Diet and Physical Activity Change or Usual Care in Improving Progression-Free Survival in Patients With Previously Treated Stage II, III, or IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Purpose
This randomized phase III trial studies whether changes in diet and physical activity can increase the length of survival without the return of cancer (progression-free survival) compared with usual care in patients with previously treated stage II, III, or IV ovarian, fallopian tube, or primary peritoneal cancer. A healthy diet and physical activity program and counseling may help patients make healthier lifestyle choices. It is not yet known whether changes in diet and exercise may help increase progression-free survival in patients with previously treated cancer.
Conditions
- Fallopian Tube Clear Cell Adenocarcinoma
- Fallopian Tube Endometrioid Adenocarcinoma
- Fallopian Tube Mucinous Adenocarcinoma
- Fallopian Tube Serous Adenocarcinoma
- Fallopian Tube Transitional Cell Carcinoma
- Malignant Ovarian Brenner Tumor
- Ovarian Clear Cell Adenocarcinoma
- Ovarian Endometrioid Adenocarcinoma
- Ovarian Mucinous Adenocarcinoma
- Ovarian Seromucinous Carcinoma
- Ovarian Serous Adenocarcinoma
- Ovarian Transitional Cell Carcinoma
- Primary Peritoneal Serous Adenocarcinoma
- Stage IIA Fallopian Tube Cancer AJCC v6 and v7
- Stage IIA Ovarian Cancer AJCC V6 and v7
- Stage IIB Fallopian Tube Cancer AJCC v6 and v7
- Stage IIB Ovarian Cancer AJCC v6 and v7
- Stage IIC Fallopian Tube Cancer AJCC v6 and v7
- Stage IIC Ovarian Cancer AJCC v6 and v7
- Stage IIIA Fallopian Tube Cancer AJCC v7
- Stage IIIA Ovarian Cancer AJCC v6 and v7
- Stage IIIA Primary Peritoneal Cancer AJCC v7
- Stage IIIB Fallopian Tube Cancer AJCC v7
- Stage IIIB Ovarian Cancer AJCC v6 and v7
- Stage IIIB Primary Peritoneal Cancer AJCC v7
- Stage IIIC Fallopian Tube Cancer AJCC v7
- Stage IIIC Ovarian Cancer AJCC v6 and v7
- Stage IIIC Primary Peritoneal Cancer AJCC v7
- Stage IV Fallopian Tube Cancer AJCC v6 and v7
- Stage IV Ovarian Cancer AJCC v6 and v7
- Stage IV Primary Peritoneal Cancer AJCC v7
- Undifferentiated Fallopian Tube Carcinoma
- Undifferentiated Ovarian Carcinoma
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Patients with a histological diagnosis of epithelial ovarian cancer, fallopian tube or primary peritoneal carcinoma, clinical stage II, III or IV at diagnosis - Patients with the following histologic epithelial cell types are eligible: serous adenocarcinoma, endometrioid adenocarcinoma, mucinous adenocarcinoma, undifferentiated carcinoma, clear cell adenocarcinoma, mixed epithelial carcinoma, transitional cell carcinoma, malignant Brenner?s tumor or adenocarcinoma not otherwise specified (N.O.S.); however, the histologic features of the tumor must be compatible with a primary M?llerian epithelial adenocarcinoma - Patients must have completed all primary chemotherapy and consolidation therapy (if administered) at least 6 weeks, and no more than 6 months and 2 weeks, prior to enrollment and must be in complete remission; consolidation therapy is defined as any chemotherapy or biological therapy used for a patient who has completed at least four courses of primary chemotherapy and had documented complete remission prior to initiation of such chemotherapy (chemo) or biological therapy - Patients must have achieved a documented complete response to treatment based on normal cancer antigen (CA)-125 (per the institution?s upper limit of normal) and computed tomography (CT) scan or magnetic resonance imaging (MRI) with contrast (i.e. there must be no clinical evidence of persistent or recurrent disease based on