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Cheung P, Faria S, Ahmed S, Chabot P, Greenland J, Kurien E, Mohamed I, Wright JR, Hollenhorst H, de Metz C, Campbell H, Vu TT, Karvat A, Wai ES, Ung YC, Goss G, Shepherd FA, O'Brien P, Ding K, O'Callaghan C. Phase II study of accelerated hypofractionated three-dimensional conformal radiotherapy for stage T1-3 N0 M0 non-small cell lung cancer: NCIC CTG BR.25. J Natl Cancer Inst 2014; 106:dju164. [PMID: 25074417 DOI: 10.1093/jnci/dju164] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A multi-institutional phase II trial was performed to assess a hypofractionated accelerated radiotherapy regimen for early stage non-small cell lung cancer (NSCLC) in an era when stereotactic body radiotherapy was not widely available. METHODS Eighty patients with biopsy-proven, peripherally located, T1-3 N0 M0 NSCLC were enrolled. Eligible patients received 60 Gy in 15 fractions using a three-dimensional conformal technique without inhomogeneity correction. The gross tumour volume (GTV) was the primary tumor only, and the planning target volume (PTV) margin was 1.0 to 1.5cm. The primary endpoint was the 2-year primary tumor control rate. Toxicities were measured using the Common Terminology Criteria for Adverse Events version 3.0. RESULTS The median follow-up of patients was 49 months (range = 21-63 months). The median age of patients was 75.9 years. The actuarial rate of primary tumor control was 87.4% (95% confidence interval [CI] = 76.2% to 93.5%) at 2 years. Overall survival was 68.7% (95% CI = 57.2% to 77.6%) at 2 years. The actuarial rates of developing regional and distant relapse at 2 years were 8.8% (95% CI = 4.1% to 18.7%) and 21.6% (95% CI = 13.5% to 33.5%), respectively. Tumor size greater than 3cm was associated with an increased risk of developing distant relapse (hazard ratio = 3.11; 95% CI = 1.30 to 7.42; two-sided log-rank test P = .007). The most common grade 3+ toxicities were fatigue (6.3%), cough (7.5%), dyspnea (13.8%), and pneumonitis (10.0%) CONCLUSIONS Conformal radiotherapy to a dose of 60 Gy in 15 fractions resulted in favorable primary tumor control and overall survival rates in patients with T1-3 N0 M0 NSCLC. Severe toxicities were uncommon with this relatively simple treatment technique.
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Affiliation(s)
- Patrick Cheung
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO).
| | - Sergio Faria
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Shahida Ahmed
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Pierre Chabot
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Jonathan Greenland
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Elizabeth Kurien
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Islam Mohamed
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - James R Wright
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Helmut Hollenhorst
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Catherine de Metz
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Holly Campbell
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Thi Toni Vu
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Anand Karvat
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Elaine S Wai
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Yee C Ung
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Glenwood Goss
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Frances A Shepherd
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Patti O'Brien
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Keyue Ding
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
| | - Chris O'Callaghan
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada (PC, YCU); Montreal General Hospital, McGill University, Montreal, Quebec, Canada (SF); CancerCare Manitoba, Winnipeg, Manitoba, Canada (SA); Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada (PC); Dr. H. Bliss Murphy Cancer Centre, St John's, Newfoundland, Canada (JG); Tom Baker Cancer Centre, Calgary, Alberta, Canada (EK); BC Cancer Agency-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada (IM); Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada (JRW); QEII Centre for Clinical Research Trials, Halifax, Nova Scotia, Canada (HH); Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada (CdM); Atlantic Health Sciences Corporation, Saint John Regional Hospital, Saint John, New Brunswick, Canada (HC); CHUM - Hopital Notre-Dame, Montreal, Quebec, Canada (TTV); BC Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada (AK); BC Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada (ESW); Ottawa Health Research Institute-General Division, Ottawa, Ontario, Canada (GG); University Health Network-OCI/Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada (FAS); NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada (PO, KD, CO)
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