Ignite Creation Date:
2025-12-25 @ 4:04 AM
Ignite Modification Date:
2026-01-29 @ 12:23 AM
Study NCT ID:
NCT03367702
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-09-05
First Post:
2017-12-05
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Stereotactic Body Radiation Therapy or Intensity-Modulated Radiation Therapy in Treating Patients With Stage IIA-B Prostate Cancer
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'interventionBrowseModule': {'meshes': [{'id': 'D050397', 'term': 'Radiotherapy, Intensity-Modulated'}, {'id': 'D016634', 'term': 'Radiosurgery'}], 'ancestors': [{'id': 'D020266', 'term': 'Radiotherapy, Conformal'}, {'id': 'D011881', 'term': 'Radiotherapy, Computer-Assisted'}, {'id': 'D011878', 'term': 'Radiotherapy'}, {'id': 'D013812', 'term': 'Therapeutics'}, {'id': 'D013238', 'term': 'Stereotaxic Techniques'}, {'id': 'D019635', 'term': 'Neurosurgical Procedures'}, {'id': 'D013514', 'term': 'Surgical Procedures, Operative'}, {'id': 'D008919', 'term': 'Investigative Techniques'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ESTIMATED', 'count': 692}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2018-02-01', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-09', 'completionDateStruct': {'date': '2027-12-01', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-09-04', 'studyFirstSubmitDate': '2017-12-05', 'studyFirstSubmitQcDate': '2017-12-05', 'lastUpdatePostDateStruct': {'date': '2025-09-05', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2017-12-11', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2027-12-01', 'type': 'ESTIMATED'}}, 'outcomesModule': {'otherOutcomes': [{'measure': 'Central manual user segmentation of tumors', 'timeFrame': 'Up to 2 years', 'description': 'Central manual user segmentation of tumors'}, {'measure': 'Performance of supervised automated tumor detection toolset', 'timeFrame': 'Up to 2 years', 'description': 'Performance of supervised automated tumor detection toolset'}, {'measure': 'Performance of supervised automated tumor segmentation toolset', 'timeFrame': 'Up to 5 years', 'description': 'Performance of supervised automated tumor segmentation toolset'}, {'measure': 'Image registration performance', 'timeFrame': 'Up to 2 years', 'description': 'Image registration performance'}, {'measure': 'Predictive utility of radiomic analysis', 'timeFrame': 'Up to 2 years', 'description': 'Predictive utility of radiomic analysis'}, {'measure': 'Predictive value for local control and biochemical failure', 'timeFrame': 'At 2 years', 'description': 'Will be assessed by MRI.'}], 'primaryOutcomes': [{'measure': 'Incidence of patients-reported gastrointestinal and genitourinary toxicity', 'timeFrame': 'Up to 2 years', 'description': 'Will be measured by Expanded Prostate Cancer Index Composite-(EPIC) 26 bowel and urinary irritation domains. Will be compared between treatment arms using a test of proportions with two-sided significance level of 0.05.'}, {'measure': 'Disease free survival', 'timeFrame': 'Time to biochemical failure (Phoenix definition), local failure, regional failure, distant metastasis, or death from any cause, assessed up to 2 years', 'description': 'Will be estimated using the Kaplan-Meier method and treatment arms compared using the stratified log-rank test.'}], 'secondaryOutcomes': [{'measure': 'Health related quality of life', 'timeFrame': 'Up to 2 years', 'description': 'Will be measured by EPIC-26 urinary incontinence, sexual, and hormonal domains.'}, {'measure': 'Biochemical failure', 'timeFrame': 'Up to 2 years', 'description': 'Will be assessed by Phoenix definition.'}, {'measure': 'Local failure', 'timeFrame': 'From the time of randomization to the date of local failure, date of precluding death, or last known follow-up date, assessed for up to 2 years'}, {'measure': 'Regional failure', 'timeFrame': 'From the time of randomization to the date of local failure, date of precluding death, or last known follow-up date, assessed for up to 2 years'}, {'measure': 'Distant metastasis', 'timeFrame': 'From the time of randomization to the date of distant metastasis, date of precluding death, or last known follow-up date, assessed for up to 2 years'}, {'measure': 'Prostate cancer specific survival', 'timeFrame': 'Up to 2 years'}, {'measure': 'Overall survival', 'timeFrame': 'From the date of randomization to the date of death or last known follow-up date, with patients alive at the last known follow-up time treated as censored, assessed up to 5 years', 'description': 'Will be estimated using the Kaplan-Meier method and treatment arms compared using the stratified log-rank test.'