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Brief Title: Standard or Comprehensive Radiation Therapy in Treating Patients With Early-Stage Breast Cancer Previously Treated With Chemotherapy and Surgery
Official Title: A Randomized Phase III Clinical Trial Evaluating Post-Mastectomy Chestwall and Regional Nodal XRT and Post-Lumpectomy Regional Nodal XRT in Patients With Positive Axillary Nodes Before Neoadjuvant Chemotherapy Who Convert to Pathologically Negative Axillary Nodes After Neoadjuvant Chemotherapy
Study ID: NCT01872975
Brief Summary: This randomized phase III trial studies standard or comprehensive radiation therapy in treating patients with early-stage breast cancer who have undergone surgery. Radiation therapy uses high-energy x rays to kill tumor cells. It is not yet known whether comprehensive radiation therapy is more effective than standard radiation therapy in treating patients with breast cancer
Detailed Description: PRIMARY OBJECTIVES: To evaluate whether the addition of chest wall + regional nodal radiation therapy (XRT) after mastectomy or breast + regional nodal XRT after breast conserving surgery will significantly reduce the rate of events for invasive breast cancer recurrence-free interval (IBC-RFI) in patients who present with histologically positive axillary nodes but convert to histologically negative axillary nodes following neoadjuvant chemotherapy. SECONDARY OBJECTIVES: I. To evaluate whether the addition of chest wall + regional nodal XRT after mastectomy or breast + regional nodal XRT after breast conserving surgery will significantly prolong overall survival (OS) in patients who present with histologically positive axillary nodes but convert to histologically negative axillary nodes following neoadjuvant chemotherapy. II. To evaluate whether the addition of chest wall + regional nodal XRT after mastectomy or breast + regional nodal XRT after breast conserving surgery will significantly reduce the rates of events for local-regional recurrence-free interval (LRRFI) in patients who present with histologically positive axillary nodes but convert to histologically negative axillary nodes following neoadjuvant chemotherapy. III. To evaluate whether the addition of chest wall + regional nodal XRT after mastectomy or breast + regional nodal XRT after breast conserving surgery will significantly reduce the rate of events for distant recurrence-free interval (DRFI) in patients who present with histologically positive axillary nodes but convert to histologically negative axillary nodes following neoadjuvant chemotherapy. IV. To compare the rates of disease-free survival (DFS)-ductal carcinoma in situ (DCIS) by treatment arm. V. To compare the rates of second primary cancer (SPC) by treatment arm. VI. To compare the effect of adding XRT on the cosmetic outcomes in mastectomy patients who have had reconstruction. VII. To compare the effect of adding XRT on quality of life including arm problems, lymphedema, pain, and fatigue. VIII. To evaluate the toxicity associated with each of the radiation therapy regimens. IX. To determine whether computed tomography (CT)-based conformal methods (intensity-modulated radiation therapy \[IMRT\] and 3-dimensional conformal radiation therapy \[3DCRT\]) for chestwall + regional nodal XRT post mastectomy and regional nodal XRT with breast XRT following breast conserving surgery are feasible in a multi-institutional setting and whether dose-volume analyses can be established to assess treatment adequacy and to develop normal tissue complication probabilities (NTCP) for the likelihood of toxicity. X. To compare the effect of XRT in patients receiving mastectomy and in patients receiving lumpectomy. XI. To examine the role of proliferation measures as a prognosticator for patients with residual disease after neoadjuvant chemotherapy. XII. To develop predictors of the degree of reduction in local regional recurrence (LRR). OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM 1: Patients are assigned to 1 of 2 treatment groups. GROUP 1A: Lumpectomy patients undergo whole breast radiation therapy using IMRT or 3DCRT once daily 5 days a week for 5 weeks followed by a radiation therapy boost to the lumpectomy cavity once daily 5 days a week for 1-1/2 weeks. GROUP 1B: Mastectomy patients do not undergo radiation therapy. ARM 2: Patients are assigned to 1 of 2 treatment groups. GROUP 2A: Lumpectomy patients undergo regional nodal radiation therapy with whole breast radiation therapy using IMRT or 3DCRT once daily 5 days a week for 5 weeks followed by a radiation therapy boost to the lumpectomy cavity once daily 5 days a week for 1-1/2 weeks. GROUP 2B: Mastectomy patients undergo regional nodal radiation therapy and chestwall XRT using IMRT or 3DCRT once daily 5 days a week for 5 weeks. All patients also receive systemic therapy as planned (hormonal therapy for patients with hormone-receptor positive breast cancer and trastuzumab or other anti-human epidermal growth factor receptor 2 \[HER2\] therapy for patients with breast cancer that is HER2-positive). After completion of study treatment, patients are followed up at 6, 12, 18, and 24 months and then yearly for 8 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
