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Sammenligning af strålebehandling med sædvanlig pleje til patienter med højrisiko knogleasymptomatiske metastaser (PREEMPT)

14. august 2026 opdateret af: NRG Oncology

Stråleterapi for højrisiko asymptomatiske knoglemetastaser: et pragmatisk multicenter randomiseret fase 3 klinisk forsøg (PREEMPT)

Dette fase III-forsøg sammenligner effekten af at tilføje strålebehandling til sædvanlig behandling på forekomsten af knoglerelaterede komplikationer hos cancerpatienter med højrisiko-knoglemetastaser, som ikke forårsager symptomer (asymptomatisk). Højrisiko-knoglemetastaser er defineret af deres placering (inklusive hofte, skulder, lange knogler og visse niveauer af rygsøjlen) eller størrelse (2 cm eller større). Disse knoglemetastaser ser ud til at have højere risiko for komplikationer såsom fraktur, rygmarvskompression og/eller smerte, der berettiger operation eller strålebehandling. Strålebehandling bruger højenergi røntgenstråler til at dræbe kræftceller og formindske tumorer. Den samlede strålingsdosis kan leveres på en enkelt dag eller opdeles i mindre doser i op til 5 dages total behandling. Sædvanlig pleje af asymptomatiske knoglemetastaser kan omfatte lægemidler, der forhindrer knogletab, ud over behandlingen for den primære cancer eller observation (hvilket betyder ingen behandling, før symptomer viser sig). Beviser har vist, at forebyggende strålebehandling kan være effektiv til at sænke antallet af knoglemetastaser-relaterede komplikationer, men det vides ikke, om denne tilgang er overlegen i forhold til sædvanlig pleje. Tilføjelse af strålebehandling til sædvanlig pleje kan være mere effektiv til at forebygge knoglerelaterede komplikationer end sædvanlig pleje alene hos cancerpatienter med asymptomatiske højrisiko-knoglemetastaser.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆR MÅL:

I. For at bestemme, om profylaktisk strålebehandling (RT) til asymptomatiske knoglemetastaser med høj risiko reducerer forekomsten af skeletrelaterede hændelser (SRE), herunder patologisk fraktur, rygmarvskompression og kirurgi i knogle (ikke inklusive palliativ stråling kun for smerte ), sammenlignet med standardbehandling (SOC).

SEKUNDÆRE MÅL:

I. At sammenligne overordnet overlevelse (OS) mellem undersøgelsesarme. II. At sammenligne forekomsten af eventuelle SRE'er (inklusive RT til lindring af smerte) blandt tilmeldte knoglemetastaser mellem undersøgelsesarme.

III. At sammenligne forekomsten af hospitalsindlæggelser relateret til eventuelle SRE'er i tilmeldte knoglemetastaser mellem undersøgelsesarme.

IV. At sammenligne smerterelateret livskvalitet (QOL) mellem undersøgelsesarme. V. At karakterisere bivirkninger af RT og sammenligne med SOC.

UNDERSØGENDE MÅL:

I. At evaluere overordnet QOL, funktionel status og kvalitetsjusterede leveår mellem undersøgelsesarme.

II. At evaluere eventuelle hospitalsindlæggelser (uanset årsag) mellem undersøgelsesarme. III. At karakterisere forskelle i primære og sekundære endepunkter mellem undersøgelsesarme (a) blandt de repræsenterede race- og etniske grupper (f. Sort, hvid, latinamerikansk/latino, asiatisk/stillehavsøboer og indianer) og (b) efter køn.

IV. At evaluere heterogeniteten af strålebehandlingseffekt baseret på kræftrelaterede faktorer (histologi, kriterier, der indikerer høj risiko for SRE), behandlingsrelaterede faktorer (brug af knoglemodificerende midler, stråledosis/teknik) og patientdemografiske faktorer (alder, køn) race/etnicitet og sundhedsrelaterede sociale behov).

OVERSIGT: Patienterne randomiseres til 1 ud af 2 arme.

ARM I: Patienter fortsætter med at modtage SOC systemisk anti-cancerterapi eller observations- og knoglemodificerende midler som bestemt af den behandlende læge. Derudover gennemgår patienterne valgfri blodprøvetagning ved undersøgelse.

ARM II: Patienter fortsætter med SOC som i arm I. Patienter gennemgår også konventionel RT eller stereotaktisk kropsstrålebehandling (SBRT) én gang dagligt (QD) i op til 5 dage (5 fraktioner) i fravær af sygdomsprogression eller uacceptabel toksicitet. Derudover gennemgår patienter computertomografi (CT) eller magnetisk resonansbilleddannelse (MRI) og valgfri blodprøvetagning ved undersøgelse.

Efter afsluttet undersøgelsesbehandling følges patienterne op efter 3, 6, 12 og 24 måneder.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