CA-125 and CT scan or MRI with contrast) - Patients must have a Gynecologic Oncology Group (GOG) performance grade of 0, 1, or 2 - Patients must not be currently enrolled in an ongoing (participating for 6 months or longer) medically prescribed diet or physical activity regimen - Patients must have no other chronic disease that would preclude randomization into a lifestyle intervention trial; such diseases include recent myocardial infarction or unstable angina (in the previous 6 months), chronic hepatitis, rheumatoid disease, renal or hepatic disease/dysfunction and diabetics receiving insulin; or other clinical condition limiting ability to walk (recent leg fracture, significant osteoarthritis, related orthopedic conditions, degenerative neurological conditions, etc.) - Patients must not have a serious psychiatric illness (e.g. lifetime bipolar disorder, schizophrenia or other psychosis, serious personality disorder, severe major depressive disorder or recent suicide or psychiatric hospitalization) (previous 12 months), or a history of an eating disorder (anorexia nervosa or bulimia nervosa) - Patients must complete all pre-entry assessments - Patients must have signed an approved informed consent and authorization permitting release of personal health information - Patients must be willing to provide name and appropriate telephone contact information and be willing to be contacted periodically via telephone by The University of Arizona Cancer Center (AZCC) staff for completion of individualized lifestyle intervention coaching, completion of the Pittsburgh Sleep Quality Index, and for clarification of patient-completed responses if necessary; patient must be willing to have Arizona Food Frequency Questionnaire (AFFQ), Arizona Physical Activity Questionnaire (APAQ), baseline questionnaire, and personal contact information sent to AZCC
Exclusion Criteria
- Patients with GOG performance grade of 3 or 4 - Patients may not have a history of other invasive malignancies within the last five years, with the exception of non-melanoma skin cancer or stage 1A endometrioid adenocarcinoma of the uterus - Patients diagnosed with chronic disease/illness precluding their participation (i.e., diabetics receiving insulin, myocardial infarction or unstable angina within previous 6 months, chronic hepatitis, rheumatoid disease, renal or hepatic disease/dysfunction) - Patients with a histological diagnosis of clinical stage I epithelial ovarian cancer, fallopian tube or primary peritoneal carcinoma - Patients who are currently undergoing treatment (primary or consolidation) for stage II, III or IV ovarian, fallopian tube or primary peritoneal cancer or who completed treatment less than six weeks ago - Patients with a life expectancy of less than one year - Patients with body mass index (BMI) < 20 kg/m^2 - Vegan vegetarians - Patients enrolled in a weight loss program or who are taking weight loss medications or dietary supplements and are unwilling to discontinue - Patients who have participated in a marathon, triathlon, or other endurance-related physical activity within the previous 24 months - Patients who have had surgery for weight loss - Note: women will not be excluded if their baseline lifestyle assessment indicates a healthy eating and moderate physical activity with the exception of the exclusion criteria above
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Prevention
- Masking
- None (Open Label)
Arm Groups
Arm | Description | Assigned Intervention |
---|---|---|
Experimental Group I (lifestyle intervention) |
