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治疗前列腺癌患者的雄激素剥夺疗法和放射疗法

2026年4月16日更新者：Radiation Therapy Oncology Group

雄激素剥夺疗法和高剂量放疗联合或不联合全盆腔放疗治疗预后不良的中度或高危前列腺癌：一项 III 期随机试验

理由：雄激素会导致前列腺癌细胞的生长。雄激素剥夺疗法可能会阻止肾上腺产生雄激素。放射疗法使用高能 X 射线杀死肿瘤细胞。

目的：这项随机 III 期试验研究雄激素剥夺疗法和放射疗法在治疗前列腺癌患者中的作用。

研究概览

地位

主动，不招人

条件

前列腺癌

干预/治疗

详细说明

目标：

基本的

证明预防性新辅助雄激素剥夺疗法 (NADT) 和全盆腔放疗 (WPRT) 将改善“不利”中危或“有利”高危前列腺癌患者的总生存期 (OS)与 NADT 和高剂量前列腺 (P) 和精囊 (SV) 放射治疗 (RT) 相比，使用强度调制 RT (IMRT) 或外照射 RT (EBRT) 具有高剂量率 (HDR) 或永久前列腺（放射性种子）植入物 (PPI) 增强。

中学

证明预防性 WPRT 可改善生化控制。
确定无远处转移 (DM) 的生存期。
确定原因特异性生存 (CSS)。
比较接受 NADT 和 WPRT 的患者与接受 NADT、P 和 SV RT 的患者之间的急性和晚期治疗不良事件。
确定由扩展前列腺癌综合指数 (EPIC) 衡量的与健康相关的生活质量 (HRQOL) 是否随着治疗积极性的增加而显着恶化（即第 2 组、NADT + WPRT）。
确定更积极的治疗（第 2 组，NADT + WPRT）是否与从基线到治疗最后一周的疲劳（PROMIS 疲劳简表）的增加以及循环炎症标志物（IL-1、IL- 1ra、IL-6、肿瘤坏死因子 (TNF)-α 和 C 反应蛋白）。
通过更积极的治疗证明 OS 和 CSS 的增量收益超过了 HRQOL 主要通用领域（即移动性、自我护理、日常活动、疼痛/不适和焦虑/抑郁）的任何损害。
确定从基线到接下来三个时间点（RT 前一周、治疗最后一周和治疗后 3 个月）的疲劳变化是否与相同时间点的循环细胞因子、情绪、睡眠和日常活动的变化相关.
收集石蜡包埋的组织块、血浆、全血和尿液，用于计划和未来的转化研究分析。

大纲：这是一项多中心研究。根据本摘要疾病特征中列出的中度至高危人群、放疗加强类型（IMRT 与近距离放疗 [使用 PPI 或 HDR 的低剂量率 (LDR)]）和雄激素持续时间对患者进行分层剥夺疗法（短期 [6 个月] 与长期 [32 个月]）。患者被随机分配到 2 个治疗组中的 1 个。

所有患者均接受新辅助雄激素剥夺治疗，包括每日一次口服比卡鲁胺 (PO) 或每日三次口服氟他胺，持续 6 个月，以及黄体生成素释放激素 (LHRH) 激动剂/拮抗剂治疗，包括醋酸亮丙瑞林、醋酸戈舍瑞林、布舍瑞林、曲普瑞林或从放疗前 2 个月开始，每 1 至 3 个月一次地加瑞克皮下注射 (SC) 或肌肉注射 (IM)，持续 6 或 32 个月。

开始 LHRH 激动剂/拮抗剂注射后 8 周内开始放疗。

第 I 组：患者使用调强放疗 (IMRT)* 或 3D 适形放疗 (3D-CRT)* 对前列腺和精囊进行高剂量放疗，每天一次，每周 5 天，持续约 9 周。患者还可能接受永久性前列腺植入物 (PPI) 近距离放射治疗或高剂量率近距离放射治疗（碘 I 125 或钯 Pd 103 可用作放射性同位素）。
第二组：患者每天接受一次全盆腔放疗 (WPRT)*（3D-CRT 或 IMRT），每周 5 天，持续约 9 周。患者也可能像第 I 组一样接受近距离放射治疗。

注意：* 接受近距离放射治疗植入物的患者接受 5 周的 IMRT、3D-CRT 或 WPRT。

患者可能会进行血液和尿液样本采集以进行相关研究。还可以收集原发性肿瘤组织样本。

患者可以在基线和治疗期间定期完成扩展前列腺癌指数综合（EPIC）、PROMIS-疲劳简表和 EuroQol（EQ-5D）生活质量（QOL）问卷。参与研究的 QOL 部分的患者还必须同意定期采血。

完成研究治疗后，患者每 3 个月随访 1 年，每 6 个月随访 3 年，之后每年随访一次。

研究类型

介入性

注册 (实际的)