University of Alabama at Birmingham Cancer Center, Birmingham, Alabama, United States
University of South Alabama Mitchell Cancer Institute, Mobile, Alabama, United States
Providence Alaska Medical Center, Anchorage, Alaska, United States
Arizona Breast Cancer Specialists-Gilbert, Gilbert, Arizona, United States
Arizona Center for Cancer Care-Peoria, Peoria, Arizona, United States
Arizona Breast Cancer Specialists-Phoenix, Phoenix, Arizona, United States
Arizona Breast Cancer Specialists-Scottsdale, Scottsdale, Arizona, United States
Arizona Center for Cancer Care-Surprise, Surprise, Arizona, United States
Arizona Oncology Associates-West Orange Grove, Tucson, Arizona, United States
The University of Arizona Medical Center-University Campus, Tucson, Arizona, United States
University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
Sutter Cancer Centers Radiation Oncology Services-Auburn, Auburn, California, United States
Mills - Peninsula Hospitals, Burlingame, California, United States
Sutter Cancer Centers Radiation Oncology Services-Cameron Park, Cameron Park, California, United States
Eden Hospital Medical Center, Castro Valley, California, United States
City of Hope Comprehensive Cancer Center, Duarte, California, United States
Epic Care-Dublin, Dublin, California, United States
Epic Care Partners in Cancer Care, Emeryville, California, United States
California Cancer Center - North Fresno, Fresno, California, United States
UC San Diego Moores Cancer Center, La Jolla, California, United States
City of Hope Antelope Valley, Lancaster, California, United States
Loma Linda University Medical Center, Loma Linda, California, United States
Los Angeles County-USC Medical Center, Los Angeles, California, United States
USC / Norris Comprehensive Cancer Center, Los Angeles, California, United States
Cedars-Sinai Medical Center, Los Angeles, California, United States
Hoag Memorial Hospital, Newport Beach, California, United States
Alta Bates Summit Medical Center - Summit Campus, Oakland, California, United States
Kaiser Permanente Oakland-Broadway, Oakland, California, United States
Saint Joseph Hospital - Orange, Orange, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange, California, United States
Desert Regional Medical Center, Palm Springs, California, United States
Huntington Memorial Hospital, Pasadena, California, United States
Pomona Valley Hospital Medical Center, Pomona, California, United States
Kaiser Permanente-Rancho Cordova Cancer Center, Rancho Cordova, California, United States
Rohnert Park Cancer Center, Rohnert Park, California, United States
Kaiser Permanente-Roseville, Roseville, California, United States
Sutter Cancer Centers Radiation Oncology Services-Roseville, Roseville, California, United States
Sutter Roseville Medical Center, Roseville, California, United States
The Permanente Medical Group-Roseville Radiation Oncology, Roseville, California, United States
Sutter General Hospital, Sacramento, California, United States
University of California Davis Comprehensive Cancer Center, Sacramento, California, United States
Saint Helena Hospital, Saint Helena, California, United States
Naval Medical Center -San Diego, San Diego, California, United States
Kaiser Permanente Medical Center - Santa Clara, Santa Clara, California, United States
City of Hope South Pasadena, South Pasadena, California, United States
Kaiser Permanente Cancer Treatment Center, South San Francisco, California, United States
Kaiser Permanente-South San Francisco, South San Francisco, California, United States
Gene Upshaw Memorial Tahoe Forest Cancer Center, Truckee, California, United States
Sutter Cancer Centers Radiation Oncology Services-Vacaville, Vacaville, California, United States
Sutter Solano Medical Center/Cancer Center, Vallejo, California, United States
Rocky Mountain Cancer Centers-Aurora, Aurora, Colorado, United States
University of Colorado Cancer Center - Anschutz Cancer Pavilion, Aurora, Colorado, United States
Rocky Mountain Cancer Centers-Boulder, Boulder, Colorado, United States
Penrose-Saint Francis Healthcare, Colorado Springs, Colorado, United States
Memorial Hospital Colorado Springs, Colorado Springs, Colorado, United States
Porter Adventist Hospital, Denver, Colorado, United States
The Shaw Regional Cancer Center, Edwards, Colorado, United States
Poudre Valley Hospital, Fort Collins, Colorado, United States
Rocky Mountain Cancer Centers-Littleton, Littleton, Colorado, United States
Saint Mary Corwin Medical Center, Pueblo, Colorado, United States
Rocky Mountain Cancer Centers-Thornton, Thornton, Colorado, United States
SCL Health Lutheran Medical Center, Wheat Ridge, Colorado, United States
Hartford Hospital, Hartford, Connecticut, United States
Middlesex Hospital, Middletown, Connecticut, United States
The Hospital of Central Connecticut, New Britain, Connecticut, United States
MedStar Georgetown University Hospital, Washington, District of Columbia, United States
MedStar Washington Hospital Center, Washington, District of Columbia, United States
Sibley Memorial Hospital, Washington, District of Columbia, United States