}, {'measure': 'Incidence of adverse events (AEs)', 'timeFrame': 'Up to 2 years', 'description': 'Will be assessed by Common Terminology Criteria for Adverse Events version 5.0. Counts of all AEs by grade will be provided by treatment arm. Counts and frequencies will be provided for the worst grade AE experienced by the patient by treatment arm. The number of patients with at least 1 grade 3 or higher AE will be compared between the treatment arms. A comparison between treatment arms of grade 3 and higher genitourinary (GU) and gastrointestinal (GI) events related to treatment (separately) will also be tested. There are 5 pre-specified AEs, dysuria, hematuria, incontinence, rectal bleeding, and fatigue. A comparison of any event and grade and higher events will be compared between treatment arms. All comparisons will be tested using a Chi-Square test with a significance level of 0.05.'}, {'measure': 'Presence of Prostate Imaging-Reporting and Data System version (PIRADSv) 2 = 4/5 disease', 'timeFrame': 'Baseline', 'description': 'Will be assessed by magnetic resonance imaging (MRI).'}, {'measure': 'Predictive value of PIRADSv2 = 4/5 disease for biochemical failure', 'timeFrame': 'Up to 2 years', 'description': 'Predictive value of PIRADSv2 = 4/5 disease for biochemical failure'}]}, 'oversightModule': {'oversightHasDmc': False, 'isFdaRegulatedDrug': False, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'conditions': ['Stage II Prostate Adenocarcinoma AJCC v7']}, 'referencesModule': {'references': [{'pmid': '41063518', 'type': 'DERIVED', 'citation': 'Alley S, Tonneau M, Olivie D, Tempany-Afdhal CM, Choyke PL, Turkbey IB, van der Heide UA, Ellis RJ, Kadoury S, Boike TP, Pennington JD, Frazier A, Lawton CAF, Leong N, Mihai AM, Morgan SC, Solanki AA, Michalski JM, Feng FY, Sandler HM, Menard C. Assessing Quality and Adherence to PI-RADSv2.1 Minimum Technical Standards of Prostate MRI in NRG-GU005. J Magn Reson Imaging. 2025 Oct 8. doi: 10.1002/jmri.70142. Online ahead of print.'}, {'pmid': '36223780', 'type': 'DERIVED', 'citation': 'Alley S, Jackson E, Olivie D, Van der Heide UA, Menard C, Kadoury S. Effect of magnetic resonance imaging pre-processing on the performance of model-based prostate tumor probability mapping. Phys Med Biol. 2022 Dec 13;67(24). doi: 10.1088/1361-6560/ac99b4.'}]}, 'descriptionModule': {'briefSummary': 'This randomized phase III trial studies how well stereotactic body radiation therapy works compared to intensity-modulated radiation therapy in treating patients with stage IIA-B prostate cancer. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Stereotactic body radiation therapy uses special equipment to position a patient and deliver radiation to tumors with high precision. This method can kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. Stereotactic body radiation therapy may work better in treating patients with prostate cancer.', 'detailedDescription': 'PRIMARY OBJECTIVES:\n\nI. To determine whether stereotactic body radiation therapy (SBRT) can be shown to be superior to hypofractionated intensity-modulated radiation therapy (IMRT) in terms of genitourinary (GU) and gastrointestinal (GI) toxicity by having fewer patients that experience a minimal important decline (MID) in urinary irritation/obstructive and bowel Health Related Quality of Life (HRQOL) as measured by Expanded Prostate Cancer Index Composite (EPIC)-26 at 24 months post completion of therapy.\n\nII. To determine if SBRT (5 fractions of 7.25 Gy) is superior to hypofractionated IMRT (28 fractions of 2.5 Gy or 20 fractions of 3 Gy) as measured by disease free survival (DFS).