Participants receive a dietary intervention designed to promote increased levels of plasma carotenoids, control weight, and to ensure adequacy of micronutrient intake. Participants also undergo a physical activity intervention comprising a moderately low aerobic regimen to raise the usual activity level. Participants also undergo face-to-face counseling, receive educational materials and counseling focused on how to read food labels to estimate grams of fat per serving and serving size, and undergo telephone counseling by a lifestyle intervention counselor twice a week for 4 weeks, then weekly for 2 weeks, twice a month for 5 months, monthly for the subsequent 6 months, and then once every other month for 12 months. Participants complete daily fat gram and step diaries at least three times per week. |
|
Active Comparator Group II (observation) |
Participants receive a study notebook containing general study-related information. Participants are not asked to record diet or physical activity but are provided a single sample diary in their study notebook. Participants receive telephone contact on a sliding scale similar to the intervention group, but at less frequent intervals (22 versus 33 calls over the course of the intervention). |
|
Recruiting Locations
Birmingham 4049979, Alabama 4829764 35233
Anchorage 5879400, Alaska 5879092 98508
Anchorage 5879400, Alaska 5879092 99508
Anchorage 5879400, Alaska 5879092 99508
Anchorage 5879400, Alaska 5879092 99508
Anchorage 5879400, Alaska 5879092 99508
Anchorage 5879400, Alaska 5879092 99508
Anchorage 5879400, Alaska 5879092 99508
Fairbanks 5861897, Alaska 5879092 99701
John A. Keech
907-458-5380
Phoenix 5308655, Arizona 5551752 85004
John H. Farley
623-207-3000
Tucson 5318313, Arizona 5551752 85719
Janiel M. Cragun
800-327-2873
Tucson 5318313, Arizona 5551752 85724
Janiel M. Cragun
520-626-9008
Hot Springs 4115412, Arkansas 4099753 71913
Mehmet S. Copur
501-622-2100
Little Rock 4119403, Arkansas 4099753 72205
Kristin K. Zorn
501-686-8274
Auburn 5325223, California 5332921 95602
Auburn 5325223, California 5332921 95603
Berkeley 5327684, California 5332921 94704
Burbank 5331835, California 5332921 91505
Burlingame 5331920, California 5332921 94010
Cameron Park 5333282, California 5332921 95682
Castro Valley 5334928, California 5332921 94546
Stacy D. D'Andre
510-537-1234
Concord 5339111, California 5332921 94520
Babak Edraki
925-674-2580
Davis 5341704, California 5332921 95616
John K. Chan
877-827-3222
Duarte 5344147, California 5332921 91010
Fremont 5350734, California 5332921 94538
Irvine 5359777, California 5332921 92618
Scott E. Lentz
626-564-3455
La Jolla 5363943, California 5332921 92093
Los Angeles 5368361, California 5332921 90027
Scott E. Lentz
626-564-3455
Los Angeles 5368361, California 5332921 90048
Bobbie J. Rimel
310-423-8965
Los Angeles 5368361, California 5332921 90095
Robin Farias-Eisner
888-798-0719
Modesto 5373900, California 5332921 95355
Mountain View 5375480, California 5332921 94040
Mountain View 5375480, California 5332921 94040
Orange 5379513, California 5332921 92868
Michael L. Berman
562-933-0900
Palo Alto 5380748, California 5332921 94301
Roseville 5388881, California 5332921 95661
Roseville 5388881, California 5332921 95661
Sacramento 5389489, California 5332921 95816
San Diego 5391811, California 5332921 92103
San Francisco 5391959, California 5332921 94115
Santa Cruz 5393052, California 5332921 95065
Santa Rosa 5393287, California 5332921 95403
Sunnyvale 5400075, California 5332921 94086
Vacaville 5405228, California 5332921 95687
Vallejo 5405380, California 5332921 94589
Aurora 5412347, Colorado 5417618 80012
Aurora 5412347, Colorado 5417618 80045
Saketh R. Guntupalli
720-848-0650