Florida Hospital Cancer Institute Altamonte, Altamonte Springs, Florida, United States
John Fitzgerald Kennedy Medical Center, Atlantis, Florida, United States
Morton Plant Hospital, Clearwater, Florida, United States
UM Sylvester Comprehensive Cancer Center at Deerfield Beach, Deerfield Beach, Florida, United States
University of Florida, Gainesville, Florida, United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital, Hollywood, Florida, United States
Jackson Memorial Hospital-Holtz Children's Hospital, Miami, Florida, United States
University of Miami Miller School of Medicine-Sylvester Cancer Center, Miami, Florida, United States
South Miami Hospital, Miami, Florida, United States
Baptist Hospital of Miami, Miami, Florida, United States
Florida Hospital Orlando, Orlando, Florida, United States
UF Cancer Center at Orlando Health, Orlando, Florida, United States
21st Century Oncology-Palatka, Palatka, Florida, United States
Saint Joseph's Hospital/Children's Hospital-Tampa, Tampa, Florida, United States
Moffitt Cancer Center, Tampa, Florida, United States
Grady Health System, Atlanta, Georgia, United States
Emory University Hospital Midtown, Atlanta, Georgia, United States
Piedmont Hospital, Atlanta, Georgia, United States
Emory University/Winship Cancer Institute, Atlanta, Georgia, United States
Saint Joseph's Hospital of Atlanta, Atlanta, Georgia, United States
Tanner Medical Center/Carrollton, Carrollton, Georgia, United States
Dekalb Medical Center, Decatur, Georgia, United States
Memorial University Medical Center, Savannah, Georgia, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler, Savannah, Georgia, United States
The Cancer Center of Hawaii-Leeward, 'Ewa Beach, Hawaii, United States
Queen's Medical Center, Honolulu, Hawaii, United States
The Cancer Center of Hawaii-Liliha, Honolulu, Hawaii, United States
Saint Alphonsus Cancer Care Center-Boise, Boise, Idaho, United States
Kootenai Cancer Center, Post Falls, Idaho, United States
Mount Sinai Hospital Medical Center, Chicago, Illinois, United States
Northwestern University, Chicago, Illinois, United States
John H Stroger Jr Hospital of Cook County, Chicago, Illinois, United States
University of Illinois, Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States
Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States
Decatur Memorial Hospital, Decatur, Illinois, United States
AMITA Health Alexian Brothers Medical Center, Elk Grove Village, Illinois, United States
Elmhurst Memorial Hospital, Elmhurst, Illinois, United States
NorthShore University HealthSystem-Evanston Hospital, Evanston, Illinois, United States
NorthShore University HealthSystem-Glenbrook Hospital, Glenview, Illinois, United States
Advocate South Suburban Hospital, Hazel Crest, Illinois, United States
NorthShore University HealthSystem-Highland Park Hospital, Highland Park, Illinois, United States
Presence Saint Mary's Hospital, Kankakee, Illinois, United States
Condell Memorial Hospital, Libertyville, Illinois, United States
Loyola University Medical Center, Maywood, Illinois, United States
Edward Hospital/Cancer Center, Naperville, Illinois, United States
UC Comprehensive Cancer Center at Silver Cross, New Lenox, Illinois, United States
Advocate Christ Medical Center, Oak Lawn, Illinois, United States
Advocate Lutheran General Hospital, Park Ridge, Illinois, United States
Illinois CancerCare-Peoria, Peoria, Illinois, United States
OSF Saint Francis Radiation Oncology at Peoria Cancer Center, Peoria, Illinois, United States
OSF Saint Francis Medical Center, Peoria, Illinois, United States
Edward Hospital/Cancer Center?Plainfield, Plainfield, Illinois, United States
SwedishAmerican Regional Cancer Center/ACT, Rockford, Illinois, United States
Memorial Medical Center, Springfield, Illinois, United States
Carle Cancer Center, Urbana, Illinois, United States
Northwestern Medicine Cancer Center Warrenville, Warrenville, Illinois, United States
Saint Vincent Anderson Regional Hospital/Cancer Center, Anderson, Indiana, United States
Parkview Hospital Randallia, Fort Wayne, Indiana, United States
Goshen Center for Cancer Care, Goshen, Indiana, United States
Indiana University/Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, United States
IU Health Methodist Hospital, Indianapolis, Indiana, United States
Community Cancer Center East, Indianapolis, Indiana, United States
Community Cancer Center South, Indianapolis, Indiana, United States
Franciscan Health Indianapolis, Indianapolis, Indiana, United States
Community Cancer Center North, Indianapolis, Indiana, United States
Saint Vincent Hospital and Health Care Center, Indianapolis, Indiana, United States
Memorial Hospital of South Bend, South Bend, Indiana, United States
Mercy Cancer Center-West Lakes, Clive, Iowa, United States
Iowa Methodist Medical Center, Des Moines, Iowa, United States
Mercy Medical Center - Des Moines, Des Moines, Iowa, United States
University of Iowa/Holden Comprehensive Cancer Center, Iowa City, Iowa, United States
University of Kansas Cancer Center, Kansas City, Kansas, United States
University of Kansas Cancer Center-Overland Park, Overland Park, Kansas, United States