2590

阶段

第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

以色列
- - Petah Tikva、以色列、49100
    - Rabin Medical Center
  - Tel Litwinsky、以色列、52621
    - Chaim Sheba Medical Center
加拿大
- Alberta
  - Calgary、Alberta、加拿大、T2N 4N2
    - Tom Baker Cancer Centre
  - Edmonton、Alberta、加拿大、T6G 1Z2
    - Cross Cancer Institute
- British Columbia
  - Kelowna、British Columbia、加拿大、V1Y 5L3
    - BCCA-Cancer Centre for the Southern Interior
  - Surrey、British Columbia、加拿大、V3V 1Z2
    - BCCA-Fraser Valley Cancer Centre
- Newfoundland and Labrador
  - St. John's、Newfoundland and Labrador、加拿大、A1B 3V6
    - Doctor H. Bliss Murphy Cancer Centre
- Nova Scotia
  - Halifax、Nova Scotia、加拿大、B3H 2Y9
    - QEII Health Sciences Centre/Nova Scotia Health Authority
- Ontario
  - London、Ontario、加拿大、N6A 4L6
    - London Regional Cancer Program
  - Newmarket、Ontario、加拿大、L3Y 2P9
    - Stronach Regional Health Centre at Southlake
  - Toronto、Ontario、加拿大、M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
- Quebec
  - Montreal、Quebec、加拿大、H3T 1E2
    - Jewish General Hospital
  - Montreal、Quebec、加拿大、H3H 2R9
    - The Research Institute of the McGill University Health Centre (MUHC)
  - Montreal、Quebec、加拿大、H2L 4M1
    - CHUM - Hopital Notre-Dame
  - Montreal、Quebec、加拿大、H2W 1S6
    - McGill University Department of Oncology
  - Montreal、Quebec、加拿大、H2X 3E4
    - CHUM - Centre Hospitalier de l'Universite de Montreal
  - Québec、Quebec、加拿大、G1R 2J6
    - CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)
  - Sherbrooke、Quebec、加拿大、J1H 5N4
    - Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
- Saskatchewan
  - Regina、Saskatchewan、加拿大、S4T 7T1
    - Allan Blair Cancer Centre
  - Saskatoon、Saskatchewan、加拿大、S7N 4H4
    - Saskatoon Cancer Centre
新加坡
- - Singapore、新加坡、169610
    - National Cancer Centre Singapore
  - Singapore、新加坡、119074
    - National University Hospital Singapore
瑞士
- - Aarau、瑞士、5001
    - Kantonsspital Aarau
美国
- Alabama
  - Mobile、Alabama、美国、36688
    - University of South Alabama Mitchell Cancer Institute
- Alaska
  - Anchorage、Alaska、美国、98508
    - Anchorage Associates in Radiation Medicine
  - Anchorage、Alaska、美国、99508
    - Alaska Oncology and Hematology LLC
  - Anchorage、Alaska、美国、99508
    - Anchorage Oncology Centre
  - Anchorage、Alaska、美国、99508
    - Katmai Oncology Group
  - Anchorage、Alaska、美国、99508
    - Providence Alaska Medical Center
  - Fairbanks、Alaska、美国、99701
    - Fairbanks Memorial Hospital
- Arizona
  - Gilbert、Arizona、美国、85297
    - Arizona Breast Cancer Specialists-Gilbert
  - Peoria、Arizona、美国、85381
    - Arizona Center for Cancer Care-Peoria
  - Phoenix、Arizona、美国、85004
    - Cancer Center at Saint Joseph's
  - Phoenix、Arizona、美国、85027
    - Arizona Oncology-Deer Valley Center
  - Phoenix、Arizona、美国、85013
    - Saint Joseph's Hospital and Medical Center
  - Phoenix、Arizona、美国、85027
    - Arizona Breast Cancer Specialists-Phoenix
  - Scottsdale、Arizona、美国、85258
    - Arizona Breast Cancer Specialists-Scottsdale
  - Scottsdale、Arizona、美国、85251
    - Arizona Breast Cancer Specialists
  - Scottsdale、Arizona、美国、85260
    - Arizona Oncology Services Foundation
  - Scottsdale、Arizona、美国、85251
    - 21st Century Oncology-Scottsdale
  - Surprise、Arizona、美国、85374
    - Arizona Center for Cancer Care-Surprise
  - Tucson、Arizona、美国、85704
    - University of Arizona Cancer Center-Orange Grove Campus
  - Tucson、Arizona、美国、85719
    - Banner University Medical Center - Tucson
  - Tucson、Arizona、美国、85719
    - University of Arizona Cancer Center-North Campus
  - Tucson、Arizona、美国、85704
    - Arizona Oncology Associates-West Orange Grove
- Arkansas
  - Hot Springs、Arkansas、美国、71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro、Arkansas、美国、72401
    - Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
  - Little Rock、Arkansas、美国、72205
    - University of Arkansas for Medical Sciences
- California
  - Auburn、California、美国、95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Bakersfield、California、美国、93301
    - AIS Cancer Center at San Joaquin Community Hospital
  - Berkeley、California、美国、94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burbank、California、美国、91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Cameron Park、California、美国、95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Carmichael、California、美国、95608
    - Mercy San Juan Medical Center
  - Chico、California、美国、95973
    - Adventist Health Cancer Care Center Chico
  - Fresno、California、美国、93720
    - Saint Agnes Medical Center
  - Fresno、California、美国、93720
    - Fresno Cancer Center
  - Greenbrae、California、美国、94904
    - Marin General Hospital
  - La Jolla、California、美国、92093
    - UC San Diego Moores Cancer Center
  - Long Beach、California、美国、90822
    - Tibor Rubin VA Medical Center
  - Los Angeles、California、美国、90033
    - USC / Norris Comprehensive Cancer Center
  - Los Angeles、California、美国、90033
    - Los Angeles County-USC Medical Center
  - Los Angeles、California、美国、90048
    - Cedars Sinai Medical Center
  - Marysville、California、美国、95901
    - Fremont - Rideout Cancer Center
  - Merced、California、美国、95340
    - Mercy UC Davis Cancer Center
  - Modesto、California、美国、95355
    - Memorial Medical Center
  - Oakland、California、美国、94611
    - Kaiser Permanente Oakland-Broadway
  - Oakland、California、美国、94609
    - Alta Bates Summit Medical Center - Summit Campus
  - Palm Springs、California、美国、92262
    - Desert Regional Medical Center
  - Palo Alto、California、美国、94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto、California、美国、94301
    - Palo Alto Medical Foundation Health Care
  - Pomona、California、美国、91767
    - Pomona Valley Hospital Medical Center
  - Rancho Cordova、California、美国、95670
    - Kaiser Permanente-Rancho Cordova Cancer Center
  - Rohnert Park、California、美国、94928
    - Rohnert Park Cancer Center
  - Roseville、California、美国、95678
    - The Permanente Medical Group-Roseville Radiation Oncology
  - Roseville、California、美国、95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Sacramento、California、美国、95816
    - Sutter Medical Center Sacramento
  - Sacramento、California、美国、95817
    - University of California Davis Comprehensive Cancer Center
  - Sacramento、California、美国、95823
    - South Sacramento Cancer Center
  - Sacramento、California、美国、95816
    - Mercy Cancer Center - Sacramento
  - San Francisco、California、美国、94158
    - UCSF Medical Center-Mission Bay
  - San Francisco、California、美国、94115
    - UCSF Medical Center-Mount Zion
  - San Jose、California、美国、95128
    - Santa Clara Valley Medical Center
  - Santa Clara、California、美国、95051
    - Kaiser Permanente Medical Center - Santa Clara
  - South San Francisco、California、美国、94080
    - Kaiser Permanente Cancer Treatment Center
  - Stockton、California、美国、95204
    - Saint Joseph's Medical Center
  - Sunnyvale、California、美国、94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Truckee、California、美国、96161
    - Gene Upshaw Memorial Tahoe Forest Cancer Center
  - Vacaville、California、美国、95687
    - Sutter Cancer Centers Radiation Oncology Services-Vacaville
- Colorado
  - Aurora、Colorado、美国、80045
    - University Of Colorado Hospital
  - Aurora、Colorado、美国、80012