\n\nSECONDARY OBJECTIVES:\n\nI. To determine whether SBRT can be shown to be superior to hypofractionated IMRT at 12 and 24 months post completion of therapy in terms of HRQOL by having fewer patients that experience a minimal important decline (MID) bowel (12 months only) sexual, hormonal, urinary irritation/obstructive (12 months only) and in urinary incontinence HRQOL as measured by EPIC-26.\n\nII. To determine if SBRT (5 fractions of 7.25 Gy) is superior to hypofractionated IMRT (28 fractions of 2.5 Gy or 20 fractions of 3 Gy) as measured by biochemical failure, overall survival, local failure, prostate cancer specific survival, and distant metastases.\n\nIII. To determine the correspondence between the diagnostic magnetic resonance imaging (MRI) and biopsy.\n\nIV. To determine if prostate imaging-reporting and data system (PIRADS)version (v)2.1 = 4/5 disease is prognostic for biochemical failure.\n\nEXPLORATORY OBJECTIVES:\n\nI. To determine whether a potentially more expensive therapy, SBRT, would be cost-effective than standard hypofractionated IMRT as measured by the European Quality of Life Five Dimension Five Level Scale Questionnaire (EQ-5D-5L).\n\nII. To determine if disease characteristics captured on baseline and follow-up MRI can be used to predict which patients will respond to SBRT versus hypofractionated IMRT.\n\nIII. To validate autosegmentation tools for the prostate and tumors. IV. Collect specimens for future translational research analyses.\n\nOUTLINE: Patients are randomized into 1 of 2 arms.\n\nARM I: Patients undergo IMRT once daily for 5 fractions per week for 20 or 28 fractions over less than 32 business days.\n\nARM II: Patients undergo SBRT at least every other day for 2-3 fractions per week over less than 17 business days.\n\nAfter completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.'}, 'eligibilityModule': {'sex': 'MALE', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Previously untreated (no local therapy such as surgery, radiation cryotherapy, high-intensity focused ultrasound \\[HIFU\\], etc.) localized adenocarcinoma of the prostate with the following clinical findings:\n\n * Clinical stage by digital rectal exam of either T1c or T2a/b (limited to one side of the gland); (American Joint Committee on Cancer \\[AJCC\\], version 7) or cT1a-c or 2a or 2b\n * Stages T1a-T1b are eligible if patient underwent transurethral prostatic resection (TURP)\n * The patient must meet one of the following 3 criteria: 1) Gleason score must be Gleason 7(3+4) with a PSA \\< 20 ng/mL, or 2) Gleason 6 (3+3) with a PSA \\> 10 ng/mL and \\< 20 ng/mL which is considered intermediate risk and eligible for the study (AJCC, version 7), or 3) Group Grade 1 with a PSA \\> 10 ng/mL and \\< 20 ng/mL or 2 with a PSA \\< 20 ng/mL\n\n * If patient is receiving a 5-alpha reductase inhibitor at the time of enrollment, the baseline PSA value may be double the initial value and the medication should be discontinued but a washout period is not required; to be eligible, a PSA drawn while still on the medicine must be:\n\n * \\< 10 ng/mL if Gleason 7(3+4) (note this patient would be on stratification level 1 if PSA \\< 5 ng/mL and stratification level 2 if less than 10 ng/mL)\n * \\> 5 ng/mL and less than 10 ng/mL for Gleason 6(3+3) (note this patient would be on stratification level 3)\n * The prostate volume must be \\< 70 cc as reported at time of biopsy or by separate measure with ultrasound or other imaging modalities including magnetic resonance imaging (MRI) or computed tomography (CT) scan\n * Patients in active surveillance who elect to be treated are eligible if they meet protocol requirements\n* Age \\>= 18\n* History and physical including a digital rectal exam 60 days prior to registration\n* Eastern Cooperative Oncology Group (ECOG) performance status 0-1 60 days prior to registration\n* MRI of the prostate and pelvis (per institutional standard of care \\[SOC\\] - should be compliant with PIRADSv2.1 guidelines) within 1 year prior to registration\n* Bone scan as clinically indicated within 120 days prior to registration\n* Charlson modified co-morbidity score =\\< 4 for patients under 