Via Christi Regional Medical Center, Wichita, Kansas, United States
Wesley Medical Center, Wichita, Kansas, United States
Wichita NCI Community Oncology Research Program, Wichita, Kansas, United States
Saint Elizabeth Medical Center South, Edgewood, Kentucky, United States
Saint Elizabeth Fort Thomas, Fort Thomas, Kentucky, United States
Norton Hospital Pavilion and Medical Campus, Louisville, Kentucky, United States
The James Graham Brown Cancer Center at University of Louisville, Louisville, Kentucky, United States
Baptist Health Louisville, Louisville, Kentucky, United States
Norton Suburban Hospital and Medical Campus, Louisville, Kentucky, United States
Owensboro Health Mitchell Memorial Cancer Center, Owensboro, Kentucky, United States
Baton Rouge General Medical Center, Baton Rouge, Louisiana, United States
Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana, United States
Woman's Hospital, Baton Rouge, Louisiana, United States
Mary Bird Cancer Center/Saint Tammany Parish, Covington, Louisiana, United States
Mary Bird Perkins Cancer Center/Terrebonne General Medical Center, Houma, Louisiana, United States
Ochsner Medical Center Kenner, Kenner, Louisiana, United States
Ochsner Medical Center Jefferson, New Orleans, Louisiana, United States
Eastern Maine Medical Center, Bangor, Maine, United States
Maine Medical Center- Scarborough Campus, Scarborough, Maine, United States
Anne Arundel Medical Center, Annapolis, Maryland, United States
University of Maryland/Greenebaum Cancer Center, Baltimore, Maryland, United States
Greater Baltimore Medical Center, Baltimore, Maryland, United States
MedStar Franklin Square Medical Center/Weinberg Cancer Institute, Baltimore, Maryland, United States
Johns Hopkins University/Sidney Kimmel Cancer Center, Baltimore, Maryland, United States
Upper Chesapeake Medical Center, Bel Air, Maryland, United States
Central Maryland Radiation Oncology in Howard County, Columbia, Maryland, United States
Tate Cancer Center, Glen Burnie, Maryland, United States
Boston Medical Center, Boston, Massachusetts, United States
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
Saint Anne's Hospital, Fall River, Massachusetts, United States
Lowell General Hospital, Lowell, Massachusetts, United States
Baystate Medical Center, Springfield, Massachusetts, United States
University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, United States
Henry Ford Cancer Institute¿Downriver, Brownstown, Michigan, United States
21st Century Oncology-Clarkston, Clarkston, Michigan, United States
Henry Ford Macomb Hospital-Clinton Township, Clinton Township, Michigan, United States
Beaumont Hospital-Dearborn, Dearborn, Michigan, United States
Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, United States
Henry Ford Hospital, Detroit, Michigan, United States
Saint John Hospital and Medical Center, Detroit, Michigan, United States
Hurley Medical Center, Flint, Michigan, United States
Genesys Hurley Cancer Institute, Flint, Michigan, United States
McLaren Cancer Institute-Flint, Flint, Michigan, United States
Spectrum Health at Butterworth Campus, Grand Rapids, Michigan, United States
Sparrow Hospital, Lansing, Michigan, United States
McLaren Cancer Institute-Lapeer Region, Lapeer, Michigan, United States
McLaren Cancer Institute-Macomb, Mount Clemens, Michigan, United States
McLaren Cancer Institute-Central Michigan, Mount Pleasant, Michigan, United States
Mercy Health Mercy Campus, Muskegon, Michigan, United States
Assarian Cancer Center, Novi, Michigan, United States
McLaren Cancer Institute-Owosso, Owosso, Michigan, United States
McLaren Cancer Institute-Northern Michigan, Petoskey, Michigan, United States
Saint Joseph Mercy Oakland, Pontiac, Michigan, United States
William Beaumont Hospital-Royal Oak, Royal Oak, Michigan, United States
Providence Hospital-Southfield Cancer Center, Southfield, Michigan, United States
21st Century Oncology-Troy, Troy, Michigan, United States
William Beaumont Hospital - Troy, Troy, Michigan, United States
Saint John Macomb-Oakland Hospital, Warren, Michigan, United States
Henry Ford West Bloomfield Hospital, West Bloomfield, Michigan, United States
Metro Health Hospital, Wyoming, Michigan, United States
Mayo Clinic Health System in Albert Lea, Albert Lea, Minnesota, United States
Fairview Ridges Hospital, Burnsville, Minnesota, United States
Unity Hospital, Fridley, Minnesota, United States
Mayo Clinic Health Systems-Mankato, Mankato, Minnesota, United States
Abbott-Northwestern Hospital, Minneapolis, Minnesota, United States
Mayo Clinic Radiation Therapy-Northfield, Northfield, Minnesota, United States
Mayo Clinic, Rochester, Minnesota, United States
Coborn Cancer Center at Saint Cloud Hospital, Saint Cloud, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park, Minnesota, United States
Regions Hospital, Saint Paul, Minnesota, United States
United Hospital, Saint Paul, Minnesota, United States
Ridgeview Medical Center, Waconia, Minnesota, United States
University of Mississippi Medical Center, Jackson, Mississippi, United States
Baptist Memorial Hospital-Desoto, Southhaven, Mississippi, United States
Saint Francis Medical Center, Cape Girardeau, Missouri, United States