    - Rocky Mountain Cancer Centers-Aurora
  - Boulder、Colorado、美国、80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs、Colorado、美国、80909
    - UCHealth Memorial Hospital Central
  - Denver、Colorado、美国、80210
    - Porter Adventist Hospital
  - Edwards、Colorado、美国、81632
    - Shaw Cancer Center
  - Greeley、Colorado、美国、80631
    - North Colorado Medical Center
  - Longmont、Colorado、美国、80501
    - Longmont United Hospital
  - Loveland、Colorado、美国、80539
    - McKee Medical Center
  - Parker、Colorado、美国、80138
    - Parker Adventist Hospital
- Connecticut
  - Bridgeport、Connecticut、美国、06606
    - Hartford HealthCare - Saint Vincent's Medical Center
  - Hartford、Connecticut、美国、06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Middletown、Connecticut、美国、06457
    - Middlesex Hospital
- Delaware
  - Newark、Delaware、美国、19713
    - Helen F Graham Cancer Center
  - Newark、Delaware、美国、19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach、Delaware、美国、19971
    - Beebe Health Campus
  - Seaford、Delaware、美国、19973
    - TidalHealth Nanticoke / Allen Cancer Center
- District of Columbia
  - Washington D.C.、District of Columbia、美国、20010
    - MedStar Washington Hospital Center
- Florida
  - Deerfield Beach、Florida、美国、33064
    - Broward Health North
  - Jacksonville、Florida、美国、32207
    - Baptist MD Anderson Cancer Center
  - Jacksonville、Florida、美国、32258
    - Baptist Medical Center South
  - Jupiter、Florida、美国、33458
    - Jupiter Medical Center
  - Miami、Florida、美国、33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Orlando、Florida、美国、32806
    - Orlando Health Cancer Institute
  - Palatka、Florida、美国、32177
    - Cancer Center of Putnam
  - Plantation、Florida、美国、33324
    - GenesisCare USA - Plantation
  - Tampa、Florida、美国、33612
    - James A. Haley Veterans Affairs Hospital
  - Trinity、Florida、美国、34655
    - Florida Cancer Affiliates
  - Weston、Florida、美国、33331
    - Cleveland Clinic-Weston
- Georgia
  - Atlanta、Georgia、美国、30308
    - Emory University Hospital Midtown
  - Atlanta、Georgia、美国、30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta、Georgia、美国、30342
    - Emory Saint Joseph's Hospital
  - Atlanta、Georgia、美国、30303
    - Grady Health System
  - Atlanta、Georgia、美国、30309
    - Piedmont Hospital
  - Columbus、Georgia、美国、31904
    - John B Amos Cancer Center
  - Decatur、Georgia、美国、30033
    - Atlanta VA Medical Center
  - Fayetteville、Georgia、美国、30214
    - Piedmont Fayette Hospital
  - Gainesville、Georgia、美国、30501
    - Northeast Georgia Medical Center-Gainesville
  - Macon、Georgia、美国、31201
    - Central Georgia Gynecologic Oncology
  - Savannah、Georgia、美国、31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
- Hawaii
  - Honolulu、Hawaii、美国、96813
    - Queen's Medical Center
  - Honolulu、Hawaii、美国、96817
    - The Cancer Center of Hawaii-Liliha
  - ‘Aiea、Hawaii、美国、96701
    - The Cancer Center of Hawaii-Pali Momi
- Idaho
  - Boise、Idaho、美国、83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Coeur d'Alene、Idaho、美国、83814
    - Kootenai Health - Coeur d'Alene
  - Meridian、Idaho、美国、83642
    - Idaho Urologic Institute-Meridian
  - Post Falls、Idaho、美国、83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint、Idaho、美国、83864
    - Kootenai Cancer Clinic
  - Twin Falls、Idaho、美国、83301
    - Saint Luke's Cancer Institute - Twin Falls
- Illinois
  - Arlington Heights、Illinois、美国、60005
    - Northwest Community Hospital
  - Aurora、Illinois、美国、60504
    - Rush - Copley Medical Center
  - Chicago、Illinois、美国、60612
    - Rush University Medical Center
  - Chicago、Illinois、美国、60612
    - John H Stroger Jr Hospital of Cook County
  - Chicago、Illinois、美国、60657
    - UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital
  - Chicago、Illinois、美国、60640
    - Weiss Memorial Hospital
  - Chicago、Illinois、美国、60657
    - Advocate Illinois Masonic Medical Center
  - Decatur、Illinois、美国、62526
    - Decatur Memorial Hospital
  - Effingham、Illinois、美国、62401
    - Crossroads Cancer Center
  - Maywood、Illinois、美国、60153
    - Loyola University Medical Center
  - Peoria、Illinois、美国、61637
    - OSF Saint Francis Medical Center
  - Peoria、Illinois、美国、61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Rockford、Illinois、美国、61114
    - SwedishAmerican Regional Cancer Center/ACT
  - Springfield、Illinois、美国、62781
    - Memorial Medical Center
  - Springfield、Illinois、美国、62702
    - Saint John's Hospital
  - Swansea、Illinois、美国、62226
    - Southwest Illinois Health Services LLP
  - Urbana、Illinois、美国、61801
    - Carle Cancer Center
- Indiana
  - Fort Wayne、Indiana、美国、46805
    - Parkview Hospital Randallia
  - Fort Wayne、Indiana、美国、46845
    - Parkview Regional Medical Center
  - Fort Wayne、Indiana、美国、46804
    - Radiation Oncology Associates PC
  - Indianapolis、Indiana、美国、46202
    - Indiana University/Melvin and Bren Simon Cancer Center
  - Indianapolis、Indiana、美国、46202
    - IU Health Methodist Hospital
  - South Bend、Indiana、美国、46601
    - Memorial Hospital of South Bend
- Iowa
  - Ames、Iowa、美国、50010
    - McFarland Clinic PC - Ames
  - Cedar Rapids、Iowa、美国、52403
    - Mercy Hospital
  - Cedar Rapids、Iowa、美国、52402
    - Saint Luke's Hospital
  - Dubuque、Iowa、美国、52001
    - Finley Hospital
- Kansas
  - Garden City、Kansas、美国、67846
    - Central Care Cancer Center - Garden City
  - Garden City、Kansas、美国、67846
    - Saint Catherine Hospital
  - Kansas City、Kansas、美国、66160
    - University of Kansas Cancer Center
  - Lawrence、Kansas、美国、66044
    - Lawrence Memorial Hospital
  - Olathe、Kansas、美国、66061
    - Olathe Health Cancer Center
  - Overland Park、Kansas、美国、66210
    - University of Kansas Cancer Center-Overland Park
  - Topeka、Kansas、美国、66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - Wichita、Kansas、美国、67214
    - Ascension Via Christi Hospitals Wichita
- Kentucky
  - Lexington、Kentucky、美国、40536
    - University of Kentucky/Markey Cancer Center
  - Owensboro、Kentucky、美国、42303
    - Owensboro Health Mitchell Memorial Cancer Center
- Louisiana
  - Baton Rouge、Louisiana、美国、70809
    - Mary Bird Perkins Cancer Center
  - Covington、Louisiana、美国、70433
    - Mary Bird Perkins Cancer Center - Covington
  - Houma、Louisiana、美国、70360
    - Mary Bird Perkins Cancer Center - Houma
  - Metairie、Louisiana、美国、70006
    - East Jefferson General Hospital
  - Metairie、Louisiana、美国、70006
    - LSU Healthcare Network / Metairie Multi-Specialty Clinic
  - New Orleans、Louisiana、美国、70121
    - Ochsner Medical Center Jefferson
  - New Orleans、Louisiana、美国、70112
    - Tulane University Health Sciences Center
  - New Orleans、Louisiana、美国、70115
    - Touro Infirmary
- Maryland
  - Annapolis、Maryland、美国、21401
    - Anne Arundel Medical Center
  - Baltimore、Maryland、美国、21204
    - Greater Baltimore Medical Center
  - Baltimore、Maryland、美国、21201
    - University of Maryland/Greenebaum Cancer Center
  - Baltimore、Maryland、美国、21229
    - Saint Agnes Hospital
  - Bel Air、Maryland、美国、21014
    - UM Upper Chesapeake Medical Center
  - Columbia、Maryland、美国、21044
    - Central Maryland Radiation Oncology in Howard County
  - Elkton、Maryland、美国、21921
    - University of Maryland Radiation Oncology Center at Union Hospital
  - Glen Burnie、Maryland、美国、21061