280

Fase

Fase 3

Kontakter og lokationer

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

Studiesteder

Canada
- Ontario
  - Toronto, Ontario, Canada, M5G 2M9
    - University Health Network-Princess Margaret Hospital
- Quebec
  - Montreal, Quebec, Canada, H3H 2R9
    - The Research Institute of the McGill University Health Centre (MUHC)
Forenede Stater
- Alaska
  - Fairbanks, Alaska, Forenede Stater, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Gilbert, Arizona, Forenede Stater, 85234
    - Banner MD Anderson Cancer Center
  - Phoenix, Arizona, Forenede Stater, 85004
    - Cancer Center at Saint Joseph's
  - Phoenix, Arizona, Forenede Stater, 85006
    - Banner-University Medical Center Phoenix
  - Tucson, Arizona, Forenede Stater, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Forenede Stater, 85719
    - University of Arizona Cancer Center-North Campus
- California
  - Anaheim, California, Forenede Stater, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, Forenede Stater, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Forenede Stater, 93420
    - Mission Hope Medical Oncology - Arroyo Grande
  - Auburn, California, Forenede Stater, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Forenede Stater, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Bakersfield, California, Forenede Stater, 93301
    - AIS Cancer Center at San Joaquin Community Hospital
  - Bellflower, California, Forenede Stater, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, Forenede Stater, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burlingame, California, Forenede Stater, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Forenede Stater, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Carmichael, California, Forenede Stater, 95608
    - Mercy San Juan Medical Center
  - Carmichael, California, Forenede Stater, 95608
    - Mercy Cancer Center - Carmichael
  - Castro Valley, California, Forenede Stater, 94546
    - Eden Hospital Medical Center
  - Corona, California, Forenede Stater, 92882
    - City of Hope Corona
  - Duarte, California, Forenede Stater, 91010
    - City of Hope Comprehensive Cancer Center
  - Dublin, California, Forenede Stater, 94568
    - Kaiser Permanente Dublin
  - Elk Grove, California, Forenede Stater, 95758
    - Mercy Cancer Center - Elk Grove
  - Encinitas, California, Forenede Stater, 92024
    - UC San Diego Health System - Encinitas
  - Fremont, California, Forenede Stater, 94538
    - Kaiser Permanente-Fremont
  - Fremont, California, Forenede Stater, 94538
    - Palo Alto Medical Foundation-Fremont
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente-Fresno
  - Fresno, California, Forenede Stater, 93720
    - Fresno Cancer Center
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente Fresno Orchard Plaza
  - Irvine, California, Forenede Stater, 92618
    - City of Hope at Irvine Lennar
  - Irvine, California, Forenede Stater, 92612
    - UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
  - La Jolla, California, Forenede Stater, 92093
    - UC San Diego Moores Cancer Center
  - Lancaster, California, Forenede Stater, 93534
    - City of Hope Antelope Valley
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Martinez, California, Forenede Stater, 94553-3156
    - Contra Costa Regional Medical Center
  - Modesto, California, Forenede Stater, 95355
    - Memorial Medical Center
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente-Modesto
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente- Modesto MOB II
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente-Oakland
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente Oakland-Broadway
  - Ontario, California, Forenede Stater, 91761
    - Kaiser Permanente-Ontario
  - 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
  - Rancho Cordova, California, Forenede Stater, 95670
    - Kaiser Permanente-Rancho Cordova Cancer Center
  - Redwood City, California, Forenede Stater, 94063
    - Kaiser Permanente- Marshall Medical Offices
  - Richmond, California, Forenede Stater, 94801
    - Kaiser Permanente-Richmond
  - Rocklin, California, Forenede Stater, 95765
    - Mercy Cancer Center - Rocklin
  - Rohnert Park, California, Forenede Stater, 94928
    - Rohnert Park Cancer Center
  - Roseville, California, Forenede Stater, 95661
    - Kaiser Permanente-Roseville
  - 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, 95814
    - Kaiser Permanente Downtown Commons
  - Sacramento, California, Forenede Stater, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forenede Stater, 95823
    - South Sacramento Cancer Center
  - Sacramento, California, Forenede Stater, 95816
    - Mercy Cancer Center - Sacramento
  - San Diego, California, Forenede Stater, 92103
    - UC San Diego Medical Center - Hillcrest
  - San Francisco, California, Forenede Stater, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Forenede Stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Forenede Stater, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Leandro, California, Forenede Stater, 94577
    - Kaiser Permanente San Leandro
  - San Luis Obispo, California, Forenede Stater, 93401
    - Pacific Central Coast Health Center-San Luis Obispo
  - San Mateo, California, Forenede Stater, 94401
    - Mills Health Center
  - San Rafael, California, Forenede Stater, 94903
    - Kaiser San Rafael-Gallinas
  - Santa Barbara, California, Forenede Stater, 93105
    - Ridley-Tree Cancer Center
  - Santa Clara, California, Forenede Stater, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Forenede Stater, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Maria, California, Forenede Stater, 93444
    - Mission Hope Medical Oncology - Santa Maria
  - Santa Rosa, California, Forenede Stater, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Forenede Stater, 95403
    - Sutter Pacific Medical Foundation
  - South Pasadena, California, Forenede Stater, 91030
    - City of Hope South Pasadena
  - South San Francisco, California, Forenede Stater, 94080
    - Kaiser Permanente Cancer Treatment Center
  - South San Francisco, California, Forenede Stater, 94080
    - Kaiser Permanente-South San Francisco
  - Stockton, California, Forenede Stater, 95210
    - Kaiser Permanente-Stockton
  - Stockton, California, Forenede Stater, 95204
    - Saint Joseph's Medical Center
  - Sunnyvale, California, Forenede Stater, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Upland, California, Forenede Stater, 91786
    - City of Hope Upland
  - Vacaville, California, Forenede Stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vallejo, California, Forenede Stater, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Forenede Stater, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Forenede Stater, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Forenede Stater, 94598
    - John Muir Medical Center-Walnut Creek
  - Walnut Creek, California, Forenede Stater, 94598
    - BASS Medical Group - Lennon
  - Woodland, California, Forenede Stater, 95695
    - Woodland Memorial Hospital
- Colorado
  - Aurora, Colorado, Forenede Stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forenede Stater, 80045
    - UCHealth University of Colorado Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Colorado Springs, Colorado, Forenede Stater, 80920
    - Memorial Hospital North
  - Colorado Springs, Colorado, Forenede Stater, 80923
    - Saint Francis Cancer Center
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forenede Stater, 80206
    - UCHealth - Cherry Creek
  - Denver, Colorado, Forenede Stater, 80210
    - AdventHealth Porter
  - Englewood, Colorado, Forenede Stater, 80113
    - The Melanoma and Skin Cancer Institute
  - Greeley, Colorado, Forenede Stater, 80631
    - Banner North Colorado Medical Center
  - Highlands Ranch, Colorado, Forenede Stater, 80129
    - UCHealth Highlands Ranch Hospital
  - Lakewood, Colorado, Forenede Stater, 80228
    - CommonSpirit Saint Anthony Hospital Cancer Center
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - AdventHealth Littleton
  - Longmont, Colorado, Forenede Stater, 80501
    - Longmont United Hospital
  - Loveland, Colorado, Forenede Stater, 80539
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker, Colorado, Forenede Stater, 80138
    - AdventHealth Parker
  - Pueblo, Colorado, Forenede Stater, 81004
    - Saint Mary Corwin Medical Center
  - Thornton, Colorado, Forenede Stater, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Westminster, Colorado, Forenede Stater, 80023
    - Saint Anthony North Hospital
- Connecticut
  - Danbury, Connecticut, Forenede Stater, 06810
    - Danbury Hospital
  - Norwalk, Connecticut, Forenede Stater, 06856
    - Norwalk Hospital
- Delaware
  - Lewes, Delaware, Forenede Stater, 19958
    - Beebe Medical Center
  - Millville, Delaware, Forenede Stater, 19967
    - Beebe South Coastal Health Campus
  - Newark, Delaware, Forenede Stater, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Forenede Stater, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Forenede Stater, 19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach, Delaware, Forenede Stater, 19971
    - Beebe Health Campus
  - Wilmington, Delaware, Forenede Stater, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington D.C., District of Columbia, Forenede Stater, 20037
    - George Washington University Medical Center
- Florida
  - Aventura, Florida, Forenede Stater, 33180
    - UM Sylvester Comprehensive Cancer Center at Aventura
  - Bay Pines, Florida, Forenede Stater, 33744
    - Bay Pines VA Healthcare System
  - Coral Gables, Florida, Forenede Stater, 33146
    - UM Sylvester Comprehensive Cancer Center at Coral Gables