Saint Luke's Hospital, Chesterfield, Missouri, United States
University of Missouri - Ellis Fischel, Columbia, Missouri, United States
Barnes-Jewish West County Hospital, Creve Coeur, Missouri, United States
Saint Luke's Hospital of Kansas City, Kansas City, Missouri, United States
North Kansas City Hospital, Kansas City, Missouri, United States
The University of Kansas Cancer Center-South, Kansas City, Missouri, United States
Research Medical Center, Kansas City, Missouri, United States
The University of Kansas Cancer Center-North, Kansas City, Missouri, United States
The University of Kansas Cancer Center-Lee's Summit, Lee's Summit, Missouri, United States
Saint Luke's East - Lee's Summit, Lee's Summit, Missouri, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
Saint Anthony's Medical Center, Saint Louis, Missouri, United States
Siteman Cancer Center-South County, Saint Louis, Missouri, United States
Missouri Baptist Medical Center, Saint Louis, Missouri, United States
Siteman Cancer Center - Saint Peters, Saint Peters, Missouri, United States
Billings Clinic Cancer Center, Billings, Montana, United States
Benefis Healthcare- Sletten Cancer Institute, Great Falls, Montana, United States
Kalispell Regional Medical Center, Kalispell, Montana, United States
CHI Health Saint Francis, Grand Island, Nebraska, United States
Alegent Health Bergan Mercy Medical Center, Omaha, Nebraska, United States
Alegent Health Lakeside Hospital, Omaha, Nebraska, United States
University of Nebraska Medical Center, Omaha, Nebraska, United States
Radiation Oncology Centers of Nevada Central, Las Vegas, Nevada, United States
Renown Regional Medical Center, Reno, Nevada, United States
Concord Hospital, Concord, New Hampshire, United States
Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, United States
Elliot Hospital, Manchester, New Hampshire, United States
Memorial Sloan Kettering Cancer Center at Basking Ridge, Basking Ridge, New Jersey, United States
Ocean Medical Center, Brick, New Jersey, United States
Cooper Hospital University Medical Center, Camden, New Jersey, United States
Englewood Hospital and Medical Center, Englewood, New Jersey, United States
Saint Barnabas Medical Center, Livingston, New Jersey, United States
Virtua Memorial, Mount Holly, New Jersey, United States
Jersey Shore Medical Center, Neptune, New Jersey, United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
The Valley Hospital-Luckow Pavilion, Paramus, New Jersey, United States
Capital Health Medical Center-Hopewell, Pennington, New Jersey, United States
Riverview Medical Center/Booker Cancer Center, Red Bank, New Jersey, United States
Valley Hospital, Ridgewood, New Jersey, United States
Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, United States
Sparta Cancer Treatment Center, Sparta, New Jersey, United States
MD Anderson Cancer Center at Cooper-Voorhees, Voorhees, New Jersey, United States
Virtua Voorhees, Voorhees, New Jersey, United States
Valley Health System-Hematology/Oncology, Westwood, New Jersey, United States
University of New Mexico Cancer Center, Albuquerque, New Mexico, United States
Lovelace Radiation Oncology, Albuquerque, New Mexico, United States
New Mexico Oncology Hematology Consultants, Albuquerque, New Mexico, United States
Memorial Medical Center - Las Cruces, Las Cruces, New Mexico, United States
Christus Saint Vincent Regional Cancer Center, Santa Fe, New Mexico, United States
Montefiore Medical Center - Moses Campus, Bronx, New York, United States
New York-Presbyterian/Brooklyn Methodist Hospital, Brooklyn, New York, United States
Maimonides Medical Center, Brooklyn, New York, United States
Putnam Hospital Center, Carmel, New York, United States
Memorial Sloan Kettering Commack, Commack, New York, United States
Mary Imogene Bassett Hospital, Cooperstown, New York, United States
Vassar Brothers Fishkill Radiation Oncology Center, Fishkill, New York, United States
Memorial Sloan Kettering Westchester, Harrison, New York, United States
Ulster Radiation Oncology Center, Kingston, New York, United States
Columbia University/Herbert Irving Cancer Center, New York, New York, United States
Memorial Sloan-Kettering Cancer Center, New York, New York, United States
Vassar Brothers Medical Center, Poughkeepsie, New York, United States
Rochester General Hospital, Rochester, New York, United States
Pluta Cancer Center, Rochester, New York, United States
Memorial Sloan Kettering Rockville Centre, Rockville Centre, New York, United States
Memorial Sloan Kettering Sleepy Hollow, Sleepy Hollow, New York, United States
State University of New York Upstate Medical University, Syracuse, New York, United States
Carolinas Medical Center/Levine Cancer Institute, Charlotte, North Carolina, United States
Novant Health Presbyterian Medical Center, Charlotte, North Carolina, United States
Carolinas Medical Center/Levine Cancer Institute-Pineville, Charlotte, North Carolina, United States
Carolinas Medical Center/Levine Cancer Institute-University, Charlotte, North Carolina, United States
Carolinas HealthCare System NorthEast, Concord, North Carolina, United States
Duke University Medical Center, Durham, North Carolina, United States