    - UM Baltimore Washington Medical Center/Tate Cancer Center
  - Salisbury、Maryland、美国、21801
    - TidalHealth Peninsula Regional
  - Towson、Maryland、美国、21204
    - UM Saint Joseph Medical Center
- Massachusetts
  - Boston、Massachusetts、美国、02114
    - Massachusetts General Hospital Cancer Center
  - Fall River、Massachusetts、美国、02721
    - Saint Anne's Hospital
  - Hyannis、Massachusetts、美国、02601
    - Cape Cod Hospital
  - Lowell、Massachusetts、美国、01854
    - Lowell General Hospital
  - Plymouth、Massachusetts、美国、02360
    - Beth Israel Deaconess Hospital-Plymouth
- Michigan
  - Adrian、Michigan、美国、49221
    - Bixby Medical Center
  - Ann Arbor、Michigan、美国、48109
    - University Of Michigan Comprehensive Cancer Center
  - Ann Arbor、Michigan、美国、48106
    - Saint Joseph Mercy Hospital
  - Ann Arbor、Michigan、美国、48105
    - Veteran's Administration Medical Center - Ann Arbor
  - Battle Creek、Michigan、美国、49017
    - Bronson Battle Creek
  - Bay City、Michigan、美国、48706
    - McLaren Cancer Institute-Bay City
  - Brownstown、Michigan、美国、48183
    - Henry Ford Cancer Institute-Downriver
  - Clarkston、Michigan、美国、48346
    - McLaren Cancer Institute-Clarkston
  - Clarkston、Michigan、美国、48346
    - GenesisCare USA - Clarkston
  - Clinton Township、Michigan、美国、48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Dearborn、Michigan、美国、48124
    - Beaumont Hospital - Dearborn
  - Detroit、Michigan、美国、48202
    - Henry Ford Hospital
  - Detroit、Michigan、美国、48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit、Michigan、美国、48236
    - Ascension Saint John Hospital
  - Farmington Hills、Michigan、美国、48334
    - Weisberg Cancer Treatment Center
  - Farmington Hills、Michigan、美国、48336
    - Beaumont Hospital - Farmington Hills
  - Farmington Hills、Michigan、美国、48334
    - GenesisCare USA - Farmington Hills
  - Flint、Michigan、美国、48532
    - McLaren Cancer Institute-Flint
  - Grand Rapids、Michigan、美国、49503
    - Spectrum Health at Butterworth Campus
  - Grand Rapids、Michigan、美国、49503
    - Mercy Health Saint Mary's
  - Kalamazoo、Michigan、美国、49007
    - West Michigan Cancer Center
  - Lansing、Michigan、美国、48912
    - Sparrow Hospital
  - Lansing、Michigan、美国、48910
    - Karmanos Cancer Institute at McLaren Greater Lansing
  - Lapeer、Michigan、美国、48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia、Michigan、美国、48154
    - Saint Mary Mercy Hospital
  - Mount Clemens、Michigan、美国、48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant、Michigan、美国、48858
    - McLaren Cancer Institute-Central Michigan
  - Muskegon、Michigan、美国、49444
    - Mercy Health Mercy Campus
  - Owosso、Michigan、美国、48867
    - McLaren Cancer Institute-Owosso
  - Petoskey、Michigan、美国、49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac、Michigan、美国、48341
    - Saint Joseph Mercy Oakland
  - Pontiac、Michigan、美国、48341
    - 21st Century Oncology-Pontiac
  - Port Huron、Michigan、美国、48060
    - McLaren-Port Huron
  - Royal Oak、Michigan、美国、48073
    - William Beaumont Hospital-Royal Oak
  - Saginaw、Michigan、美国、48601
    - Ascension Saint Mary's Hospital
  - Saint Joseph、Michigan、美国、49085
    - Lakeland Medical Center Saint Joseph
  - Troy、Michigan、美国、48085
    - William Beaumont Hospital - Troy
  - Troy、Michigan、美国、48098
    - GenesisCare USA - Troy
  - Warren、Michigan、美国、48093
    - Saint John Macomb-Oakland Hospital
  - West Bloomfield、Michigan、美国、48322
    - Henry Ford West Bloomfield Hospital
  - Wyoming、Michigan、美国、49519
    - Metro Health Hospital
- Minnesota
  - Albert Lea、Minnesota、美国、56007
    - Mayo Clinic Health System in Albert Lea
  - Bemidji、Minnesota、美国、56601
    - Sanford Joe Lueken Cancer Center
  - Duluth、Minnesota、美国、55805
    - Saint Luke's Hospital of Duluth
  - Mankato、Minnesota、美国、56001
    - Mayo Clinic Health Systems-Mankato
  - Minneapolis、Minnesota、美国、55415
    - Hennepin County Medical Center
  - Monticello、Minnesota、美国、55362
    - Monticello Cancer Center
  - Saint Cloud、Minnesota、美国、56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Louis Park、Minnesota、美国、55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Paul、Minnesota、美国、55101
    - Regions Hospital
  - Willmar、Minnesota、美国、56201
    - Rice Memorial Hospital
- Mississippi
  - Jackson、Mississippi、美国、39216
    - University of Mississippi Medical Center
  - Pascagoula、Mississippi、美国、39581
    - Singing River Hospital
- Missouri
  - Cape Girardeau、Missouri、美国、63703
    - Saint Francis Medical Center
  - Cape Girardeau、Missouri、美国、63703
    - Southeast Cancer Center
  - City of Saint Peters、Missouri、美国、63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Creve Coeur、Missouri、美国、63141
    - Siteman Cancer Center at West County Hospital
  - Joplin、Missouri、美国、64804
    - Freeman Health System
  - Kansas City、Missouri、美国、64128
    - Kansas City Veterans Affairs Medical Center
  - Kansas City、Missouri、美国、64154
    - University of Kansas Cancer Center - North
  - Kansas City、Missouri、美国、64116
    - North Kansas City Hospital
  - Kansas City、Missouri、美国、64131
    - The University of Kansas Cancer Center-South
  - Lee's Summit、Missouri、美国、64064
    - University of Kansas Cancer Center - Lee's Summit
  - Rolla、Missouri、美国、65401
    - Delbert Day Cancer Institute at PCRMC
  - Saint Joseph、Missouri、美国、64506
    - Heartland Regional Medical Center
  - Springfield、Missouri、美国、65807
    - CoxHealth South Hospital
  - St Louis、Missouri、美国、63110
    - Washington University School of Medicine
  - St Louis、Missouri、美国、63129
    - Siteman Cancer Center-South County
  - St Louis、Missouri、美国、63131
    - Missouri Baptist Medical Center
  - St Louis、Missouri、美国、63141
    - Mercy Hospital Saint Louis
  - St Louis、Missouri、美国、63125
    - Veteran's Affairs Medical Center - Saint Louis
- Montana
  - Billings、Montana、美国、59101
    - Billings Clinic Cancer Center
  - Great Falls、Montana、美国、59405
    - Benefis Healthcare- Sletten Cancer Institute
- Nebraska
  - Omaha、Nebraska、美国、68198
    - University of Nebraska Medical Center
  - Omaha、Nebraska、美国、68124
    - Alegent Health Bergan Mercy Medical Center
- Nevada
  - Reno、Nevada、美国、89502
    - Renown Regional Medical Center
- New Hampshire
  - Exeter、New Hampshire、美国、03833
    - Exeter Hospital
  - Lebanon、New Hampshire、美国、03756
    - Dartmouth Hitchcock Medical Center
- New Jersey
  - Egg Harbor、New Jersey、美国、08234
    - AtlantiCare Surgery Center
  - Mount Holly、New Jersey、美国、08060
    - Virtua Memorial
  - Mullica Hill、New Jersey、美国、08062
    - Inspira Medical Center Mullica Hill
  - Plainsboro、New Jersey、美国、08536
    - Penn Medicine Princeton Health
  - Sewell、New Jersey、美国、08080
    - Sidney Kimmel Cancer Center Washington Township
  - Somerville、New Jersey、美国、08876
    - Robert Wood Johnson University Hospital Somerset
  - Sparta、New Jersey、美国、07871
    - Sparta Cancer Treatment Center
  - Vineland、New Jersey、美国、08360
    - Inspira Medical Center Vineland
  - Voorhees Township、New Jersey、美国、08043
    - Virtua Voorhees
- New Mexico
  - Las Cruces、New Mexico、美国、88011
    - Memorial Medical Center - Las Cruces
- New York
  - Bay Shore、New York、美国、11706
    - South Shore University Hospital
  - Brooklyn、New York、美国、11215
    - New York-Presbyterian/Brooklyn Methodist Hospital