  - Daytona Beach, Florida, Forenede Stater, 32117
    - AdventHealth Daytona Beach
  - Deerfield Beach, Florida, Forenede Stater, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Doral, Florida, Forenede Stater, 33166
    - UM Sylvester Comprehensive Cancer Center at Doral
  - Fort Lauderdale, Florida, Forenede Stater, 33308
    - Holy Cross Hospital
  - Hollywood, Florida, Forenede Stater, 33021
    - Memorial Regional Hospital/Joe DiMaggio Children's Hospital
  - Miami, Florida, Forenede Stater, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami, Florida, Forenede Stater, 33176
    - Miami Cancer Institute
  - Miami, Florida, Forenede Stater, 33176
    - UM Sylvester Comprehensive Cancer Center at Kendall
  - Pembroke Pines, Florida, Forenede Stater, 33028
    - Memorial Hospital West
  - Plantation, Florida, Forenede Stater, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Ruskin, Florida, Forenede Stater, 33570
    - Moffitt Cancer Center at SouthShore
  - Tampa, Florida, Forenede Stater, 33612
    - Moffitt Cancer Center
  - Tampa, Florida, Forenede Stater, 33607
    - Moffitt Cancer Center-International Plaza
  - Tampa, Florida, Forenede Stater, 33612
    - Moffitt Cancer Center - McKinley Campus
  - Wesley Chapel, Florida, Forenede Stater, 33544
    - Moffitt Cancer Center at Wesley Chapel
- Georgia
  - Atlanta, Georgia, Forenede Stater, 30308
    - Emory University Hospital Midtown
  - Atlanta, Georgia, Forenede Stater, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Forenede Stater, 30342
    - Emory Saint Joseph's Hospital
  - Atlanta, Georgia, Forenede Stater, 30303
    - Grady Health System
  - Decatur, Georgia, Forenede Stater, 30033
    - Emory Decatur Hospital
- Hawaii
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Cancer Cenrer - POB I
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Forenede Stater, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Kailua, Hawaii, Forenede Stater, 96734
    - Castle Medical Center
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Hawaii Cancer Care - Westridge
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - The Cancer Center of Hawaii-Pali Momi
  - ‘Ewa Beach, Hawaii, Forenede Stater, 96706
    - The Queen's Medical Center - West Oahu
- 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
  - Meridian, Idaho, Forenede Stater, 83642
    - Idaho Urologic Institute-Meridian
  - Nampa, Idaho, Forenede Stater, 83687
    - Saint Alphonsus Cancer Care Center-Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Clinic Cancer Services - Post Falls
- Illinois
  - Alton, Illinois, Forenede Stater, 62002
    - Alton Memorial Hospital
  - Aurora, Illinois, Forenede Stater, 60504
    - Rush-Copley Medical Center
  - Aurora, Illinois, Forenede Stater, 60506
    - Advocate Outpatient Center - Aurora
  - Barrington, Illinois, Forenede Stater, 60010
    - Advocate Good Shepherd Hospital
  - Bloomington, Illinois, Forenede Stater, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Forenede Stater, 61701
    - OSF Saint Joseph Medical Center
  - Canton, Illinois, Forenede Stater, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, Forenede Stater, 62902
    - Memorial Hospital of Carbondale
  - Carterville, Illinois, Forenede Stater, 62918
    - SIH Cancer Institute
  - Carthage, Illinois, Forenede Stater, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Forenede Stater, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Forenede Stater, 60611
    - Northwestern University
  - Chicago, Illinois, Forenede Stater, 60657
    - Advocate Illinois Masonic Medical Center
  - Chicago, Illinois, Forenede Stater, 60612
    - Rush MD Anderson Cancer Center
  - Crystal Lake, Illinois, Forenede Stater, 60014
    - AMG Crystal Lake - Oncology
  - Danville, Illinois, Forenede Stater, 61832
    - Carle at The Riverfront
  - DeKalb, Illinois, Forenede Stater, 60115
    - Northwestern Medicine Cancer Center Kishwaukee
  - Decatur, Illinois, Forenede Stater, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Forenede Stater, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Dixon, Illinois, Forenede Stater, 61021
    - Illinois CancerCare-Dixon
  - Downers Grove, Illinois, Forenede Stater, 60515
    - Advocate Good Samaritan Hospital
  - Effingham, Illinois, Forenede Stater, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Forenede Stater, 62401
    - Carle Physician Group-Effingham
  - Elgin, Illinois, Forenede Stater, 60123
    - Advocate Sherman Hospital
  - Elmhurst, Illinois, Forenede Stater, 60126
    - Elmhurst Memorial Hospital
  - Eureka, Illinois, Forenede Stater, 61530
    - Illinois CancerCare-Eureka
  - Galesburg, Illinois, Forenede Stater, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, Forenede Stater, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Hazel Crest, Illinois, Forenede Stater, 60429
    - Advocate South Suburban Hospital
  - Kewanee, Illinois, Forenede Stater, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Forenede Stater, 60048
    - Condell Memorial Hospital
  - Libertyville, Illinois, Forenede Stater, 60048
    - AMG Libertyville - Oncology
  - Macomb, Illinois, Forenede Stater, 61455
    - Illinois CancerCare-Macomb
  - Mattoon, Illinois, Forenede Stater, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood, Illinois, Forenede Stater, 60153
    - Loyola University Medical Center
  - Naperville, Illinois, Forenede Stater, 60540
    - Edward Hospital/Cancer Center
  - Normal, Illinois, Forenede Stater, 61761
    - Carle Cancer Institute Normal
  - Normal, Illinois, Forenede Stater, 61761
    - Carle BroMenn Medical Center
  - O'Fallon, Illinois, Forenede Stater, 62269
    - Cancer Care Center of O'Fallon
  - O'Fallon, Illinois, Forenede Stater, 62269
    - HSHS Saint Elizabeth's Hospital
  - Oak Brook, Illinois, Forenede Stater, 60523
    - Northwestern Medicine Oak Brook
  - Oak Lawn, Illinois, Forenede Stater, 60453-2699
    - Advocate Christ Medical Center
  - Oak Park, Illinois, Forenede Stater, 60304
    - Rush MD Anderson Cancer Center at Rush Oak Park
  - Orland Park, Illinois, Forenede Stater, 60462
    - Northwestern Medicine Orland Park
  - Ottawa, Illinois, Forenede Stater, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Palos Heights, Illinois, Forenede Stater, 60463
    - Advocate High Tech Medical Park
  - Park Ridge, Illinois, Forenede Stater, 60068
    - Advocate Lutheran General Hospital
  - Pekin, Illinois, Forenede Stater, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, Forenede Stater, 61554
    - OSF Saint Francis Radiation Oncology at Pekin
  - 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
  - Rockford, Illinois, Forenede Stater, 61114
    - UW Health Carbone Cancer Center Rockford
  - Shiloh, Illinois, Forenede Stater, 62269
    - Memorial Hospital East
  - Springfield, Illinois, Forenede Stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forenede Stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forenede Stater, 62781
    - Springfield Memorial Hospital
  - Urbana, Illinois, Forenede Stater, 61801
    - Carle Cancer Center
  - Warrenville, Illinois, Forenede Stater, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Washington, Illinois, Forenede Stater, 61571
    - Illinois CancerCare - Washington
  - Zion, Illinois, Forenede Stater, 60099
    - Midwestern Regional Medical Center
- Indiana
  - Avon, Indiana, Forenede Stater, 46123
    - IU Health West Hospital
  - Carmel, Indiana, Forenede Stater, 46032
    - IU Health North Hospital
  - Crown Point, Indiana, Forenede Stater, 46307
    - Northwest Cancer Center - Crown Point
  - Dyer, Indiana, Forenede Stater, 46311
    - Northwest Oncology LLC
  - Goshen, Indiana, Forenede Stater, 46526
    - Goshen Center for Cancer Care
  - Hobart, Indiana, Forenede Stater, 46342
    - Northwest Cancer Center - Hobart
  - Hobart, Indiana, Forenede Stater, 46342
    - Saint Mary Medical Center
  - Indianapolis, Indiana, Forenede Stater, 46202
    - Indiana University/Melvin and Bren Simon Cancer Center
  - Indianapolis, Indiana, Forenede Stater, 46202
    - IU Health Methodist Hospital
  - Munster, Indiana, Forenede Stater, 46321
    - The Community Hospital
  - Munster, Indiana, Forenede Stater, 46321
    - Women's Diagnostic Center - Munster
  - Richmond, Indiana, Forenede Stater, 47374
    - Reid Health
  - Valparaiso, Indiana, Forenede Stater, 46383
    - Northwest Cancer Center - Valparaiso
- Iowa
  - Ames, Iowa, Forenede Stater, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Forenede Stater, 50010
    - McFarland Clinic - Ames
  - Ankeny, Iowa, Forenede Stater, 50023
    - UI Health Care Mission Cancer and Blood - Ankeny Clinic
  - Cedar Rapids, Iowa, Forenede Stater, 52402
    - Saint Luke's Hospital
  - Clive, Iowa, Forenede Stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forenede Stater, 50325
    - UI Health Care Mission Cancer and Blood - West Des Moines Clinic
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - 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
    - UI Health Care Mission Cancer and Blood - Des Moines Clinic
  - Des Moines, Iowa, Forenede Stater, 50314
    - UI Health Care Mission Cancer and Blood - Laurel Clinic
  - Waukee, Iowa, Forenede Stater, 50263
    - UI Health Care Mission Cancer and Blood - Waukee Clinic
  - West Des Moines, Iowa, Forenede Stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Lawrence, Kansas, Forenede Stater, 66044
    - Lawrence Memorial Hospital
  - Olathe, Kansas, Forenede Stater, 66061
    - The University of Kansas Cancer Center - Olathe
  - Overland Park, Kansas, Forenede Stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Forenede Stater, 66211