CaroMont Regional Medical Center, Gastonia, North Carolina, United States
Cone Health Cancer Center, Greensboro, North Carolina, United States
East Carolina University, Greenville, North Carolina, United States
Matthews Radiation Oncology Center, Matthews, North Carolina, United States
Carolinas HealthCare System Union, Monroe, North Carolina, United States
South Atlantic Radiation Oncology, Supply, North Carolina, United States
Coastal Carolina Radiation Oncology, Wilmington, North Carolina, United States
Sanford Bismarck Medical Center, Bismarck, North Dakota, United States
Summa Akron City Hospital/Cooper Cancer Center, Akron, Ohio, United States
Akron General Medical Center, Akron, Ohio, United States
Summa Barberton Hospital, Barberton, Ohio, United States
UHHS-Chagrin Highlands Medical Center, Beachwood, Ohio, United States
Aultman Health Foundation, Canton, Ohio, United States
Geaugra Hospital, Chardon, Ohio, United States
University of Cincinnati/Barrett Cancer Center, Cincinnati, Ohio, United States
Good Samaritan Hospital - Cincinnati, Cincinnati, Ohio, United States
Bethesda North Hospital, Cincinnati, Ohio, United States
Case Western Reserve University, Cleveland, Ohio, United States
Cleveland Clinic Cancer Center/Fairview Hospital, Cleveland, Ohio, United States
Cleveland Clinic Foundation, Cleveland, Ohio, United States
Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States
The Mark H Zangmeister Center, Columbus, Ohio, United States
Mount Carmel Health Center West, Columbus, Ohio, United States
Delaware Radiation Oncology, Delaware, Ohio, United States
Cleveland Clinic Cancer Center Independence, Independence, Ohio, United States
Hillcrest Hospital Cancer Center, Mayfield Heights, Ohio, United States
Summa Health Center at Lake Medina, Medina, Ohio, United States
Lake University Ireland Cancer Center, Mentor, Ohio, United States
Southwest General Health Center Ireland Cancer Center, Middleburg Heights, Ohio, United States
University Hospitals Parma Medical Center, Parma, Ohio, United States
North Coast Cancer Care, Sandusky, Ohio, United States
Cleveland Clinic Cancer Center Strongsville, Strongsville, Ohio, United States
University Pointe, West Chester, Ohio, United States
UHHS-Westlake Medical Center, Westlake, Ohio, United States
Cleveland Clinic Wooster Family Health and Surgery Center, Wooster, Ohio, United States
Cancer Centers of Southwest Oklahoma Research, Lawton, Oklahoma, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Mercy Hospital Oklahoma City, Oklahoma City, Oklahoma, United States
Willamette Valley Cancer Center, Eugene, Oregon, United States
Compass Oncology Rose Quarter, Portland, Oregon, United States
Kaiser Permanente Northwest, Portland, Oregon, United States
Mid-Columbia Medical Center/Celilo Cancer Center, The Dalles, Oregon, United States
Lehigh Valley Hospital-Cedar Crest, Allentown, Pennsylvania, United States
UPMC-Heritage Valley Health System Beaver, Beaver, Pennsylvania, United States
Saint Luke's University Hospital-Bethlehem Campus, Bethlehem, Pennsylvania, United States
Northeast Radiation Oncology Center, Dunmore, Pennsylvania, United States
Ephrata Cancer Center, Ephrata, Pennsylvania, United States
The Regional Cancer Center, Erie, Pennsylvania, United States
Fox Chase Cancer Center Buckingham, Furlong, Pennsylvania, United States
Adams Cancer Center, Gettysburg, Pennsylvania, United States
UPMC Cancer Centers - Arnold Palmer Pavilion, Greensburg, Pennsylvania, United States
PinnacleHealth Cancer Center-Community Campus, Harrisburg, Pennsylvania, United States
Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
Lancaster General Hospital, Lancaster, Pennsylvania, United States
Holy Redeemer Hospital and Medical Center, Meadowbrook, Pennsylvania, United States
Intercommunity Cancer Center, Monroeville, Pennsylvania, United States
UPMC-Coraopolis/Heritage Valley Radiation Oncology, Moon, Pennsylvania, United States
Allegheny Valley Hospital, Natrona Heights, Pennsylvania, United States
University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania, United States
Pennsylvania Hospital, Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States
Temple University Hospital, Philadelphia, Pennsylvania, United States
Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
UPMC-Magee Womens Hospital, Pittsburgh, Pennsylvania, United States
UPMC-Saint Margaret, Pittsburgh, Pennsylvania, United States
UPMC-Shadyside Hospital, Pittsburgh, Pennsylvania, United States
Reading Hospital, West Reading, Pennsylvania, United States
Wexford Health and Wellness Pavilion, Wexford, Pennsylvania, United States
WellSpan Health-York Hospital, York, Pennsylvania, United States
Rhode Island Hospital, Providence, Rhode Island, United States
Radiation Oncology Associates Incorporated, Providence, Rhode Island, United States
Women and Infants Hospital, Providence, Rhode Island, United States
Kent County Hospital, Warwick, Rhode Island, United States
Roper Hospital, Charleston, South Carolina, United States
Bon Secours Saint Francis Hospital, Charleston, South Carolina, United States
Medical University of South Carolina, Charleston, South Carolina, United States