60 and =\\< 5 for patients 60 and over 21 days prior to registration\n* International prostate symptom score (IPSS) of \\< 15 21 days prior to registration\n* The patient must provide study-specific informed consent prior to study entry\n* Willingness and ability to complete the Expanded Prostate Cancer Index Composite (EPIC-26) questionnaire\n* Completion of all items of the EPIC-26 which will be data entered at registration 60 days prior to registration\n* Only English, Spanish, and French-speaking patients are eligible to participate as these are the only languages EPIC-26 has been validated in\n\nExclusion Criteria:\n\n* Definitive clinical or radiologic evidence of metastatic disease; no nodal involvement or evidence of metastatic disease allowed as defined by screening of the pelvis\n* Definitive T3 disease on MRI\n* Prior or current invasive malignancy with current evidence of active disease within the past 2 years\n\n * Exceptions: Non-melanomatous skin cancer, carcinoma in situ of the male breast, penis, oral cavity, or stage Ta of the bladder, or stage I completely resected melanoma\n* Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable; must be off treatment for at least 3 years\n* Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields\n* The use of hormonal therapy is not allowed; if the patient is on a 5-alpha reductase inhibitor, then they should be stopped prior to treatment once enrolled onto the study; no washout period is required for this study to participate\n* Severe, active co-morbidity defined as follows:\n\n * Human immunodeficiency virus (HIV) positive with CD4 count \\< 200 cells/microliter; Note that patients who are HIV positive are eligible, provided they are under treatment with highly active antiretroviral therapy (HAART) and have a CD4 count \\>= 200 cells/microliter within 30 days prior to registration; Note also that HIV testing is not required for eligibility for this protocol; this exclusion criterion is necessary because the treatments involved in this protocol may be significantly immunosuppressive\n * Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol; (patients on Coumadin or other blood thinning agents are eligible for this study)\n* Contraindication to MRI\n\n * Cardiac pacemaker or defibrillator\n * Surgically implanted electrical devices such as spinal stimulation devices or intracranial stimulation devices, cochlear implants, the presence of metallic foreign bodies in the orbits, and incompatible old mechanical heart valves and aneurysm clips'}, 'identificationModule': {'nctId': 'NCT03367702', 'briefTitle': 'Stereotactic Body Radiation Therapy or Intensity-Modulated Radiation Therapy in Treating Patients With Stage IIA-B Prostate Cancer', 'organization': {'class': 'OTHER', 'fullName': 'NRG Oncology'}, 'officialTitle': 'Phase III IGRT and SBRT vs IGRT and Hypofractionated IMRT for Localized Intermediate Risk Prostate Cancer', 'orgStudyIdInfo': {'id': 'NRG-GU005'}, 'secondaryIdInfos': [{'id': 'NCI-2017-01398', 'type': 'REGISTRY', 'domain': 'CTRP (Clinical Trial Reporting Program)'}, {'id': 'NRG-GU005', 'type': 'OTHER', 'domain': 'NRG Oncology'}, {'id': 'NRG-GU005', 'type': 'OTHER', 'domain': 'CTEP'}, {'id': 'U10CA180868', 'link': 'https://reporter.nih.gov/quickSearch/U10CA180868', 'type': 'NIH'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'ACTIVE_COMPARATOR', 'label': 'Arm I (IMRT)', 'description': 'Patients undergo IMRT once daily for 5 fractions per week for 20 or 28 fractions over less than 32 business days.', 'interventionNames': ['Radiation: Intensity-Modulated Radiation Therapy', 'Other: Quality-of-Life Assessment', 'Other: Questionnaire Administration']}, {'type': 'EXPERIMENTAL', 'label': 'Arm II (SBRT)', 'description': 'Patients undergo SBRT at least every other day for 2-3 fractions per week over less than 17 business days.', 'interventionNames': ['Other: Quality-of-Life Assessment', 'Other: Questionnaire Administration', 'Radiation: Stereotactic Body Radiation Therapy']}], 'interventions': [{'name': 'Intensity-Modulated Radiation Therapy', 'type': 'RADIATION', 'otherNames': ['IMRT', 'Intensity modulated