    - University of Kansas Hospital-Indian Creek Campus
  - Salina, Kansas, Forenede Stater, 67401
    - Salina Regional Health Center
  - Topeka, Kansas, Forenede Stater, 66606
    - University of Kansas Health System Saint Francis Campus
  - Westwood, Kansas, Forenede Stater, 66205
    - University of Kansas Hospital-Westwood Cancer Center
- Kentucky
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Forenede Stater, 40509
    - Saint Joseph Hospital East
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Hospital
  - Louisville, Kentucky, Forenede Stater, 40202
    - Norton Hospital Pavilion and Medical Campus
  - Louisville, Kentucky, Forenede Stater, 40241
    - Norton Brownsboro Hospital and Medical Campus
  - Louisville, Kentucky, Forenede Stater, 40207
    - Norton Suburban Hospital and Medical Campus
  - Louisville, Kentucky, Forenede Stater, 40217
    - Norton Audubon Hospital and Medical Campus
- Maine
  - Bath, Maine, Forenede Stater, 04530
    - MaineHealth Coastal Cancer Treatment Center
  - Belfast, Maine, Forenede Stater, 04915
    - MaineHealth Waldo Hospital
  - Damariscotta, Maine, Forenede Stater, 04543
    - MaineHealth LincolnHealth Hospital
  - Portland, Maine, Forenede Stater, 04102
    - MaineHealth Maine Medical Center - Portland
  - Rockport, Maine, Forenede Stater, 04856
    - Penobscot Bay Medical Center
  - Sanford, Maine, Forenede Stater, 04073
    - MaineHealth Cancer Care Center of York County
  - Scarborough, Maine, Forenede Stater, 04074
    - MaineHealth Maine Medical Center- Scarborough
  - South Portland, Maine, Forenede Stater, 04106
    - MaineHealth Cancer Care and IV Therapy - South Portland
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Forenede Stater, 21201
    - University of Maryland/Greenebaum Cancer Center
  - Baltimore, Maryland, Forenede Stater, 21201
    - Maryland Proton Treatment Center
  - Bel Air, Maryland, Forenede Stater, 21014
    - UM Upper Chesapeake Medical Center
  - Columbia, Maryland, Forenede Stater, 21044
    - Central Maryland Radiation Oncology in Howard County
  - Cumberland, Maryland, Forenede Stater, 21502
    - UPMC Western Maryland
  - Easton, Maryland, Forenede Stater, 21601
    - University of Maryland Shore Medical Center at Easton
  - Glen Burnie, Maryland, Forenede Stater, 21061
    - UM Baltimore Washington Medical Center/Tate Cancer Center
  - Largo, Maryland, Forenede Stater, 20774
    - UM Capital Region Medical Center
  - Towson, Maryland, Forenede Stater, 21204
    - UM Saint Joseph Medical Center
  - Westminster, Maryland, Forenede Stater, 21157
    - William E Kahlert Regional Cancer Center/Sinai Hospital
- Massachusetts
  - Boston, Massachusetts, Forenede Stater, 02111
    - Tufts Medical Center
- Michigan
  - Alma, Michigan, Forenede Stater, 48801
    - MyMichigan Medical Center Gratiot
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Trinity Health Saint Joseph Mercy Hospital Ann Arbor
  - Bay City, Michigan, Forenede Stater, 48706
    - McLaren Cancer Institute-Bay City
  - Brighton, Michigan, Forenede Stater, 48114
    - Trinity Health IHA Medical Group Hematology Oncology - Brighton
  - Brighton, Michigan, Forenede Stater, 48114
    - Trinity Health Medical Center - Brighton
  - Canton, Michigan, Forenede Stater, 48188
    - Trinity Health IHA Medical Group Hematology Oncology - Canton
  - Canton, Michigan, Forenede Stater, 48188
    - Trinity Health Medical Center - Canton
  - Chelsea, Michigan, Forenede Stater, 48118
    - Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
  - Chelsea, Michigan, Forenede Stater, 48118
    - Chelsea Hospital
  - Clarkston, Michigan, Forenede Stater, 48346
    - McLaren Cancer Institute-Clarkston
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Forenede Stater, 48236
    - Henry Ford Health Saint John Hospital
  - Farmington Hills, Michigan, Forenede Stater, 48334
    - Weisberg Cancer Treatment Center
  - Flint, Michigan, Forenede Stater, 48532
    - McLaren Cancer Institute-Flint
  - Flint, Michigan, Forenede Stater, 48503
    - Hurley Medical Center
  - Flint, Michigan, Forenede Stater, 48503
    - Genesys Hurley Cancer Institute
  - Grosse Pointe Woods, Michigan, Forenede Stater, 48236
    - Henry Ford Saint John Hospital - Van Elslander
  - Lansing, Michigan, Forenede Stater, 48910
    - Karmanos Cancer Institute at McLaren Greater Lansing
  - Lansing, Michigan, Forenede Stater, 48912
    - University of Michigan Health - Sparrow Lansing
  - Lapeer, Michigan, Forenede Stater, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, Forenede Stater, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Macomb, Michigan, Forenede Stater, 48044
    - Henry Ford Saint John Hospital - Macomb Medical
  - Midland, Michigan, Forenede Stater, 48670
    - MyMichigan Medical Center Midland
  - Mount Clemens, Michigan, Forenede Stater, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, Forenede Stater, 48858
    - McLaren Cancer Institute-Central Michigan
  - Petoskey, Michigan, Forenede Stater, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Forenede Stater, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Pontiac, Michigan, Forenede Stater, 48341
    - Michigan Healthcare Professionals Pontiac
  - Port Huron, Michigan, Forenede Stater, 48060
    - McLaren-Port Huron
  - Saginaw, Michigan, Forenede Stater, 48601
    - MyMichigan Medical Center Saginaw
  - Tawas City, Michigan, Forenede Stater, 48764
    - MyMichigan Medical Center Tawas
  - Warren, Michigan, Forenede Stater, 48093
    - Henry Ford Health Warren Hospital
  - Ypsilanti, Michigan, Forenede Stater, 48197
    - Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
- Minnesota
  - Brainerd, Minnesota, Forenede Stater, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Forenede Stater, 55337
    - Minnesota Oncology - Burnsville
  - Coon Rapids, Minnesota, Forenede Stater, 55433
    - Mercy Hospital
  - Deer River, Minnesota, Forenede Stater, 56636
    - Essentia Health - Deer River Clinic
  - Detroit Lakes, Minnesota, Forenede Stater, 56501
    - Essentia Health Saint Mary's - Detroit Lakes Clinic
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Forenede Stater, 55435
    - Fairview Southdale Hospital
  - Fosston, Minnesota, Forenede Stater, 56542
    - Essentia Health - Fosston
  - Hibbing, Minnesota, Forenede Stater, 55746
    - Essentia Health Hibbing Clinic
  - Maple Grove, Minnesota, Forenede Stater, 55369
    - Fairview Clinics and Surgery Center Maple Grove
  - 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
  - Monticello, Minnesota, Forenede Stater, 55362
    - Monticello Cancer Center
  - Park Rapids, Minnesota, Forenede Stater, 56470
    - Essentia Health - Park Rapids
  - Robbinsdale, Minnesota, Forenede Stater, 55422
    - North Memorial Medical Health Center
  - Saint Cloud, Minnesota, Forenede Stater, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - 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
  - Sandstone, Minnesota, Forenede Stater, 55072
    - Essentia Health Sandstone
  - Shakopee, Minnesota, Forenede Stater, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, Forenede Stater, 55082
    - Lakeview Hospital
  - Virginia, Minnesota, Forenede Stater, 55792
    - Essentia Health Virginia Clinic
  - 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
- Missouri
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Saint Francis Medical Center
  - City of Saint Peters, Missouri, Forenede Stater, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Columbia, Missouri, Forenede Stater, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Creve Coeur, Missouri, Forenede Stater, 63141
    - Siteman Cancer Center at West County Hospital
  - Farmington, Missouri, Forenede Stater, 63640
    - Parkland Health Center - Farmington
  - Kansas City, Missouri, Forenede Stater, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Forenede Stater, 64116
    - University of Kansas Cancer Center - Briarcliff
  - Lee's Summit, Missouri, Forenede Stater, 64064
    - University of Kansas Cancer Center - Lee's Summit
  - Sainte Genevieve, Missouri, Forenede Stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - St Louis, Missouri, Forenede Stater, 63110
    - Washington University School of Medicine
  - St Louis, Missouri, Forenede Stater, 63129
    - Siteman Cancer Center-South County
  - St Louis, Missouri, Forenede Stater, 63131
    - Missouri Baptist Medical Center
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forenede Stater, 63127
    - BJC Outpatient Center at Sunset Hills
- Montana
  - Billings, Montana, Forenede Stater, 59101
    - Billings Clinic Cancer Center
  - Bozeman, Montana, Forenede Stater, 59715
    - Bozeman Health Deaconess Hospital
  - Great Falls, Montana, Forenede Stater, 59405
    - Great Falls Clinic
  - Great Falls, Montana, Forenede Stater, 59405
    - Benefis Sletten Cancer Institute
  - Havre, Montana, Forenede Stater, 59501
    - Hi-Line Sletten Cancer Center
  - Kalispell, Montana, Forenede Stater, 59901
    - Logan Health Medical Center
  - Missoula, Montana, Forenede Stater, 59804
    - Community Medical Center
- Nebraska
  - Bellevue, Nebraska, Forenede Stater, 68123
    - Nebraska Medicine-Bellevue
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Omaha, Nebraska, Forenede Stater, 68198
    - University of Nebraska Medical Center
  - Omaha, Nebraska, Forenede Stater, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, Forenede Stater, 68118
    - Nebraska Medicine-Village Pointe
  - Omaha, Nebraska, Forenede Stater, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Forenede Stater, 68130
    - Alegent Health Lakeside Hospital
- New Hampshire