Boulder 5574991, Colorado 5417618 80301
Boulder 5574991, Colorado 5417618 80304
Colorado Springs 5417598, Colorado 5417618 80907
Mehmet S. Copur
501-622-2100
Colorado Springs 5417598, Colorado 5417618 80907
Mehmet S. Copur
501-622-2100
Denver 5419384, Colorado 5417618 80210
Mehmet S. Copur
501-622-2100
Denver 5419384, Colorado 5417618 80218
Denver 5419384, Colorado 5417618 80218
Denver 5419384, Colorado 5417618 80218
Denver 5419384, Colorado 5417618 80218
Denver 5419384, Colorado 5417618 80220
Denver 5419384, Colorado 5417618 80220
Denver 5419384, Colorado 5417618 80222
Durango 5420241, Colorado 5417618 81301
Mehmet S. Copur
501-622-2100
Durango 5420241, Colorado 5417618 81301
Englewood 5421250, Colorado 5417618 80113
Englewood 5421250, Colorado 5417618 80113
Fort Collins 5577147, Colorado 5417618 80524
Diana C. Medgyesy
970-297-6150
Golden 5423294, Colorado 5417618 80401
Mehmet S. Copur
501-622-2100
Greeley 5577592, Colorado 5417618 80631
Lakewood 5427946, Colorado 5417618 80228
Mehmet S. Copur
501-622-2100
Lakewood 5427946, Colorado 5417618 80228
Mehmet S. Copur
501-622-2100
Littleton 5429032, Colorado 5417618 80120
Littleton 5429032, Colorado 5417618 80122
Mehmet S. Copur
501-622-2100
Lone Tree 5429208, Colorado 5417618 80124
Longmont 5579276, Colorado 5417618 80501
Mehmet S. Copur
501-622-2100
Longmont 5579276, Colorado 5417618 80501
Mehmet S. Copur
501-622-2100
Loveland 5579368, Colorado 5417618 80539
Parker 5434006, Colorado 5417618 80138
Mehmet S. Copur
501-622-2100
Parker 5434006, Colorado 5417618 80138
Mehmet S. Copur
501-622-2100
Pueblo 5435464, Colorado 5417618 81004
Mehmet S. Copur
501-622-2100
Pueblo 5435464, Colorado 5417618 81008
Mehmet S. Copur
501-622-2100
Thornton 5441492, Colorado 5417618 80260
Mehmet S. Copur
501-622-2100
Wheat Ridge 5443948, Colorado 5417618 80033
Bridgeport 5282804, Connecticut 4831725 06606
Farmington 4834272, Connecticut 4831725 06030
Molly A. Brewer
800-579-7822
Hartford 4835797, Connecticut 4831725 06105
Elena S. Ratner
203-785-5702
Middletown 4838633, Connecticut 4831725 06457
New Haven 4839366, Connecticut 4831725 06520
Elena S. Ratner
203-785-5702
Lewes 4143354, Delaware 4142224 19958
Mark E. Borowsky
302-733-6227
Newark 4143861, Delaware 4142224 19713
Mark E. Borowsky
302-733-6227
Newark 4143861, Delaware 4142224 19713
Mark E. Borowsky
302-733-6227
Newark 4143861, Delaware 4142224 19713
Mark E. Borowsky
302-733-6227
Newark 4143861, Delaware 4142224 19713
Mark E. Borowsky
302-733-6227
Newark 4143861, Delaware 4142224 19718
Mark E. Borowsky
302-733-6227
Rehoboth Beach 4144284, Delaware 4142224 19971
Mark E. Borowsky
302-733-6227
Seaford 4144600, Delaware 4142224 19973
Mark E. Borowsky
302-733-6227
Wilmington 4145381, Delaware 4142224 19801
Mark E. Borowsky
302-733-6227
Orlando 4167147, Florida 4155751 32803
Sarasota 4172131, Florida 4155751 34239
James V. Fiorica
941-917-2225
Atlanta 4180439, Georgia 4197000 30342
Guilherme Henrique C. Cantuaria
404-303-3355
Augusta 4180531, Georgia 4197000 30912
Decatur 4191124, Georgia 4197000 30033
Savannah 4221552, Georgia 4197000 31405
Honolulu 5856195, Hawaii 5855797 96813
Michael E. Carney
808-586-2979
Honolulu 5856195, Hawaii 5855797 96813
Michael E. Carney
808-586-2979
Honolulu 5856195, Hawaii 5855797 96813
Michael E. Carney
808-586-2979
Honolulu 5856195, Hawaii 5855797 96826
Michael E. Carney
808-586-2979
Boise 5586437, Idaho 5596512 83706
Philip J. Stella
734-712-4673
Boise 5586437, Idaho 5596512 83712
Caldwell 5587698, Idaho 5596512 83605
J. R. Liu
208-367-7954
Coeur d'Alene 5589173, Idaho 5596512 83814
Emmett 5592562, Idaho 5596512 83617
J. R. Liu
208-367-7954
Fruitland 5593708, Idaho 5596512 83619