  - Canandiaqua、New York、美国、14424
    - Sands Cancer Center
  - Cooperstown、New York、美国、13326
    - Mary Imogene Bassett Hospital
  - Elmira、New York、美国、14905
    - Arnot Ogden Medical Center/Falck Cancer Center
  - Lake Success、New York、美国、11042
    - Northwell Health/Center for Advanced Medicine
  - New Hyde Park、New York、美国、11040
    - Long Island Jewish Medical Center
  - New York、New York、美国、10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - Rochester、New York、美国、14642
    - University of Rochester
  - Rochester、New York、美国、14620
    - Highland Hospital
  - Rochester、New York、美国、14606
    - Wilmot Cancer Institute Radiation Oncology at Greece
  - Stony Brook、New York、美国、11794
    - Stony Brook University Medical Center
  - The Bronx、New York、美国、10468
    - James J Peters VA Medical Center
- North Carolina
  - Chapel Hill、North Carolina、美国、27599
    - UNC Lineberger Comprehensive Cancer Center
  - Durham、North Carolina、美国、27710
    - Duke University Medical Center
  - Durham、North Carolina、美国、27705
    - Durham VA Medical Center
  - Morehead City、North Carolina、美国、28557
    - The Coleman Radiation Center-Carteret General Hospital
  - Pinehurst、North Carolina、美国、28374
    - FirstHealth of the Carolinas-Moore Regional Hospital
  - Raleigh、North Carolina、美国、27607
    - UNC Rex Cancer Center
  - Supply、North Carolina、美国、28462
    - NHRMC Radiation Oncology - Supply
  - Wilmington、North Carolina、美国、28401
    - NHRMC Radiation Oncology - 16th Street
  - Winston-Salem、North Carolina、美国、27157
    - Wake Forest University Health Sciences
  - Winston-Salem、North Carolina、美国、27103
    - Novant Health Forsyth Medical Center
- North Dakota
  - Fargo、North Dakota、美国、58122
    - Sanford Broadway Medical Center
- Ohio
  - Akron、Ohio、美国、44307
    - Cleveland Clinic Akron General
  - Akron、Ohio、美国、44304
    - Summa Health System - Akron Campus
  - Barberton、Ohio、美国、44203
    - Summa Health System - Barberton Campus
  - Beachwood、Ohio、美国、44122
    - UHHS-Chagrin Highlands Medical Center
  - Canton、Ohio、美国、44708
    - Cleveland Clinic Mercy Hospital
  - Chardon、Ohio、美国、44024
    - Geauga Hospital
  - Chillicothe、Ohio、美国、45601
    - Adena Regional Medical Center
  - Cleveland、Ohio、美国、44106
    - Case Western Reserve University
  - Cleveland、Ohio、美国、44195
    - Cleveland Clinic Foundation
  - Cleveland、Ohio、美国、44111
    - Cleveland Clinic Cancer Center/Fairview Hospital
  - Columbus、Ohio、美国、43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus、Ohio、美国、43219
    - The Mark H Zangmeister Center
  - Columbus、Ohio、美国、43222
    - Mount Carmel Health Center West
  - Elyria、Ohio、美国、44035
    - Mercy Cancer Center-Elyria
  - Independence、Ohio、美国、44131
    - Cleveland Clinic Cancer Center Independence
  - Mansfield、Ohio、美国、44906
    - Cleveland Clinic Cancer Center Mansfield
  - Maumee、Ohio、美国、43537
    - Toledo Clinic Cancer Centers-Maumee
  - Mayfield Heights、Ohio、美国、44124
    - Hillcrest Hospital Cancer Center
  - Medina、Ohio、美国、44256
    - Summa Health Medina Medical Center
  - Mentor、Ohio、美国、44060
    - UH Seidman Cancer Center at Lake Health Mentor Campus
  - Middleburg Heights、Ohio、美国、44130
    - UH Seidman Cancer Center at Southwest General Hospital
  - Oregon、Ohio、美国、43616
    - Saint Charles Hospital
  - Parma、Ohio、美国、44129
    - University Hospitals Parma Medical Center
  - Portsmouth、Ohio、美国、45662
    - Southern Ohio Medical Center
  - Ravenna、Ohio、美国、44266
    - University Hospitals Portage Medical Center
  - Salem、Ohio、美国、44460
    - UH Seidman Cancer Center at Salem Regional Medical Center
  - Sandusky、Ohio、美国、44870
    - North Coast Cancer Care
  - Sandusky、Ohio、美国、44870
    - UH Seidman Cancer Center at Firelands Regional Medical Center
  - Strongsville、Ohio、美国、44136
    - Cleveland Clinic Cancer Center Strongsville
  - Sylvania、Ohio、美国、43560
    - ProMedica Flower Hospital
  - Toledo、Ohio、美国、43623
    - Mercy Health - Saint Anne Hospital
  - Toledo、Ohio、美国、43614
    - University of Toledo
  - Westlake、Ohio、美国、44145
    - UHHS-Westlake Medical Center
  - Wooster、Ohio、美国、44691
    - Cleveland Clinic Wooster Family Health and Surgery Center
  - Wooster、Ohio、美国、44691
    - Cancer Treatment Center
  - Wpafb、Ohio、美国、45433
    - Wright-Patterson Medical Center
  - Zanesville、Ohio、美国、43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Oklahoma City、Oklahoma、美国、73104
    - University of Oklahoma Health Sciences Center
  - Tulsa、Oklahoma、美国、74104
    - Saint John Medical Center
- Oregon
  - Clackamas、Oregon、美国、97015
    - Clackamas Radiation Oncology Center
  - Grants Pass、Oregon、美国、97527
    - Three Rivers Community Hospital
  - Medford、Oregon、美国、97504
    - Providence Medford Medical Center
  - Medford、Oregon、美国、97504
    - Rogue Valley Medical Center
  - Portland、Oregon、美国、97213
    - Providence Portland Medical Center
  - Portland、Oregon、美国、97225
    - Providence Saint Vincent Medical Center
  - Portland、Oregon、美国、97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Abington、Pennsylvania、美国、19001
    - Jefferson Abington Hospital
  - Allentown、Pennsylvania、美国、18103
    - Lehigh Valley Hospital-Cedar Crest
  - Danville、Pennsylvania、美国、17822
    - Geisinger Medical Center
  - Dunmore、Pennsylvania、美国、18512
    - Northeast Radiation Oncology Center
  - Ephrata、Pennsylvania、美国、17522
    - Ephrata Cancer Center
  - Furlong、Pennsylvania、美国、18925
    - Fox Chase Cancer Center Buckingham
  - Gettysburg、Pennsylvania、美国、17325
    - Adams Cancer Center
  - Hanover、Pennsylvania、美国、17331
    - Cherry Tree Cancer Center
  - Hershey、Pennsylvania、美国、17033-0850
    - Penn State Milton S Hershey Medical Center
  - Lebanon、Pennsylvania、美国、17042
    - Sechler Family Cancer Center
  - Milford、Pennsylvania、美国、18337
    - Upper Delaware Valley Cancer Center
  - Philadelphia、Pennsylvania、美国、19111
    - Fox Chase Cancer Center
  - Pittsburgh、Pennsylvania、美国、15240
    - VA Pittsburgh Healthcare System
  - West Reading、Pennsylvania、美国、19611
    - Reading Hospital
  - Wilkes-Barre、Pennsylvania、美国、18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Willow Grove、Pennsylvania、美国、19090
    - Asplundh Cancer Pavilion
  - York、Pennsylvania、美国、17403
    - WellSpan Health-York Hospital
- South Carolina
  - Anderson、South Carolina、美国、29621
    - AnMed Health Cancer Center
  - Boiling Springs、South Carolina、美国、29316
    - Prisma Health Cancer Institute - Spartanburg
  - Charleston、South Carolina、美国、29425
    - Medical University of South Carolina
  - Georgetown、South Carolina、美国、29440
    - Tidelands Georgetown Memorial Hospital
  - Greenville、South Carolina、美国、29605
    - Prisma Health Cancer Institute - Faris
  - Greenville、South Carolina、美国、29607
    - Saint Francis Cancer Center
  - Greenville、South Carolina、美国、29615
    - Prisma Health Cancer Institute - Eastside
  - Greenwood、South Carolina、美国、29646
    - Self Regional Healthcare
  - Greer、South Carolina、美国、29650
    - Prisma Health Cancer Institute - Greer
  - Greer、South Carolina、美国、29651
    - Gibbs Cancer Center-Pelham
  - Hilton Head Island、South Carolina、美国、29926
    - The Radiation Oncology Center-Hilton Head/Bluffton