  - Lebanon, New Hampshire, Forenede Stater, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Manchester, New Hampshire, Forenede Stater, 03104
    - Dartmouth Cancer Center - Manchester/ DCC Manchester
  - Nashua, New Hampshire, Forenede Stater, 03063
    - Dartmouth Cancer Center - Nashua
- New Jersey
  - Camden, New Jersey, Forenede Stater, 08103
    - Cooper Hospital University Medical Center
  - Cherry Hill, New Jersey, Forenede Stater, 08002
    - Jefferson Cherry Hill Hospital
  - Mount Laurel, New Jersey, Forenede Stater, 08054
    - Cooper CyberKnife Center
  - New Brunswick, New Jersey, Forenede Stater, 08901
    - Saint Peter's University Hospital
  - Paramus, New Jersey, Forenede Stater, 07652
    - The Valley Hospital - Luckow Pavilion
  - Sewell, New Jersey, Forenede Stater, 08080
    - Sidney Kimmel Cancer Center Washington Township
  - Voorhees Township, New Jersey, Forenede Stater, 08043
    - MD Anderson Cancer Center at Cooper-Voorhees
- New Mexico
  - Albuquerque, New Mexico, Forenede Stater, 87106
    - University of New Mexico Cancer Center
  - Las Cruces, New Mexico, Forenede Stater, 88011
    - Memorial Medical Center-Las Cruces
- New York
  - Astoria, New York, Forenede Stater, 11102
    - Mount Sinai Queens
  - Bay Shore, New York, Forenede Stater, 11706
    - Northwell Health Imbert Cancer Center
  - Bronxville, New York, Forenede Stater, 10708
    - New York-Presbyterian Westchester Hospital
  - Brooklyn, New York, Forenede Stater, 11220
    - NYU Langone Hospital - Brooklyn
  - Buffalo, New York, Forenede Stater, 14263
    - Roswell Park Cancer Institute
  - Canandaigua, New York, Forenede Stater, 14424
    - Sands Cancer Center
  - Dansville, New York, Forenede Stater, 14437
    - Noyes Memorial Hospital/Myers Cancer Center
  - Forest Hills, New York, Forenede Stater, 11375
    - Northwell Health Physicians Partners Radiation Medicine at Queens
  - Glens Falls, New York, Forenede Stater, 12801
    - Glens Falls Hospital
  - Greenlawn, New York, Forenede Stater, 11740
    - Northwell Health Cancer Institute at Huntington
  - Lake Success, New York, Forenede Stater, 11042
    - Northwell Health/Center for Advanced Medicine
  - Mineola, New York, Forenede Stater, 11501
    - NYU Langone Hospital - Long Island
  - New York, New York, Forenede Stater, 10019
    - Mount Sinai West
  - New York, New York, Forenede Stater, 10029
    - Mount Sinai Hospital
  - New York, New York, Forenede Stater, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - New York, New York, Forenede Stater, 10011
    - Mount Sinai Chelsea
  - New York, New York, Forenede Stater, 10016
    - Laura and Isaac Perlmutter Cancer Center at NYU Langone
  - New York, New York, Forenede Stater, 10075
    - Lenox Hill Hospital
  - New York, New York, Forenede Stater, 10065
    - Manhattan Eye Ear and Throat Hospital
  - New York, New York, Forenede Stater, 10003
    - Mount Sinai Union Square
  - Rego Park, New York, Forenede Stater, 11374
    - Queens Cancer Center
  - Rochester, New York, Forenede Stater, 14642
    - University of Rochester
  - Rochester, New York, Forenede Stater, 14620
    - Highland Hospital
  - Rochester, New York, Forenede Stater, 14606
    - Wilmot Cancer Institute Radiation Oncology at Greece
  - Rochester, New York, Forenede Stater, 14623
    - Pluta Cancer Center
  - Stony Brook, New York, Forenede Stater, 11794
    - Stony Brook University Medical Center
  - The Bronx, New York, Forenede Stater, 10461
    - Montefiore Medical Center-Einstein Campus
  - The Bronx, New York, Forenede Stater, 10467
    - Montefiore Medical Center - Moses Campus
  - The Bronx, New York, Forenede Stater, 10468
    - James J Peters VA Medical Center
  - Webster, New York, Forenede Stater, 14580
    - Wilmot Cancer Institute at Webster
- North Carolina
  - Albemarle, North Carolina, Forenede Stater, 28002
    - Atrium Health Stanly/LCI-Albemarle
  - Burlington, North Carolina, Forenede Stater, 27215
    - Cone Health Cancer Center at Alamance Regional
  - Chapel Hill, North Carolina, Forenede Stater, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Charlotte, North Carolina, Forenede Stater, 28203
    - Carolinas Medical Center/Levine Cancer Institute
  - Charlotte, North Carolina, Forenede Stater, 28210
    - Atrium Health Pineville/LCI-Pineville
  - Charlotte, North Carolina, Forenede Stater, 28262
    - Atrium Health University City/LCI-University
  - Clemmons, North Carolina, Forenede Stater, 27012
    - Wake Forest University at Clemmons
  - Concord, North Carolina, Forenede Stater, 28025
    - Atrium Health Cabarrus/LCI-Concord
  - Gastonia, North Carolina, Forenede Stater, 28054
    - CaroMont Regional Medical Center
  - Greensboro, North Carolina, Forenede Stater, 27403
    - Cone Health Cancer Center
  - High Point, North Carolina, Forenede Stater, 27262
    - Hayworth Cancer Center
  - Lincolnton, North Carolina, Forenede Stater, 28092
    - CaroMont Health - Lincoln Cancer Center
  - Monroe, North Carolina, Forenede Stater, 28112
    - Atrium Health Union/LCI-Union
  - Reidsville, North Carolina, Forenede Stater, 27320
    - Annie Penn Memorial Hospital
  - Shelby, North Carolina, Forenede Stater, 28150
    - Atrium Health Cleveland/LCI-Cleveland
  - Statesville, North Carolina, Forenede Stater, 28677
    - Wake Forest Baptist Health - Hematology Oncology - Statesville
  - Wilkesboro, North Carolina, Forenede Stater, 28659
    - Wake Forest Baptist Health - Wilkes Medical Center
  - Winston-Salem, North Carolina, Forenede Stater, 27157
    - Wake Forest University Health Sciences
- North Dakota
  - Fargo, North Dakota, Forenede Stater, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Jamestown, North Dakota, Forenede Stater, 58401
    - Essentia Health - Jamestown Clinic
- Ohio
  - Akron, Ohio, Forenede Stater, 44307
    - Cleveland Clinic Akron General
  - Beavercreek, Ohio, Forenede Stater, 45431
    - Indu and Raj Soin Medical Center
  - Boardman, Ohio, Forenede Stater, 44512
    - Saint Elizabeth Boardman Hospital
  - Canton, Ohio, Forenede Stater, 44708
    - Cleveland Clinic Mercy Hospital
  - Centerville, Ohio, Forenede Stater, 45459
    - Dayton Physicians LLC-Miami Valley South
  - 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
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - 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, 43228
    - Doctors Hospital
  - Columbus, Ohio, Forenede Stater, 43215
    - Grant Medical Center
  - Dayton, Ohio, Forenede Stater, 45415
    - Dayton Physician LLC - Englewood
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Forenede Stater, 43015
    - Grady Memorial Hospital
  - Dublin, Ohio, Forenede Stater, 43016
    - Dublin Methodist Hospital
  - Findlay, Ohio, Forenede Stater, 45840
    - Blanchard Valley Hospital
  - Findlay, Ohio, Forenede Stater, 45840
    - Armes Family Cancer Center
  - Findlay, Ohio, Forenede Stater, 45840
    - Orion Cancer Care
  - Franklin, Ohio, Forenede Stater, 45005
    - Dayton Physicians LLC-Atrium
  - Greenville, Ohio, Forenede Stater, 45331
    - Wayne Hospital
  - Greenville, Ohio, Forenede Stater, 45331
    - Dayton Physicians LLC-Wayne
  - Independence, Ohio, Forenede Stater, 44131
    - Cleveland Clinic Cancer Center Independence
  - Kettering, Ohio, Forenede Stater, 45429
    - Kettering Medical Center
  - Kettering, Ohio, Forenede Stater, 45409
    - Greater Dayton Cancer Center
  - Mansfield, Ohio, Forenede Stater, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - Mansfield, Ohio, Forenede Stater, 44903
    - OhioHealth Mansfield Hospital
  - Marion, Ohio, Forenede Stater, 43302
    - OhioHealth Marion General Hospital
  - Mayfield Heights, Ohio, Forenede Stater, 44124
    - Hillcrest Hospital Cancer Center
  - Sandusky, Ohio, Forenede Stater, 44870
    - North Coast Cancer Care
  - Strongsville, Ohio, Forenede Stater, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - Troy, Ohio, Forenede Stater, 45373
    - Dayton Physicians LLC - Troy
  - Warren, Ohio, Forenede Stater, 44484
    - Saint Joseph Warren Hospital
  - West Chester, Ohio, Forenede Stater, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Youngstown, Ohio, Forenede Stater, 44501
    - Saint Elizabeth Youngstown Hospital
- Oregon
  - Portland, Oregon, Forenede Stater, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Allentown, Pennsylvania, Forenede Stater, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Allentown, Pennsylvania, Forenede Stater, 18104
    - Saint Luke's Cancer Center - Allentown
  - Beaver, Pennsylvania, Forenede Stater, 15009
    - UPMC-Heritage Valley Health System Beaver
  - 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
  - Chadds Ford, Pennsylvania, Forenede Stater, 19317
    - Christiana Care Health System-Concord Health Center
  - Chambersburg, Pennsylvania, Forenede Stater, 17201
    - Chambersburg Hospital
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - East Norriton, Pennsylvania, Forenede Stater, 19401
    - Fox Chase Cancer Center - East Norriton Hospital Outpatient Center
  - East Stroudsburg, Pennsylvania, Forenede Stater, 18301
    - Pocono Medical Center
  - Easton, Pennsylvania, Forenede Stater, 18045
    - Saint Luke's Hospital-Anderson Campus
  - Ephrata, Pennsylvania, Forenede Stater, 17522
    - Ephrata Cancer Center
  - Erie, Pennsylvania, Forenede Stater, 16505
    - UPMC Hillman Cancer Center Erie
  - Farrell, Pennsylvania, Forenede Stater, 16121
    - UPMC Cancer Center at UPMC Horizon
  - Furlong, Pennsylvania, Forenede Stater, 18925
    - Fox Chase Cancer Center Buckingham
  - Gettysburg, Pennsylvania, Forenede Stater, 17325
    - Adams Cancer Center
  - Greensburg, Pennsylvania, Forenede Stater, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hershey, Pennsylvania, Forenede Stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Indiana, Pennsylvania, Forenede Stater, 15701