radiation therapy (procedure)', 'Intensity Modulated RT', 'Intensity-Modulated Radiotherapy', 'Radiation, Intensity-Modulated Radiotherapy'], 'description': 'Undergo IMRT', 'armGroupLabels': ['Arm I (IMRT)']}, {'name': 'Quality-of-Life Assessment', 'type': 'OTHER', 'otherNames': ['Quality of Life Assessment'], 'description': 'Ancillary studies', 'armGroupLabels': ['Arm I (IMRT)', 'Arm II (SBRT)']}, {'name': 'Questionnaire Administration', 'type': 'OTHER', 'description': 'Ancillary studies', 'armGroupLabels': ['Arm I (IMRT)', 'Arm II (SBRT)']}, {'name': 'Stereotactic Body Radiation Therapy', 'type': 'RADIATION', 'otherNames': ['SABR', 'SBRT', 'Stereotactic Ablative Body Radiation Therapy'], 'description': 'Undergo SBRT', 'armGroupLabels': ['Arm II (SBRT)']}]}, 'contactsLocationsModule': {'locations': [{'zip': '36607', 'city': 'Mobile', 'state': 'Alabama', 'country': 'United States', 'facility': 'Mobile Infirmary Medical Center', 'geoPoint': {'lat': 30.69436, 'lon': -88.04305}}, {'zip': '35401', 'city': 'Tuscaloosa', 'state': 'Alabama', 'country': 'United States', 'facility': 'Lewis and Faye Manderson Cancer Center', 'geoPoint': {'lat': 33.20984, 'lon': -87.56917}}, {'zip': '85297', 'city': 'Gilbert', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Center for Cancer Care - Gilbert', 'geoPoint': {'lat': 33.35283, 'lon': -111.78903}}, {'zip': '85381', 'city': 'Peoria', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Center for Cancer Care-Peoria', 'geoPoint': {'lat': 33.5806, 'lon': -112.23738}}, {'zip': '85258', 'city': 'Scottsdale', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Center for Cancer Care - Scottsdale', 'geoPoint': {'lat': 33.50921, 'lon': -111.89903}}, {'zip': '85374', 'city': 'Surprise', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Center for Cancer Care-Surprise', 'geoPoint': {'lat': 33.63059, 'lon': -112.33322}}, {'zip': '85704', 'city': 'Tucson', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Oncology Associates-West Orange Grove', 'geoPoint': {'lat': 32.22174, 'lon': -110.92648}}, {'zip': '72205', 'city': 'Little Rock', 'state': 'Arkansas', 'country': 'United States', 'facility': 'University of Arkansas for Medical Sciences', 'geoPoint': {'lat': 34.74648, 'lon': -92.28959}}, {'zip': '92806', 'city': 'Anaheim', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente-Anaheim', 'geoPoint': {'lat': 33.83529, 'lon': -117.9145}}, {'zip': '94704', 'city': 'Berkeley', 'state': 'California', 'country': 'United States', 'facility': 'Alta Bates Summit Medical Center-Herrick Campus', 'geoPoint': {'lat': 37.87159, 'lon': -122.27275}}, {'zip': '95608', 'city': 'Carmichael', 'state': 'California', 'country': 'United States', 'facility': 'Mercy Cancer Center - Carmichael', 'geoPoint': {'lat': 38.61713, 'lon': -121.32828}}, {'zip': '95608', 'city': 'Carmichael', 'state': 'California', 'country': 'United States', 'facility': 'Mercy San Juan Medical Center', 'geoPoint': {'lat': 38.61713, 'lon': -121.32828}}, {'zip': '94568', 'city': 'Dublin', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente Dublin', 'geoPoint': {'lat': 37.70215, 'lon': -121.93579}}, {'zip': '95758', 'city': 'Elk Grove', 'state': 'California', 'country': 'United States', 'facility': 'Mercy Cancer Center - Elk Grove', 'geoPoint': {'lat': 38.4088, 'lon': -121.37162}}, {'zip': '93720', 'city': 'Fresno', 'state': 'California', 'country': 'United States', 'facility': 'Fresno Cancer Center', 'geoPoint': {'lat': 36.74773, 'lon': -119.77237}}, {'zip': '94904', 'city': 'Greenbrae', 'state': 'California', 'country': 'United States', 'facility': 'Marin General Hospital', 'geoPoint': {'lat': 37.94854, 'lon': -122.5247}}, {'zip': '92093', 'city': 'La Jolla', 'state': 'California', 'country': 'United States', 'facility': 'UC San Diego Moores Cancer Center', 'geoPoint': {'lat': 32.84727, 'lon': -117.2742}}, {'zip': '90027', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente Los Angeles Medical Center', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}, {'zip': '90033', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'Los Angeles General Medical