Georgetown Hospital System, Georgetown, South Carolina, United States
Greenville Health System Cancer Institute-Andrews, Greenville, South Carolina, United States
Greenville Health System Cancer Institute-Faris, Greenville, South Carolina, United States
Saint Francis Cancer Center, Greenville, South Carolina, United States
Greenville Health System Cancer Institute-Eastside, Greenville, South Carolina, United States
Greenville Health System Cancer Institute-Greer, Greer, South Carolina, United States
Gibbs Cancer Center-Pelham, Greer, South Carolina, United States
The Radiation Oncology Center-Hilton Head/Bluffton, Hilton Head Island, South Carolina, United States
Greenville Health System Cancer Institute-Seneca, Seneca, South Carolina, United States
Spartanburg Medical Center, Spartanburg, South Carolina, United States
Greenville Health System Cancer Institute-Spartanburg, Spartanburg, South Carolina, United States
Lexington Medical Center, West Columbia, South Carolina, United States
Avera Cancer Institute, Sioux Falls, South Dakota, United States
Sanford USD Medical Center - Sioux Falls, Sioux Falls, South Dakota, United States
The West Clinic - Wolf River, Germantown, Tennessee, United States
Thompson Cancer Survival Center, Knoxville, Tennessee, United States
Baptist Memorial Hospital and Cancer Center-Memphis, Memphis, Tennessee, United States
Vanderbilt University/Ingram Cancer Center, Nashville, Tennessee, United States
Texas Cancer Center, Abilene, Texas, United States
The Don and Sybil Harrington Cancer Center, Amarillo, Texas, United States
Texas Oncology-Arlington South, Arlington, Texas, United States
Texas Oncology-Austin Midtown, Austin, Texas, United States
Texas Oncology - Central Austin Cancer Center, Austin, Texas, United States
Texas Oncology - South Austin Cancer Center, Austin, Texas, United States
Texas Oncology Bedford, Bedford, Texas, United States
Parkland Memorial Hospital, Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-Dallas, Dallas, Texas, United States
Texas Oncology-Flower Mound, Flower Mound, Texas, United States
The Klabzuba Cancer Center, Fort Worth, Texas, United States
Memorial Hermann Memorial City Medical Center, Houston, Texas, United States
M D Anderson Cancer Center, Houston, Texas, United States
The Methodist Hospital System, Houston, Texas, United States
MD Anderson Regional Care Center-Katy, Houston, Texas, United States
Doctor's Hospital of Laredo, Laredo, Texas, United States
Covenant Medical Center-Lakeside, Lubbock, Texas, United States
University Medical Center, Lubbock, Texas, United States
Texas Tech University Health Sciences Center-Lubbock, Lubbock, Texas, United States
MD Anderson Regional Care Center-Bay Area, Nassau Bay, Texas, United States
Texas Oncology-Plano West, Plano, Texas, United States
Scott and White Healthcare Round Rock, Round Rock, Texas, United States
Texas Oncology - Round Rock Cancer Center, Round Rock, Texas, United States
University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
Texas Cancer Center-Sherman, Sherman, Texas, United States
MD Anderson Regional Care Center-Sugar Land, Sugar Land, Texas, United States
Texas Oncology Cancer Center Sugar Land, Sugar Land, Texas, United States
Scott and White Memorial Hospital, Temple, Texas, United States
MD Anderson Regional Care Center-The Woodlands, The Woodlands, Texas, United States
Deke Slayton Cancer Center, Webster, Texas, United States
Intermountain Medical Center, Murray, Utah, United States
Utah Valley Regional Medical Center, Provo, Utah, United States
Huntsman Cancer Institute/University of Utah, Salt Lake City, Utah, United States
South Jordan Health Center, South Jordan, Utah, United States
Norris Cotton Cancer Center-North, Saint Johnsbury, Vermont, United States
Inova Alexandria Hospital, Alexandria, Virginia, United States
University of Virginia Cancer Center, Charlottesville, Virginia, United States
Inova Fairfax Hospital, Falls Church, Virginia, United States
Augusta Health Cancer Center, Fishersville, Virginia, United States
Mary Washington Hospital, Fredericksburg, Virginia, United States
Sentara Cancer Institute at Sentara CarePlex Hospital, Hampton, Virginia, United States
Sentara Norfolk General Hospital, Norfolk, Virginia, United States
Naval Medical Center - Portsmouth, Portsmouth, Virginia, United States
Virginia Commonwealth University/Massey Cancer Center, Richmond, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia, Roanoke, Virginia, United States
Sentara Virginia Beach General Hospital, Virginia Beach, Virginia, United States
MultiCare Auburn Medical Center, Auburn, Washington, United States
Overlake Hospital Medical Center, Bellevue, Washington, United States
Harrison Medical Center, Bremerton, Washington, United States
Virginia Mason Federal Way Medical Center, Federal Way, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Gig Harbor, Gig Harbor, Washington, United States
MultiCare Gig Harbor Medical Park, Gig Harbor, Washington, United States
Tri-Cities Cancer Center, Kennewick, Washington, United States
Skagit Valley Hospital Regional Cancer Care Center, Mount Vernon, Washington, United States