    - IRMC Cancer Center
  - Johnstown, Pennsylvania, Forenede Stater, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - Lebanon, Pennsylvania, Forenede Stater, 17042
    - Sechler Family Cancer Center
  - Lewisburg, Pennsylvania, Forenede Stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Meadowbrook, Pennsylvania, Forenede Stater, 19046
    - Redeemer Health
  - Mechanicsburg, Pennsylvania, Forenede Stater, 17050
    - UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
  - Media, Pennsylvania, Forenede Stater, 19063
    - Riddle Memorial Hospital
  - Monroeville, Pennsylvania, Forenede Stater, 15146
    - UPMC Cancer Center - Monroeville
  - New Castle, Pennsylvania, Forenede Stater, 16105
    - UPMC Hillman Cancer Center - New Castle
  - Paoli, Pennsylvania, Forenede Stater, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Forenede Stater, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19114
    - Jefferson Torresdale Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19140
    - Temple University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19141
    - Einstein Medical Center Philadelphia
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Forenede Stater, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottsville, Pennsylvania, Forenede Stater, 17901
    - Geisinger Cancer Services-Pottsville
  - Quakertown, Pennsylvania, Forenede Stater, 18951
    - Saint Luke's Hospital - Upper Bucks Campus
  - Stroudsburg, Pennsylvania, Forenede Stater, 18360
    - Saint Luke's Hospital - Monroe Campus
  - Washington, Pennsylvania, Forenede Stater, 15301
    - UPMC Washington Hospital Radiation Oncology
  - Washington, Pennsylvania, Forenede Stater, 15301
    - UPMC Cancer Center-Washington
  - West Chester, Pennsylvania, Forenede Stater, 19380
    - Chester County Hospital
  - Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Willow Grove, Pennsylvania, Forenede Stater, 19090
    - Asplundh Cancer Pavilion
  - 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
  - Charleston, South Carolina, Forenede Stater, 29425
    - Medical University of South Carolina
  - Greenville, South Carolina, Forenede Stater, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, Forenede Stater, 29601
    - Saint Francis Hospital
  - Greenwood, South Carolina, Forenede Stater, 29646
    - Self Regional Healthcare
  - Rock Hill, South Carolina, Forenede Stater, 29730
    - Rock Hill Radiation Therapy Center
- Tennessee
  - Nashville, Tennessee, Forenede Stater, 37203
    - Sarah Cannon Cancer Center
- 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
    - Memorial Hermann Texas Medical Center
  - San Antonio, Texas, Forenede Stater, 78229
    - University of Texas Health Science Center at San Antonio
- Vermont
  - Berlin Corners, Vermont, Forenede Stater, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Forenede Stater, 05401
    - University of Vermont Medical Center
  - Burlington, Vermont, Forenede Stater, 05405
    - University of Vermont and State Agricultural College
  - Saint Johnsbury, Vermont, Forenede Stater, 05819
    - Dartmouth Cancer Center - North
- Virginia
  - Alexandria, Virginia, Forenede Stater, 22304
    - Inova Alexandria Hospital
  - Fairfax, Virginia, Forenede Stater, 22031
    - Inova Schar Cancer Institute
  - Fairfax, Virginia, Forenede Stater, 22033
    - Inova Fair Oaks Hospital
  - Harrisonburg, Virginia, Forenede Stater, 22801
    - Sentara Rockingham Memorial Hospital Hahn Cancer Center
  - Leesburg, Virginia, Forenede Stater, 20176
    - Inova Loudoun Hospital
  - Mechanicsville, Virginia, Forenede Stater, 23116
    - Bon Secours Memorial Regional Medical Center
  - Mechanicsville, Virginia, Forenede Stater, 23116
    - VCU Massey Cancer Center at Hanover Medical Park
  - Midlothian, Virginia, Forenede Stater, 23114
    - Bon Secours Saint Francis Medical Center
  - Richmond, Virginia, Forenede Stater, 23235
    - VCU Massey Cancer Center at Stony Point
  - Richmond, Virginia, Forenede Stater, 23226
    - Bon Secours Saint Mary's Hospital
  - Richmond, Virginia, Forenede Stater, 23230
    - Bon Secours Cancer Institute at Reynolds Crossing
  - Richmond, Virginia, Forenede Stater, 23298
    - VCU Massey Comprehensive Cancer Center
- Washington
  - Seattle, Washington, Forenede Stater, 98195
    - University of Washington Medical Center - Montlake
  - Seattle, Washington, Forenede Stater, 98109
    - Fred Hutchinson Cancer Center
  - Seattle, Washington, Forenede Stater, 98133
    - FHCC at Northwest Hospital
  - Silverdale, Washington, Forenede Stater, 98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
- West Virginia
  - Bridgeport, West Virginia, Forenede Stater, 26330
    - United Hospital Center
  - Morgantown, West Virginia, Forenede Stater, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, Forenede Stater, 26101
    - Camden Clark Medical Center
  - Princeton, West Virginia, Forenede Stater, 24740
    - Princeton Community Hospital
  - Wheeling, West Virginia, Forenede Stater, 26003
    - Wheeling Hospital/Schiffler Cancer Center
- Wisconsin
  - Antigo, Wisconsin, Forenede Stater, 54409
    - Langlade Hospital and Cancer Center
  - Appleton, Wisconsin, Forenede Stater, 54915
    - Ascension Saint Elizabeth Hospital
  - Ashland, Wisconsin, Forenede Stater, 54806
    - Duluth Clinic Ashland
  - Ashland, Wisconsin, Forenede Stater, 54806
    - Northwest Wisconsin Cancer Center
  - Brookfield, Wisconsin, Forenede Stater, 53045
    - Ascension Southeast Wisconsin Hospital - Elmbrook Campus
  - Burlington, Wisconsin, Forenede Stater, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Chilton, Wisconsin, Forenede Stater, 53014
    - Ascension Calumet Hospital
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Marshfield Medical Center-EC Cancer Center
  - Franklin, Wisconsin, Forenede Stater, 53132
    - Ascension Saint Francis - Reiman Cancer Center
  - Franklin, Wisconsin, Forenede Stater, 53132
    - Ascension Southeast Wisconsin Hospital - Franklin
  - Germantown, Wisconsin, Forenede Stater, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Forenede Stater, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Forenede Stater, 54311
    - Aurora BayCare Medical Center
  - 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
  - Hayward, Wisconsin, Forenede Stater, 54843
    - Essentia Health-Hayward Clinic
  - Johnson Creek, Wisconsin, Forenede Stater, 53038
    - University of Wisconsin Carbone Cancer Center - Johnson Creek
  - Kenosha, Wisconsin, Forenede Stater, 53142
    - Aurora Cancer Care-Kenosha South
  - Madison, Wisconsin, Forenede Stater, 53705
    - William S Middleton VA Medical Center
  - Madison, Wisconsin, Forenede Stater, 53792
    - University of Wisconsin Carbone Cancer Center - University Hospital
  - Madison, Wisconsin, Forenede Stater, 53718
    - University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Medical Center-Marshfield
  - Medford, Wisconsin, Forenede Stater, 54451
    - Aspirus Medford Hospital
  - Mequon, Wisconsin, Forenede Stater, 53097
    - Ascension Columbia Saint Mary's Hospital Ozaukee
  - Milwaukee, Wisconsin, Forenede Stater, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Forenede Stater, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53233
    - Aurora Sinai Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53210
    - Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
  - Milwaukee, Wisconsin, Forenede Stater, 53211
    - Ascension Columbia Saint Mary's Hospital - Milwaukee
  - Milwaukee, Wisconsin, Forenede Stater, 53215
    - Ascension Saint Francis Hospital
  - Milwaukee, Wisconsin, Forenede Stater, 53295
    - Zablocki Veterans Administration Medical Center
  - Mukwonago, Wisconsin, Forenede Stater, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, Forenede Stater, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, Forenede Stater, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Ascension Mercy Hospital
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forenede Stater, 53406
    - Aurora Cancer Care-Racine
  - Racine, Wisconsin, Forenede Stater, 53405
    - Ascension All Saints Hospital
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Aspirus Cancer Care - James Beck Cancer Center
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Saint Vincent Hospital Cancer Center at Sheboygan
  - Spooner, Wisconsin, Forenede Stater, 54801
    - Essentia Health-Spooner Clinic
  - Stevens Point, Wisconsin, Forenede Stater, 54482
    - Marshfield Medical Center-River Region at Stevens Point
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Aspirus Cancer Care - Stevens Point
  - Sturgeon Bay, Wisconsin, Forenede Stater, 54235-1495
    - Saint Vincent Hospital Cancer Center at Sturgeon Bay
  - Summit, Wisconsin, Forenede Stater, 53066
    - Aurora Medical Center in Summit
  - Superior, Wisconsin, Forenede Stater, 54880
    - Essentia Health Saint Mary's Hospital - Superior
  - Two Rivers, Wisconsin, Forenede Stater, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - UW Cancer Center at ProHealth Care
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Aspirus Regional Cancer Center
  - Wauwatosa, Wisconsin, Forenede Stater, 53226
    - Aurora Cancer Care-Milwaukee West
  - Wauwatosa, Wisconsin, Forenede Stater, 53226
    - Ascension Medical Group Southeast Wisconsin - Mayfair Road
  - West Allis, Wisconsin, Forenede Stater, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Aspirus Cancer Care - Wisconsin Rapids
- Wyoming
  - Cheyenne, Wyoming, Forenede Stater, 82001
    - Memorial Hospital of Laramie County

