CA027469 (U.S. NIH-bevilling/kontrakt)
  • NCI-2009-00603 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • CDR0000550975

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Burkina Faso

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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