MultiCare Good Samaritan Hospital, Puyallup, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Puyallup, Puyallup, Washington, United States
Virginia Mason Medical Center, Seattle, Washington, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
Seattle Cancer Care Alliance, Seattle, Washington, United States
University of Washington Medical Center, Seattle, Washington, United States
Cancer Care Northwest - Spokane South, Spokane, Washington, United States
Spokane Valley Cancer Center-Mayfair, Spokane, Washington, United States
MultiCare Tacoma General Hospital, Tacoma, Washington, United States
Northwest Medical Specialties PLLC, Tacoma, Washington, United States
Saint Joseph Medical Center, Tacoma, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Saint Joe's, Tacoma, Washington, United States
Compass Oncology Vancouver, Vancouver, Washington, United States
West Virginia University Healthcare, Morgantown, West Virginia, United States
Langlade Hospital and Cancer Center, Antigo, Wisconsin, United States
Fox Valley Surgical Associates Limited, Appleton, Wisconsin, United States
Radiology Associates of Appleton/ThedaCare Regional Medical Center, Appleton, Wisconsin, United States
ThedaCare Regional Cancer Center, Appleton, Wisconsin, United States
Sacred Heart Hospital, Eau Claire, Wisconsin, United States
Aurora Cancer Care-Grafton, Grafton, Wisconsin, United States
Saint Vincent Hospital Cancer Center Green Bay, Green Bay, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Saint Mary's, Green Bay, Wisconsin, United States
Aurora BayCare Medical Center, Green Bay, Wisconsin, United States
UW Cancer Center Johnson Creek, Johnson Creek, Wisconsin, United States
Aurora Cancer Care-Kenosha South, Kenosha, Wisconsin, United States
Gundersen Lutheran Medical Center, La Crosse, Wisconsin, United States
Mayo Clinic Health System-Franciscan Healthcare, La Crosse, Wisconsin, United States
University of Wisconsin Hospital and Clinics, Madison, Wisconsin, United States
Marshfield Clinic, Marshfield, Wisconsin, United States
Saint Joseph's Hospital, Marshfield, Wisconsin, United States
Community Memorial Hospital, Menomonee Falls, Wisconsin, United States
Aurora Saint Luke's Medical Center, Milwaukee, Wisconsin, United States
Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Aurora Sinai Medical Center, Milwaukee, Wisconsin, United States
Marshfield Clinic-Minocqua Center, Minocqua, Wisconsin, United States
Surgical Associates of Neenah SC, Neenah, Wisconsin, United States
ProHealth Oconomowoc Memorial Hospital, Oconomowoc, Wisconsin, United States
Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh, Wisconsin, United States
Wheaton Franciscan Cancer Care - All Saints, Racine, Wisconsin, United States
Marshfield Clinic-Rice Lake Center, Rice Lake, Wisconsin, United States
Saint Michael's Hospital, Stevens Point, Wisconsin, United States
Marshfield Clinic Stevens Point Center, Stevens Point, Wisconsin, United States
Aurora Medical Center in Summit, Summit, Wisconsin, United States
Vince Lombardi Cancer Clinic-Two Rivers, Two Rivers, Wisconsin, United States
ProHealth Waukesha Memorial Hospital, Waukesha, Wisconsin, United States
UW Cancer Center at ProHealth Care, Waukesha, Wisconsin, United States
Aspirus Regional Cancer Center, Wausau, Wisconsin, United States
Aurora Cancer Care-Milwaukee West, Wauwatosa, Wisconsin, United States
Aurora West Allis Medical Center, West Allis, Wisconsin, United States
The Alyce and Elmore Kraemer Cancer Care Center, West Bend, Wisconsin, United States
Diagnostic and Treatment Center, Weston, Wisconsin, United States
Tom Baker Cancer Centre, Calgary, Alberta, Canada
Cross Cancer Institute, Edmonton, Alberta, Canada
CancerCare Manitoba, Winnipeg, Manitoba, Canada
Atlantic Health Sciences Corporation-Saint John Regional Hospital, Saint John, New Brunswick, Canada
University Health Network-Princess Margaret Hospital, Toronto, Ontario, Canada
CIUSSSEMTL-Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
McGill University Department of Oncology, Montreal, Quebec, Canada
Jewish General Hospital, Montreal, Quebec, Canada
CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ), Quebec City, Quebec, Canada
Centre Hospitalier Universitaire de Sherbrooke-Fleurimont, Sherbrooke, Quebec, Canada
Allan Blair Cancer Centre, Regina, Saskatchewan, Canada
Saskatoon Cancer Centre, Saskatoon, Saskatchewan, Canada
Saint Lukes Hospital, Dublin, Co Dublin, Ireland
University College Hospital Galway, Galway, Co Galway, Ireland
Chaim Sheba Medical Center, Tel Hashomer, , Israel
Tohoku University School of Medicine, Sendai, Aoba-ku, Japan
Hokkaido University Hospital, Sapporo, Hokkaido, Japan
Hyogo Cancer Center, Akashi-city, Hyogo, Japan
Iwate Medical University School of Medicine, Morioka, Iwate, Japan
Gunma University Hospital, Gunma, Maebashi, Japan
Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
Shikoku Cancer Center, Matsuyama, , Japan
Saitama Medical University International Medical Center, Saitama, , Japan
Yonsei University Health System-Severance Hospital, Seoul, , Korea, Republic of
San Juan City Hospital, San Juan, , Puerto Rico
Name: Norman Wolmark, MD
Affiliation: NSABP Foundation Inc
Role: PRINCIPAL_INVESTIGATOR