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

Voksen
Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

• Patienter med polymetastatisk cancer defineret som mere end 5 steder med radiografisk tydelig systemisk metastatisk sygdom (eksklusive intrakraniel sygdom)
- "Højrisiko" asymptomatisk knoglemetastase (Brief Pain Inventory [BPI]-score på < 5 på det "maksimale" smertepunkt) defineret som at opfylde mindst et af følgende fire højrisikokriterier:
  - omfangsrigt sygdomssted i knogler (≥ 2 cm);
  - Sygdom, der involverer hoften (acetabulum, lårbenshovedet, lårbenshalsen), skulderen (acromion, glenoid, humerushovedet) eller sacroiliacale led;
  - Sygdom i lange knogler, der optager op til 2/3 af den kortikale tykkelse (humerus, radius, ulna, kravebenet, lårbenet, skinnebenet, fibula, metacarpals, phalanges); og/eller
  - Sygdom i junctional rygsøjle (C7-T1, T12-L1, L5-S1) og/eller sygdom med posterolateralt element (pedikler og/eller facetled) involvering
  - BEMÆRK: Sternum, ribben og scapula er defineret som flade knogler, så læsioner på disse steder vil kun blive inkluderet, hvis de er voluminøse
- Patienter med enhver solid tumortype (undtagen myelomatose)
- Patienter skal have systemisk sygdomsevaluering gennem standardbehandlingsdiagnostisk billeddannelse, herunder enten CT bryst/mave/bækken eller kropspositronemissionstomografi (PET)/CT, med radiologirapport tilgængelig
- Patienter med behandlede hjernemetastaser og ingen kendt leptomeningeal sygdom er kvalificerede, hvis disse læsioner er blevet behandlet før indskrivning
- Alder ≥ 18
- Præstationsstatus: Eastern Cooperative Oncology Group (ECOG) 0-2 eller Karnofsky præstationsstatus (KPS) ≥ 60
- Ingen tidligere strålebehandling til de tilsigtede indskrevne sygdomssteder
- Ingen epidural rygmarvskompression (ESCC) ≥ grad 1c (defineret som deformation af thecal sac med spinal cord abutment) ved de indskrevne knoglemetastaser(er)
- Ingen tidligere fraktur ved de indskrevne knoglemetastaser

Ekskluderingskriterier:

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Primært formål: Støttende pleje
Tildeling: Randomiseret
Interventionel model: Parallel tildeling
Maskning: Ingen (Åben etiket)

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Eksperimentel: ARM II (RT, SOC) Patienter fortsætter SOC som i ARM I. Patienter gennemgår også konventionel RT eller SBRT QD i op til 5 dage (5 fraktioner) i fravær af sygdomsprogression eller uacceptabel toksicitet. Derudover gennemgår patienter CT eller MR til RT -planlægning og valgfri blodprøveopsamling på undersøgelse.	Andet: Spørgeskemaadministration Hjælpestudier Procedure: MR scanning Gennemgå MR Andre navne: MR Magnetisk resonans Magnetisk resonansbilledscanning Medicinsk billeddannelse, magnetisk resonans / kernemagnetisk resonans HR MR billeddannelse MR-scanning NMR billeddannelse NMRI Kernemagnetisk resonansbilleddannelse Magnetisk resonansbilleddannelse (MRI) sMRI Magnetisk resonansbilleddannelse (procedure) MRI'er Strukturel MR Procedure: Computertomografi Gennemgå CT Andre navne: CT KAT CAT-scanning Beregnet aksial tomografi Computerstyret aksial tomografi Computerstyret tomografi CT-scanning tomografi Computerstyret aksial tomografi (procedure) Computerstyret tomografi (CT) scanning Diagnostisk CAT -scanning Diagnostic CAT Scan Service Type Procedure: Bioprøvesamling Gennemgå blodprøvetagning Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Stråling: Stereotaktisk kropsstrålingsterapi Gennemgå SBRT Andre navne: SBRT SABR Stereotaktisk ablativ kropsstrålingsterapi Andet: Bedste praksis Givet SOC systemisk anti-cancer terapi Andre navne: plejestandard standard terapi Andet: Patientobservation Gennemgå SOC observation Andre navne: Observation Aktiv overvågning udskudt terapi forventningsfuld ledelse Vagtende venter Andet: Behandling af knoglemetastaser Givet knoglemodificerende middel Procedure: Konventionel strålebehandling Gennemgå konventionel RT Andre navne: 2-dimensionel konventionel strålebehandling 2D konventionel strålebehandling 2D strålebehandling 2D-Rt Stråling, 2D konventionel
Aktiv komparator: Arm I (standardbehandling) Patienterne fortsætter med at modtage SOC-systemisk anti-cancer-terapi eller observation og knoglemodificerende midler som bestemt af den behandlende læge. Desuden gennemgår patienterne valgfri blodprøveindsamling i forbindelse med studiet.	Andet: Spørgeskemaadministration Hjælpestudier Procedure: Bioprøvesamling Gennemgå blodprøvetagning Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Andet: Bedste praksis Givet SOC systemisk anti-cancer terapi Andre navne: plejestandard standard terapi Andet: Patientobservation Gennemgå SOC observation Andre navne: Observation Aktiv overvågning udskudt terapi forventningsfuld ledelse Vagtende venter Andet: Behandling af knoglemetastaser Givet knoglemodificerende middel

Deltagergruppe / Arm

Intervention / Behandling

Eksperimentel: ARM II (RT, SOC)

Patienter fortsætter SOC som i ARM I. Patienter gennemgår også konventionel RT eller SBRT QD i op til 5 dage (5 fraktioner) i fravær af sygdomsprogression eller uacceptabel toksicitet. Derudover gennemgår patienter CT eller MR til RT -planlægning og valgfri blodprøveopsamling på undersøgelse.

Andet: Spørgeskemaadministration

Hjælpestudier

Procedure: MR scanning

Gennemgå MR

Andre navne:

MR
Magnetisk resonans
Magnetisk resonansbilledscanning
Medicinsk billeddannelse, magnetisk resonans / kernemagnetisk resonans
HR
MR billeddannelse
MR-scanning
NMR billeddannelse
NMRI
Kernemagnetisk resonansbilleddannelse
Magnetisk resonansbilleddannelse (MRI)
sMRI
Magnetisk resonansbilleddannelse (procedure)
MRI'er
Strukturel MR

Procedure: Computertomografi

Gennemgå CT

Andre navne:

CT
KAT
CAT-scanning
Beregnet aksial tomografi
Computerstyret aksial tomografi
Computerstyret tomografi
CT-scanning
tomografi
Computerstyret aksial tomografi (procedure)
Computerstyret tomografi (CT) scanning
Diagnostisk CAT -scanning
Diagnostic CAT Scan Service Type

Procedure: Bioprøvesamling

Gennemgå blodprøvetagning

Andre navne:

Biologisk prøvesamling
Bioprøve indsamlet
Prøvesamling

Stråling: Stereotaktisk kropsstrålingsterapi

Gennemgå SBRT

Andre navne:

SBRT
SABR
Stereotaktisk ablativ kropsstrålingsterapi

Andet: Bedste praksis

Givet SOC systemisk anti-cancer terapi

Andre navne:

plejestandard
standard terapi

Andet: Patientobservation

Gennemgå SOC observation

Andre navne:

Observation
Aktiv overvågning
udskudt terapi
forventningsfuld ledelse
Vagtende venter

Andet: Behandling af knoglemetastaser

Givet knoglemodificerende middel

Procedure: Konventionel strålebehandling

Gennemgå konventionel RT

Andre navne:

2-dimensionel konventionel strålebehandling
2D konventionel strålebehandling
2D strålebehandling
2D-Rt
Stråling, 2D konventionel

Aktiv komparator: Arm I (standardbehandling)

Patienterne fortsætter med at modtage SOC-systemisk anti-cancer-terapi eller observation og knoglemodificerende midler som bestemt af den behandlende læge. Desuden gennemgår patienterne valgfri blodprøveindsamling i forbindelse med studiet.