  - Seneca、South Carolina、美国、29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg、South Carolina、美国、29303
    - Spartanburg Medical Center
- South Dakota
  - Sioux Falls、South Dakota、美国、57117-5134
    - Sanford USD Medical Center - Sioux Falls
- Tennessee
  - Chattanooga、Tennessee、美国、37403
    - Erlanger Medical Center
  - Kingsport、Tennessee、美国、37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Nashville、Tennessee、美国、37232
    - Vanderbilt University/Ingram Cancer Center
- Texas
  - Abilene、Texas、美国、79606
    - Texas Cancer Center
  - Beaumont、Texas、美国、77702
    - Texas Oncology PA Beaumont
  - Dallas、Texas、美国、75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - Denison、Texas、美国、75020
    - Texas Oncology - Denison Cancer Center
  - Fort Sam Houston、Texas、美国、78234
    - Brooke Army Medical Center
  - Fort Worth、Texas、美国、76104
    - Texas Oncology - Fort Worth Cancer Center
  - Galveston、Texas、美国、77555-0565
    - University of Texas Medical Branch
  - Houston、Texas、美国、77030
    - Ben Taub General Hospital
  - Houston、Texas、美国、77024
    - Memorial Hermann Memorial City Medical Center
  - League City、Texas、美国、77573
    - UTMB Cancer Center at Victory Lakes
  - McAllen、Texas、美国、78503
    - Texas Oncology-McAllen
  - McKinney、Texas、美国、75071
    - Texas Oncology-McKinney
  - Odessa、Texas、美国、79761
    - West Texas Cancer Center
  - Plano、Texas、美国、75093
    - Texas Oncology-Plano West
  - San Antonio、Texas、美国、78229
    - University of Texas Health Science Center at San Antonio
  - Sugar Land、Texas、美国、77479
    - Texas Oncology Cancer Center Sugar Land
  - Webster、Texas、美国、77598
    - Deke Slayton Cancer Center
- Utah
  - American Fork、Utah、美国、84003
    - American Fork Hospital / Huntsman Intermountain Cancer Center
  - Cedar City、Utah、美国、84720
    - Sandra L Maxwell Cancer Center
  - Murray、Utah、美国、84107
    - Intermountain Medical Center
  - Ogden、Utah、美国、84403
    - McKay-Dee Hospital Center
  - Ogden、Utah、美国、84405
    - Ogden Regional Medical Center
  - Provo、Utah、美国、84604
    - Utah Valley Regional Medical Center
  - Salt Lake City、Utah、美国、84112
    - Huntsman Cancer Institute/University of Utah
  - Salt Lake City、Utah、美国、84106
    - Utah Cancer Specialists-Salt Lake City
  - St. George、Utah、美国、84770
    - Dixie Medical Center Regional Cancer Center
- Vermont
  - Bennington、Vermont、美国、05201
    - Southwestern Vermont Medical Center
  - Berlin Corners、Vermont、美国、05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington、Vermont、美国、05401
    - University of Vermont Medical Center
  - Saint Johnsbury、Vermont、美国、05819
    - Norris Cotton Cancer Center-North
- Virginia
  - Charlottesville、Virginia、美国、22908
    - University of Virginia Cancer Center
  - Fishersville、Virginia、美国、22939
    - Augusta Health Center for Cancer and Blood Disorders
  - Hampton、Virginia、美国、23666
    - Sentara Cancer Institute at Sentara CarePlex Hospital
  - Harrisonburg、Virginia、美国、22801
    - Sentara Rockingham Memorial Hospital Hahn Cancer Center
  - Norfolk、Virginia、美国、23507
    - Sentara Norfolk General Hospital
  - Norfolk、Virginia、美国、23505
    - Bon Secours DePaul Medical Center
  - Portsmouth、Virginia、美国、23708-2197
    - Naval Medical Center - Portsmouth
  - Richmond、Virginia、美国、23249
    - Hunter Holmes McGuire Veterans Administration Medical Center
  - Roanoke、Virginia、美国、24014
    - Oncology and Hematology Associates of Southwest Virginia
  - Suffolk、Virginia、美国、23434
    - Sentara Obici Hospital
  - Virginia Beach、Virginia、美国、23454
    - Sentara Virginia Beach General Hospital
- Washington
  - Federal Way、Washington、美国、98003
    - Saint Francis Hospital
  - Seattle、Washington、美国、98101
    - Virginia Mason Medical Center
  - Tacoma、Washington、美国、98431
    - Madigan Army Medical Center
  - Vancouver、Washington、美国、98664
    - PeaceHealth Southwest Medical Center
  - Yakima、Washington、美国、98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
- West Virginia
  - Bridgeport、West Virginia、美国、26330
    - United Hospital Center
  - Morgantown、West Virginia、美国、26506
    - West Virginia University Healthcare
- Wisconsin
  - Antigo、Wisconsin、美国、54409
    - Langlade Hospital and Cancer Center
  - Appleton、Wisconsin、美国、54911
    - ThedaCare Regional Cancer Center
  - Appleton、Wisconsin、美国、54911
    - ThedaCare Regional Medical Center - Appleton
  - Brookfield、Wisconsin、美国、53045
    - Ascension Southeast Wisconsin Hospital - Elmbrook Campus
  - Eau Claire、Wisconsin、美国、54701
    - Marshfield Medical Center-EC Cancer Center
  - Eau Claire、Wisconsin、美国、54703
    - Mayo Clinic Health System Eau Claire Hospital-Luther Campus
  - Franklin、Wisconsin、美国、53132
    - Ascension Saint Francis - Reiman Cancer Center
  - Green Bay、Wisconsin、美国、54311
    - Aurora BayCare Medical Center
  - Green Bay、Wisconsin、美国、54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay、Wisconsin、美国、54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Johnson Creek、Wisconsin、美国、53038
    - UW Cancer Center Johnson Creek
  - La Crosse、Wisconsin、美国、54601
    - Gundersen Lutheran Medical Center
  - La Crosse、Wisconsin、美国、54601
    - Mayo Clinic Health System-Franciscan Healthcare
  - Madison、Wisconsin、美国、53792
    - University of Wisconsin Hospital and Clinics
  - Marinette、Wisconsin、美国、54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette、Wisconsin、美国、54143
    - Bay Area Medical Center
  - Marshfield、Wisconsin、美国、54449
    - Marshfield Medical Center-Marshfield
  - Menomonee Falls、Wisconsin、美国、53051
    - Froedtert Menomonee Falls Hospital
  - Mequon、Wisconsin、美国、53097
    - Ascension Columbia Saint Mary's Hospital Ozaukee
  - Milwaukee、Wisconsin、美国、53226
    - Medical College of Wisconsin
  - Milwaukee、Wisconsin、美国、53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee、Wisconsin、美国、53210
    - Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
  - Milwaukee、Wisconsin、美国、53211
    - Ascension Columbia Saint Mary's Hospital - Milwaukee
  - Milwaukee、Wisconsin、美国、53295
    - Zablocki Veterans Administration Medical Center
  - Minocqua、Wisconsin、美国、54548
    - Marshfield Clinic-Minocqua Center
  - Oshkosh、Wisconsin、美国、54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine、Wisconsin、美国、53405
    - Ascension All Saints Hospital
  - Rice Lake、Wisconsin、美国、54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan、Wisconsin、美国、53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan、Wisconsin、美国、53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point、Wisconsin、美国、54482
    - Marshfield Clinic Stevens Point Center
  - Sturgeon Bay、Wisconsin、美国、54235-1495
    - Saint Vincent Hospital Cancer Center at Sturgeon Bay
  - Summit、Wisconsin、美国、53066
    - Aurora Medical Center in Summit
  - Two Rivers、Wisconsin、美国、54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Wausau、Wisconsin、美国、54401
    - Aspirus Regional Cancer Center
  - West Allis、Wisconsin、美国、53227
    - Aurora West Allis Medical Center
  - West Bend、Wisconsin、美国、53095
    - Froedtert West Bend Hospital/Kraemer Cancer Center
  - Wisconsin Rapids、Wisconsin、美国、54494
    - Aspirus Cancer Care - Wisconsin Rapids
- Wyoming
  - Cody、Wyoming、美国、82414
    - Billings Clinic-Cody
香港
- - Chai Wan、香港
    - Pamela Youde Nethersole Eastern Hospital