Meridian 5600685, Idaho 5596512 83642
J. R. Liu
208-367-7954
Meridian 5600685, Idaho 5596512 83642
Nampa 5601933, Idaho 5596512 83686
J. R. Liu
208-367-7954
Nampa 5601933, Idaho 5596512 83686
Post Falls 5604353, Idaho 5596512 83854
Sandpoint 5606401, Idaho 5596512 83864
Twin Falls 5610810, Idaho 5596512 83301
Aurora 4883817, Illinois 4896861 60504
Bloomington 4885164, Illinois 4896861 61704
James L. Wade
309-243-3605
Canton 4831990, Illinois 4896861 61520
James L. Wade
309-243-3605
Carbondale 4235193, Illinois 4896861 62902
James L. Wade
309-243-3605
Carthage 4886716, Illinois 4896861 62321
James L. Wade
309-243-3605
Centralia 4235587, Illinois 4896861 62801
James L. Wade
309-243-3605
Chicago 4887398, Illinois 4896861 60611
Chicago 4887398, Illinois 4896861 60612
Chicago 4887398, Illinois 4896861 60637
John W. Moroney
773-834-7424
Danville 4889426, Illinois 4896861 61832
Decatur 4236895, Illinois 4896861 62526
James L. Wade
309-243-3605
Decatur 4236895, Illinois 4896861 62526
James L. Wade
309-243-3605
Effingham 4237727, Illinois 4896861 62401
Effingham 4237727, Illinois 4896861 62401
James L. Wade
309-243-3605
Eureka 4891310, Illinois 4896861 61530
James L. Wade
309-243-3605
Galesburg 4893392, Illinois 4896861 61401
James L. Wade
309-243-3605
Galesburg 4893392, Illinois 4896861 61401
James L. Wade
309-243-3605
Hinsdale 4896012, Illinois 4896861 60521
Kewanee 4898433, Illinois 4896861 61443
James L. Wade
309-243-3605
Macomb 4900817, Illinois 4896861 61455
James L. Wade
309-243-3605
Mattoon 4244099, Illinois 4896861 61938
Maria T. Grosse-Perdekamp
217-258-5900
New Lenox 4903535, Illinois 4896861 60451
John W. Moroney
773-834-7424
Ottawa 4905006, Illinois 4896861 61350
James L. Wade
309-243-3605
Pekin 4905599, Illinois 4896861 61554
James L. Wade
309-243-3605
Pekin 4905599, Illinois 4896861 61554
James L. Wade
309-243-3605
Peoria 4905687, Illinois 4896861 61603
James L. Wade
309-243-3605
Peoria 4905687, Illinois 4896861 61615
James L. Wade
309-243-3605
Peoria 4905687, Illinois 4896861 61615
James L. Wade
309-243-3605
Peoria 4905687, Illinois 4896861 61637
James L. Wade
309-243-3605
Peru 4905770, Illinois 4896861 61354
James L. Wade
309-243-3605
Peru 4905770, Illinois 4896861 61354
James L. Wade
309-243-3605
Princeton 4906818, Illinois 4896861 61356
James L. Wade
309-243-3605
Springfield 4250542, Illinois 4896861 62702
James L. Wade
309-243-3605
Springfield 4250542, Illinois 4896861 62702
James L. Wade
309-243-3605
Springfield 4250542, Illinois 4896861 62781
James L. Wade
309-243-3605
Swansea 4251003, Illinois 4896861 62226
James L. Wade
309-243-3605
Urbana 4914570, Illinois 4896861 61801
Maria T. Grosse-Perdekamp
800-446-5532
Urbana 4914570, Illinois 4896861 61801
Maria T. Grosse-Perdekamp
800-446-5532
Yorkville 4917298, Illinois 4896861 60560
Indianapolis 4259418, Indiana 4921868 46202
Jeanne M. Schilder
317-630-7808
Indianapolis 4259418, Indiana 4921868 46260
South Bend 4926563, Indiana 4921868 46628
Michael W. Method
574-237-1328
Clive 4852065, Iowa 4862182 50325
Mehmet S. Copur
501-622-2100
Clive 4852065, Iowa 4862182 50325
Mehmet S. Copur
501-622-2100
Council Bluffs 4852832, Iowa 4862182 51503
Mehmet S. Copur
501-622-2100
Creston 4853078, Iowa 4862182 50801
Mehmet S. Copur
501-622-2100
Des Moines 4853828, Iowa 4862182 50314
Mehmet S. Copur
501-622-2100
Des Moines 4853828, Iowa 4862182 50314
Mehmet S. Copur
501-622-2100
West Des Moines 4881346, Iowa 4862182 50266
Mehmet S. Copur
501-622-2100
Chanute 4269392, Kansas 4273857 66720
Shaker R. Dakhil
316-268-5374
Dodge City 5445298, Kansas 4273857 67801
Shaker R. Dakhil
316-268-5374
El Dorado 4270863, Kansas 4273857 67042
Shaker R. Dakhil
316-268-5374