Andet: Spørgeskemaadministration

Hjælpestudier

Procedure: Bioprøvesamling

Gennemgå blodprøvetagning

Andre navne:

Biologisk prøvesamling
Bioprøve indsamlet
Prøvesamling

Andet: Bedste praksis

Givet SOC systemisk anti-cancer terapi

Andre navne:

plejestandard
standard terapi

Andet: Patientobservation

Gennemgå SOC observation

Andre navne:

Observation
Aktiv overvågning
udskudt terapi
forventningsfuld ledelse
Vagtende venter

Andet: Behandling af knoglemetastaser

Givet knoglemodificerende middel

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Forekomst af skeletrelaterede hændelser (SRE'er) (eksklusive palliativ stråling mod smerter) Tidsramme: Fra randomisering til første SRE op til 24 måneder	Gray's test vil blive brugt til at teste for statistisk signifikant forskel i fordelingen af SRE-fejltider (Gray 1988), hvilket tager højde for død som en konkurrerende risiko. Den årsagsspecifikke Cox proportional hazards model vil blive brugt til at evaluere behandlingseffekten og stratificeringsvariabler (Cox 1972). Analysen vil blive udført på en intent-to-treat basis med alle randomiserede patienter. Analyser af behandlingseffekt vil blive udført ved brug af Cox proportional hazard model med stratifikationsfaktorerne som faste kovariater. Det justerede estimat af behandlingsrisikoforholdet med et 95 % konfidensinterval vil blive givet.	Fra randomisering til første SRE op til 24 måneder

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Samlet overlevelse (OS) Tidsramme: Fra tidspunktet for studiestart til død op til 24 måneder	OS vil blive sammenlignet mellem de to behandlingsarme. En stratificeret Cox proportional hazards model vil blive brugt til at evaluere behandlingseffekten og stratificeringsvariablerne (Cox 1972). Analysen vil blive udført på en intent-to-treat basis med alle randomiserede patienter. Det justerede estimat af behandlingsrisikoforholdet med et 95 % konfidensinterval vil blive givet.	Fra tidspunktet for studiestart til død op til 24 måneder
Indlæggelser for SRE Tidsramme: Op til 24 måneder	Indlæggelse for SRE som hændelse vil blive analyseret med en logistisk regressionsmodel efter behandlingsstatus, justeret for stratifikationsfaktorer. Det justerede estimat af behandlingsoddsforholdet med et 95 % konfidensinterval vil blive givet.	Op til 24 måneder
Brief Pain Inventory (BPI) score Tidsramme: Ved baseline og op til 24 måneder	Den gennemsnitlige BPI-score på hvert indsamlet tidspunkt (og deres 95 % konfidensintervaller) pr. behandlingsarm vil blive estimeret. En mixed-effects model vil blive brugt til at estimere og sammenligne den gennemsnitlige BPI værste smertescore for behandlingsarmene. Modelkovariater vil omfatte patienternes tilfældigt tildelte undersøgelsesbehandling, stratificeringsfaktorer, baseline BPI værste smertescore, enhver opioidbrug og en behandling-for-vurdering tidsinteraktionsperiode.	Ved baseline og op til 24 måneder
Forekomst af bivirkninger (AE'er) Tidsramme: Op til 42 dage fra registrering (arm I) og op til 30 dage fra afslutning af behandling (arm II)	AE'er vil blive indsamlet ved hjælp af Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Beskrivende statistik vil blive brugt til at opsummere AE'er. Disse analyser vil fokusere på personer, der påbegyndte deres tildelte behandling, og vil opsummere den maksimale grad af AE'er, der forekommer under behandling og opfølgning, klassificeret efter CTCAE-kategori. Det primære resumé af AE'er vil præsentere tællinger og procenter, uanset om AE blev tilskrevet nogen af undersøgelsesmidlerne.	Op til 42 dage fra registrering (arm I) og op til 30 dage fra afslutning af behandling (arm II)

Andre resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Samlet livskvalitet, funktionsstatus og kvalitetsjusterede leveår Tidsramme: Ved baseline og op til 24 måneder	Sammenligning af overordnet livskvalitet mellem armene vil blive evalueret ved hjælp af den europæiske livskvalitet fem dimension fem niveau (EQ-5D-5L) skala. Analyser af EQ-5D-5L er primært beskrivende og involverer estimering af forskelle i gennemsnitsscore for hver behandlingsgruppe med konfidensintervaller. En mixed-effects model vil blive brugt til at estimere og sammenligne de gennemsnitlige scores for behandlingsgrupperne over tid. Modeljusteringskovariater vil omfatte patienternes tilfældigt tildelte undersøgelsesbehandling, stratificeringsfaktorer, baseline EQ-5D-5L-score og vurderingstid.	Ved baseline og op til 24 måneder
Hospitalsindlæggelser (af enhver årsag) Tidsramme: Op til 24 måneder	Indlæggelser uanset årsag som en hændelse vil blive analyseret med en logistisk regressionsmodel efter behandlingsstatus, justeret for stratifikationsfaktorer. Det justerede estimat af behandlingsoddsforholdet med et 95 % konfidensinterval vil blive givet.	Op til 24 måneder
Heterogenitet af strålebehandlingseffekter Tidsramme: Op til 24 måneder	Sociodemografiske variabler indsamlet ved baseline vil blive evalueret for potentiel interaktion med strålebehandling.	Op til 24 måneder
Behandlingsforskelle efter race og etnicitet, køn og sundhedsrelaterede sociale behov Tidsramme: Op til 24 måneder	Forskelle i primære og sekundære endpoints vil kun blive karakteriseret beskrivende. Estimationer af behandlingseffekten for det primære udfald og det tilsvarende 95 % konfidensinterval vil blive præsenteret efter køn, race og etnicitet.	Op til 24 måneder

Samarbejdspartnere og efterforskere

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

Sponsor

NRG Oncology

Efterforskere

Ledende efterforsker: Erin F Gillespie, NRG Oncology

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Lapen K, Zhang Z, White C, Barker CA, Kotecha R, McIntosh AF, Nipp RD, Iyengar P, Yang JT, Yerramilli D, Gillespie EF. Predictors of Skeletal-Related Events and Quality-of-Life Dimensions Among Patients With High-Risk Asymptomatic Bone Metastases With or Without Early Radiation Therapy: Secondary Analysis of a Multicenter Randomized Phase II Clinical Trial. J Natl Compr Canc Netw. 2026 Mar 9;24(4):e257126. doi: 10.6004/jnccn.2025.7126.

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)

7. maj 2025

Primær færdiggørelse (Anslået)

1. februar 2029

Studieafslutning (Anslået)

1. februar 2034

Datoer for studieregistrering

Først indsendt

17. december 2024

Først indsendt, der opfyldte QC-kriterier

17. december 2024

Først opslået (Faktiske)

20. december 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

17. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

NRG-CC014 (Anden identifikator: CTEP)
UG1CA189867 (U.S. NIH-bevilling/kontrakt)
NCI-2024-08199 (Registry Identifier: CTRP (Clinical Trial Reporting Program))

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

IPD-planbeskrivelse

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ingen

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 .

Sammenligning af strålebehandling med sædvanlig pleje til patienter med højrisiko knogleasymptomatiske metastaser (PREEMPT)

Stråleterapi for højrisiko asymptomatiske knoglemetastaser: et pragmatisk multicenter randomiseret fase 3 klinisk forsøg (PREEMPT)

Studieoversigt

Status

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Undersøgelsestype

Tilmelding (Anslået)

Fase

Kontakter og lokationer

Studiesteder

Deltagelseskriterier

Berettigelseskriterier

Aldre berettiget til at studere

Tager imod sunde frivillige

Beskrivelse

Studieplan

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Antal våben

Våben og indgreb

Deltagergruppe / Arm

Intervention / Behandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Andre resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

Efterforskere

Publikationer og nyttige links

Generelle publikationer

Datoer for undersøgelser

Studer store datoer

Studiestart (Faktiske)

Primær færdiggørelse (Anslået)

Studieafslutning (Anslået)

Datoer for studieregistrering

Først indsendt

Først indsendt, der opfyldte QC-kriterier

Først opslået (Faktiske)

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

IPD-planbeskrivelse

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Studerer et amerikansk FDA-reguleret enhedsprodukt

produkt fremstillet i og eksporteret fra U.S.A.