Center', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}, {'zip': '90033', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'USC / Norris Comprehensive Cancer Center', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}, {'zip': '95355', 'city': 'Modesto', 'state': 'California', 'country': 'United States', 'facility': 'Memorial Medical Center', 'geoPoint': {'lat': 37.6391, 'lon': -120.99688}}, {'zip': '94611', 'city': 'Oakland', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente Oakland-Broadway', 'geoPoint': {'lat': 37.80437, 'lon': -122.2708}}, {'zip': '92868', 'city': 'Orange', 'state': 'California', 'country': 'United States', 'facility': 'Saint Joseph Hospital - Orange', 'geoPoint': {'lat': 33.78779, 'lon': -117.85311}}, {'zip': '94304', 'city': 'Palo Alto', 'state': 'California', 'country': 'United States', 'facility': 'Stanford Cancer Institute Palo Alto', 'geoPoint': {'lat': 37.44188, 'lon': -122.14302}}, {'zip': '95670', 'city': 'Rancho Cordova', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente-Rancho Cordova Cancer Center', 'geoPoint': {'lat': 38.58907, 'lon': -121.30273}}, {'zip': '95765', 'city': 'Rocklin', 'state': 'California', 'country': 'United States', 'facility': 'Mercy Cancer Center - Rocklin', 'geoPoint': {'lat': 38.79073, 'lon': -121.23578}}, {'zip': '94928', 'city': 'Rohnert Park', 'state': 'California', 'country': 'United States', 'facility': 'Rohnert Park Cancer Center', 'geoPoint': {'lat': 38.33964, 'lon': -122.7011}}, {'zip': '95678', 'city': 'Roseville', 'state': 'California', 'country': 'United States', 'facility': 'The Permanente Medical Group-Roseville Radiation Oncology', 'geoPoint': {'lat': 38.75212, 'lon': -121.28801}}, {'zip': '95816', 'city': 'Sacramento', 'state': 'California', 'country': 'United States', 'facility': 'Mercy Cancer Center - Sacramento', 'geoPoint': {'lat': 38.58157, 'lon': -121.4944}}, {'zip': '95816', 'city': 'Sacramento', 'state': 'California', 'country': 'United States', 'facility': 'Sutter Medical Center Sacramento', 'geoPoint': {'lat': 38.58157, 'lon': -121.4944}}, {'zip': '95817', 'city': 'Sacramento', 'state': 'California', 'country': 'United States', 'facility': 'University of California Davis Comprehensive Cancer Center', 'geoPoint': {'lat': 38.58157, 'lon': -121.4944}}, {'zip': '93901', 'city': 'Salinas', 'state': 'California', 'country': 'United States', 'facility': 'Salinas Valley Memorial', 'geoPoint': {'lat': 36.67774, 'lon': -121.6555}}, {'zip': '95124', 'city': 'San Jose', 'state': 'California', 'country': 'United States', 'facility': 'Stanford Cancer Center South Bay', 'geoPoint': {'lat': 37.33939, 'lon': -121.89496}}, {'zip': '95051', 'city': 'Santa Clara', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente Medical Center - Santa Clara', 'geoPoint': {'lat': 37.35411, 'lon': -121.95524}}, {'zip': '94080', 'city': 'South San Francisco', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente Cancer Treatment Center', 'geoPoint': {'lat': 37.65466, 'lon': -122.40775}}, {'zip': '96161', 'city': 'Truckee', 'state': 'California', 'country': 'United States', 'facility': 'Gene Upshaw Memorial Tahoe Forest Cancer Center', 'geoPoint': {'lat': 39.32796, 'lon': -120.18325}}, {'zip': '95695', 'city': 'Woodland', 'state': 'California', 'country': 'United States', 'facility': 'Woodland Memorial Hospital', 'geoPoint': {'lat': 38.67852, 'lon': -121.7733}}, {'zip': '80045', 'city': 'Aurora', 'state': 'Colorado', 'country': 'United States', 'facility': 'UCHealth University of Colorado Hospital', 'geoPoint': {'lat': 39.72943, 'lon': -104.83192}}, {'zip': '80909', 'city': 'Colorado Springs', 'state': 'Colorado', 'country': 'United States', 'facility': 'UCHealth Memorial Hospital Central', 'geoPoint': {'lat': 38.83388, 'lon': -104.82136}}, {'zip': '80920', 'city': 'Colorado Springs', 'state': 'Colorado', 'country': 'United States', 'facility': 'Memorial Hospital North', 'geoPoint': {'lat': 38.83388, 'lon': -104.82136}}, {'zip': '80210', 'city': 'Denver', 'state': 'Colorado', 'country': 'United States', 'facility': 'AdventHealth Porter', 'geoPoint': {'lat': 39.73915, 'lon': -104.9847}}, {'zip': 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