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

14年及以上 (成人、年长者)

接受健康志愿者

不

描述

疾病特征：

注册后 180 天内经病理学（组织学或细胞学）证实诊断为前列腺癌，并由以下组合之一确定为中度至高度复发风险：
- 格里森评分 7-10 + T1c-T2b（触诊）+ 前列腺特异性抗原 (PSA) < 50 ng/mL（包括中危和高危患者）
- 格里森评分 6 + T2c-T4（触诊）+ PSA < 50 ng/mL 或
- 格里森评分 6 + >= 50%（阳性）活检 + PSA < 50 ng/ml
- Gleason 评分 6 + T1c-T2b（触诊）+ PSA > 20 ng/mL 先前诊断为低风险前列腺癌并接受主动监测且根据方案重新活检发现患有不利的中等风险疾病或有利的高风险疾病的患者标准符合在重复活检程序后 180 天内入组的条件。
注册前 90 天内的病史和/或体格检查（至少包括前列腺直肠指检以及骨骼系统和腹部检查）
注册前 90 天内通过影像学（盆腔和/或腹部 CT 或 MR）（但不是通过淋巴结取样或解剖）确定的临床阴性淋巴结
- 如果淋巴结≤ 1.5 cm，则淋巴结模糊或可疑的患者符合条件
- 淋巴结清扫阴性后的患者状态不符合条件
注册前 120 天内骨扫描无骨转移 (M0) 证据（Na F PET/CT 是可接受的替代）
- 如果平片（或 CT 或 MRI）对转移呈阴性，则允许骨扫描结果不明确
注册前 120 天内使用 FDA 批准的测定法（例如 Abbott、Hybritech）进行的基线血清 PSA 值
不应在以下时间范围内获得入学 PSA：
- 前列腺活检后十天
- 激素治疗开始后
- 停用非那雄胺后 30 天内
- 度他雄胺停药后 90 天内

患者特征：

祖布罗德表现状态 0-1
中性粒细胞绝对计数 (ANC) ≥ 1,500/mm³
血小板计数≥100,000/mm³
血红蛋白 (Hgb) ≥ 8.0 g/dL（可以通过输血或其他干预措施使 Hgb ≥ 8.0 g/dL）
之前没有侵袭性（非黑色素瘤皮肤癌除外）恶性肿瘤，除非至少 3 年（1,095 天）无病并且不在骨盆中
- 例如，口腔原位癌是允许的；但是，不允许有膀胱癌病史的患者
- 既往无血液学（例如白血病、淋巴瘤或骨髓瘤）恶性肿瘤
- 既往未接受根治性手术（前列腺切除术）或前列腺癌冷冻手术
- 既往无盆腔放疗、前列腺近距离放疗或双侧睾丸切除术
- 既往未接受过激素治疗，例如 LHRH 激动剂（例如亮丙瑞林、戈舍瑞林、布舍瑞林、曲普瑞林）或 LHRH 拮抗剂（例如地加瑞克）、抗雄激素药（例如氟他胺、比卡鲁胺、醋酸环丙孕酮）、雌激素（例如 DES）或手术去势（睾丸切除术）
仅当雄激素消融（LHRH 激动剂和口服抗雄激素）开始于注册日期前 ≤ 45 天时，才允许先前对前列腺癌进行药物雄激素消融。
没有严重的活动性合并症，定义为以下任何一项：
- 最近 6 个月内需要住院治疗的不稳定型心绞痛和/或充血性心力衰竭
- 最近 6 个月内发生透壁性心肌梗死
- 注册时需要静脉注射抗生素的急性细菌或真菌感染
- 慢性阻塞性肺疾病恶化或其他呼吸系统疾病需要住院治疗或在注册时排除研究治疗
- 导致临床黄疸和/或凝血缺陷或严重肝功能障碍的肝功能不全
- 根据当前疾病控制中心 (CDC) 的定义获得性免疫缺陷综合症 (AIDS)
  - 协议特定要求也可能排除免疫功能低下的患者
  - 加入本协议不需要进行 HIV 检测
没有性活跃且不愿意/不能使用医学上可接受的避孕方式的患者
之前没有对本方案中涉及的激素产生过敏反应

先前的同步治疗：

见疾病特征
既往未接受根治性手术（前列腺切除术）或前列腺癌冷冻手术
既往无盆腔照射、前列腺近距离放射治疗或双侧睾丸切除术
既往未接受过激素治疗，如促黄体激素释放激素 (LHRH) 激动剂（如亮丙瑞林、戈舍瑞林、布舍瑞林、曲普瑞林）或 LHRH 拮抗剂（如地加瑞克）、抗雄激素药物（如氟他胺、比卡鲁胺、醋酸环丙孕酮），雌激素（例如己烯雌酚 (DES)）或手术去势（睾丸切除术）
除非雄激素消融开始于注册日期前 ≤ 45 天，否则没有针对前列腺癌进行过药物雄激素消融
注册前 30 天内未使用非那雄胺
注册前 90 天内没有使用度他雄胺或度他雄胺/坦索罗辛 (Jalyn)
没有先前或同时进行的前列腺癌细胞毒性化疗
- 允许先前对不同癌症进行化疗
先前未对研究癌症区域进行会导致放射治疗野重叠的放射治疗，包括近距离放射治疗

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

主要用途：治疗
分配：随机化
介入模型：并行分配
屏蔽：无（打开标签）

手臂数量

武器和干预

参与者组/臂	干预/治疗
有源比较器：Prostate/Seminal Vesicle Radiotherapy + ADT + Prostate Boost (Arm 1) Participants receive androgen deprivation therapy (ADT), consisting of an oral anti androgen plus a luteinizing hormone-releasing hormone (LHRH) agonist or antagonist, for a total duration of 4, 6, or 32 months. Approximately 8-10 weeks after starting the LHRH agent, participants undergo external beam radiation therapy (EBRT) to the prostate and entire seminal vesicles, delivered as 45 Gy in 25 fractions using three-dimensional conformal radiotherapy (3D CRT) or intensity modulated radiotherapy (IMRT). A boost to the prostate and proximal seminal vesicles follows, using either IMRT (34.2 Gy in 19 fractions, with protocol specified dose reduction options when indicated) or brachytherapy delivered as low dose rate (LDR) or high dose rate (HDR) implant per protocol.	辐射：three-dimensional conformal radiotherapy Daily fractions 辐射：intensity modulated radiotherapy Daily fractions 辐射：Brachytherapy Implant 药品：Anti-androgen Tablet 药品：luteinizing hormone-releasing hormone (LHRH) agonist or antagonist Injection
实验性的：Whole Pelvic Radiotherapy + ADT + Prostate Boost (Arm 2) Participants receive ADT as in Arm 1. Approximately 8-10 weeks after starting the LHRH agent, participants undergo external beam radiation therapy (EBRT) to the whole pelvis-including prostate, seminal vesicles, and pelvic lymph nodes-delivered as 45 Gy in 25 fractions using three-dimensional conformal radiotherapy (3D CRT) or intensity modulated radiotherapy (IMRT). A boost is then administered as specified for Arm 1.	辐射：three-dimensional conformal radiotherapy Daily fractions 辐射：intensity modulated radiotherapy Daily fractions 辐射：Brachytherapy Implant 药品：Anti-androgen Tablet 药品：luteinizing hormone-releasing hormone (LHRH) agonist or antagonist Injection

参与者组/臂

干预/治疗

有源比较器：Prostate/Seminal Vesicle Radiotherapy + ADT + Prostate Boost (Arm 1)

Participants receive androgen deprivation therapy (ADT), consisting of an oral anti androgen plus a luteinizing hormone-releasing hormone (LHRH) agonist or antagonist, for a total duration of 4, 6, or 32 months. Approximately 8-10 weeks after starting the LHRH agent, participants undergo external beam radiation therapy (EBRT) to the prostate and entire seminal vesicles, delivered as 45 Gy in 25 fractions using three-dimensional conformal radiotherapy (3D CRT) or intensity modulated radiotherapy (IMRT). A boost to the prostate and proximal seminal vesicles follows, using either IMRT (34.2 Gy in 19 fractions, with protocol specified dose reduction options when indicated) or brachytherapy delivered as low dose rate (LDR) or high dose rate (HDR) implant per protocol.

辐射：three-dimensional conformal radiotherapy

Daily fractions

辐射：intensity modulated radiotherapy

Daily fractions

辐射：Brachytherapy

Implant

药品：Anti-androgen

Tablet

药品：luteinizing hormone-releasing hormone (LHRH) agonist or antagonist

Injection

实验性的：Whole Pelvic Radiotherapy + ADT + Prostate Boost (Arm 2)

Participants receive ADT as in Arm 1. Approximately 8-10 weeks after starting the LHRH agent, participants undergo external beam radiation therapy (EBRT) to the whole pelvis-including prostate, seminal vesicles, and pelvic lymph nodes-delivered as 45 Gy in 25 fractions using three-dimensional conformal radiotherapy (3D CRT) or intensity modulated radiotherapy (IMRT). A boost is then administered as specified for Arm 1.

辐射：three-dimensional conformal radiotherapy

Daily fractions

辐射：intensity modulated radiotherapy

Daily fractions

辐射：Brachytherapy

Implant

药品：Anti-androgen

Tablet

药品：luteinizing hormone-releasing hormone (LHRH) agonist or antagonist

Injection

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
Percentage of Participants Alive (Overall Survival) 大体时间：From randomization to death or last follow-up. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.	Survival rates are estimated using the Kaplan-Meier method, censoring participants alive at time of analysis.	From randomization to death or last follow-up. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.

次要结果测量

结果测量	措施说明	大体时间
Percent of Participants Who Died Due to Prostate Cancer 大体时间：From randomization to death due to prostate cancer or last follow-up. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.	Prostate cancer death rates were estimated using the cumulative incidence method, treating death due to other causes as a competing risk, and otherwise censoring participants alive at time of analysis.	From randomization to death due to prostate cancer or last follow-up. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.
Percentage of Participants With Distant Metastasis 大体时间：From date of randomization to distant metastasis, death, or last follow-up, whichever occurs first. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.	Distant metastasis rates were estimated using the cumulative incidence method, treating death as a competing risk, and otherwise censoring participants alive without distant metastasis at time of analysis.	From date of randomization to distant metastasis, death, or last follow-up, whichever occurs first. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.
Percentage of Participants With Biochemical Failure 大体时间：From date of randomization to the date of biochemical failure, death, or last follow-up, whichever occurs first. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.	Biochemical failure is defined as a rise in prostate-specific antigen (PSA) of ≥2.0 ng/mL above the post-treatment PSA nadir following radiation therapy for prostate cancer (Phoenix definition). Biochemical failure rates were estimated using the cumulative incidence method, treating death as a competing risk, and otherwise censoring participants alive without biochemical failure at time of analysis.	From date of randomization to the date of biochemical failure, death, or last follow-up, whichever occurs first. Median follow-up at time of analysis was 6.8 years. Five- and ten-year estimates are reported.
Number of Participants by Highest Grade Acute Adverse Event Reported 大体时间：From protocol treatment start date to 30 days from completion of radiation therapy. RT begins approximately weeks 8-10 after starting protocol therapy and ends approximately weeks 19-22, depending on boost technique.	Common Terminology Criteria for Adverse Events (version 4.0) grades adverse event severity as follows: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = death related to adverse event. Acute adverse events are defined as those occurring within 30 days after the completion of radiation therapy. RT begins approximately weeks 8-10 after starting protocol therapy and ends approximately weeks 19-22, depending on boost technique. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data.	From protocol treatment start date to 30 days from completion of radiation therapy. RT begins approximately weeks 8-10 after starting protocol therapy and ends approximately weeks 19-22, depending on boost technique.
Number of Participants by Highest Grade Late Adverse Event Reported 大体时间：From 30 days after completion of radiation therapy (approximately weeks 19-22, depending on boost technique) to highest grade late adverse event. Median follow-up at time of analysis was 6.7 years.	Common Terminology Criteria for Adverse Events (version 4.0) grades adverse event severity as follows: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = death related to adverse event. Late adverse events are defined as occurring ≥ 30 days after end of RT (approximately weeks 19-22, depending on boost technique). Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data.	From 30 days after completion of radiation therapy (approximately weeks 19-22, depending on boost technique) to highest grade late adverse event. Median follow-up at time of analysis was 6.7 years.
EPIC-26 Urinary Bowel Domain Score Change From Baseline at 6 Months 大体时间：Baseline and 6 months after the end of RT, approximately 19-22 weeks, depending on boost technique.	The Expanded Prostate Cancer Index Composite-26 (EPIC-26) measures health-related quality of life in men with prostate cancer across urinary incontinence, urinary irritative/obstructive, bowel, sexual, and hormonal domains. Possible scores range from 0 to 100, with higher scores indicating better quality of life. Change is defined as the time point score minus the baseline score, where positive values indicate improvement and negative values indicate decline.	Baseline and 6 months after the end of RT, approximately 19-22 weeks, depending on boost technique.
EPIC-26 Urinary Irritative/Obstructive Subscore Change From Baseline at 6 Months 大体时间：Baseline and 6 months after the end of RT, approximately 19-22 weeks, depending on boost technique.	The Expanded Prostate Cancer Index Composite-26 (EPIC-26) measures health-related quality of life in men with prostate cancer across urinary incontinence, urinary irritative/obstructive, bowel, sexual, and hormonal domains. Possible scores range from 0 to 100, with higher scores indicating better quality of life. Change is defined as the time point score minus the baseline score, where positive values indicate improvement and negative values indicate decline.	Baseline and 6 months after the end of RT, approximately 19-22 weeks, depending on boost technique.
PROMIS Fatigue Score Change From Baseline Line at Last Week of Radiation Treatment 大体时间：Baseline and last week of radiation treatment, approximately 19-22 weeks, depending on boost technique.	The Patient-Reported Outcome Measurement Information System (PROMIS) fatigue score measures self-reported fatigue symptoms over the past 7 days. Possible raw scores range from 29.4 to 83.2 (higher raw score indicating greater fatigue) and are converted into standardized T-scores (mean=50, standard deviation=10) with higher scores also indicating greater fatigue. Change score is calculated by subtracting baseline T-score from later T-score, with a positive change score indicating increased fatigue.	Baseline and last week of radiation treatment, approximately 19-22 weeks, depending on boost technique.
Quality Adjusted Life Years (QALYs) 大体时间：Baseline; the week prior to radiation therapy (RT); the last week of RT; 6 months, 1 year, and 5 years after RT. RT begins about weeks 8-10 after starting protocol therapy and ends about weeks 19-22, depending on boost technique.	Quality adjusted life years is calculated as the weighted sum of the number of years spent in different health states. The weight value is a utility score between 0 (worst health state) and 1 (best health state) derived from the EQ-5D questionnaire, designed to describe and value health based on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.	Baseline; the week prior to radiation therapy (RT); the last week of RT; 6 months, 1 year, and 5 years after RT. RT begins about weeks 8-10 after starting protocol therapy and ends about weeks 19-22, depending on boost technique.

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Radiation Therapy Oncology Group

合作者

National Cancer Institute (NCI)

NRG Oncology

调查人员

首席研究员：Mack Roach, MD、University of California, San Francisco

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2011年7月1日

初级完成 (实际的)

2025年4月17日

研究完成 (估计的)

2031年7月1日

研究注册日期

首次提交

2011年6月7日

首先提交符合 QC 标准的

2011年6月7日

首次发布 (估计的)

2011年6月8日

研究记录更新

最后更新发布 (实际的)

2026年5月8日

上次提交的符合 QC 标准的更新

2026年4月16日

最后验证

2026年4月1日

治疗前列腺癌患者的雄激素剥夺疗法和放射疗法

雄激素剥夺疗法和高剂量放疗联合或不联合全盆腔放疗治疗预后不良的中度或高危前列腺癌：一项 III 期随机试验

研究概览

地位

条件

干预/治疗

详细说明

研究类型

注册 (实际的)

阶段

联系人和位置

学习地点

参与标准

资格标准

适合学习的年龄

接受健康志愿者

描述

学习计划

研究是如何设计的？

设计细节

手臂数量

武器和干预

参与者组/臂

干预/治疗

研究衡量的是什么？

主要结果指标

结果测量

措施说明

大体时间

次要结果测量

结果测量

措施说明

大体时间

合作者和调查者

赞助

合作者

调查人员

研究记录日期

研究主要日期

学习开始 (实际的)

初级完成 (实际的)

研究完成 (估计的)

研究注册日期

首次提交

首先提交符合 QC 标准的

首次发布 (估计的)

研究记录更新

最后更新发布 (实际的)

上次提交的符合 QC 标准的更新

最后验证

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

计划个人参与者数据 (IPD)

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IPD 计划说明