Fort Scott 4271690, Kansas 4273857 66701
Shaker R. Dakhil
316-268-5374
Independence 4273359, Kansas 4273857 67301
Shaker R. Dakhil
316-268-5374
Kansas City 4273837, Kansas 4273857 66160
Kingman 4273978, Kansas 4273857 67068
Shaker R. Dakhil
316-268-5374
Lawrence 4274277, Kansas 4273857 66044
Shaker R. Dakhil
316-268-5374
Liberal 5445820, Kansas 4273857 67905
Shaker R. Dakhil
316-268-5374
Manhattan 4274994, Kansas 4273857 66502
Shaker R. Dakhil
316-268-5374
McPherson 4275261, Kansas 4273857 67460
Shaker R. Dakhil
316-268-5374
Newton 4276248, Kansas 4273857 67114
Shaker R. Dakhil
316-268-5374
Parsons 4277011, Kansas 4273857 67357
Shaker R. Dakhil
316-268-5374
Prairie Village 4277718, Kansas 4273857 66208
Pratt 4277752, Kansas 4273857 67124
Shaker R. Dakhil
316-268-5374
Salina 4278890, Kansas 4273857 67401
Shaker R. Dakhil
316-268-5374
Wellington 4281386, Kansas 4273857 67152
Shaker R. Dakhil
316-268-5374
Wichita 4281730, Kansas 4273857 67208
Shaker R. Dakhil
316-268-5374
Wichita 4281730, Kansas 4273857 67208
Shaker R. Dakhil
316-268-5374
Wichita 4281730, Kansas 4273857 67214
Shaker R. Dakhil
316-268-5374
Wichita 4281730, Kansas 4273857 67214
Shaker R. Dakhil
316-268-5374
Wichita 4281730, Kansas 4273857 67214
Shaker R. Dakhil
316-268-5374
Winfield 4281897, Kansas 4273857 67156
Shaker R. Dakhil
316-268-5374
Bardstown 4283133, Kentucky 6254925 40004
Mehmet S. Copur
501-622-2100
Corbin 4288656, Kentucky 6254925 40701
Mehmet S. Copur
501-622-2100
Edgewood 4290873, Kentucky 6254925 41017
Lexington 4297983, Kentucky 6254925 40504
Mehmet S. Copur
501-622-2100
Lexington 4297983, Kentucky 6254925 40509
Mehmet S. Copur
501-622-2100
Lexington 4297983, Kentucky 6254925 40536
Frederick R. Ueland
859-257-3379
London 4298960, Kentucky 6254925 40741
Louisville 4299276, Kentucky 6254925 40202
Mehmet S. Copur
501-622-2100
Louisville 4299276, Kentucky 6254925 40215
Mehmet S. Copur
501-622-2100
Louisville 4299276, Kentucky 6254925 40245
Mehmet S. Copur
501-622-2100
Shepherdsville 4308163, Kentucky 6254925 40165
Mehmet S. Copur
501-622-2100
Baton Rouge 4315588, Louisiana 4331987 70817
Portland 4975802, Maine 4971068 04102
Christopher J. Darus
207-885-7565
Scarborough 4977882, Maine 4971068 04074
Christopher J. Darus
207-885-7565
Baltimore 4347778, Maryland 4361885 21204
Paul Celano
443-849-3706
Bethesda 4348599, Maryland 4361885 20889-5600
Chad A. Hamilton
301-319-2100
Boston 4930956, Massachusetts 6254926 02111
Burlington 4931737, Massachusetts 6254926 01805
Corrine L. Zarwan
781-744-8027
Ann Arbor 4984247, Michigan 5001836 48106
Philip J. Stella
734-712-4673
Battle Creek 4985153, Michigan 5001836 49017
Brighton 4986994, Michigan 5001836 48114
J. R. Liu
208-367-7954
Brighton 4986994, Michigan 5001836 48114
J. R. Liu
208-367-7954
Canton 4987990, Michigan 5001836 48188
J. R. Liu
208-367-7954
Canton 4987990, Michigan 5001836 48188
J. R. Liu
208-367-7954
Caro 4988059, Michigan 5001836 48723
J. R. Liu
208-367-7954
Chelsea 4988628, Michigan 5001836 48118
J. R. Liu
208-367-7954
Chelsea 4988628, Michigan 5001836 48118
J. R. Liu
208-367-7954
Clarkston 4988997, Michigan 5001836 48346
J. R. Liu
208-367-7954
Clarkston 4988997, Michigan 5001836 48346
J. R. Liu
208-367-7954
Dearborn 4990510, Michigan 5001836 48124
J. R. Liu
208-367-7954
Detroit 4990729, Michigan 5001836 48236
Philip J. Stella
734-712-4673
East China Township, Michigan 5001836 48054
J. R. Liu
208-367-7954
Flint 4992982, Michigan 5001836 48503
J. R. Liu
208-367-7954
Flint 4992982, Michigan 5001836 48503
J. R. Liu
208-367-7954
Flint 4992982, Michigan 5001836 48503
Philip J. Stella
734-712-4673
Flint 4992982, Michigan 5001836 48503
Philip J. Stella
734-712-4673
Grand Rapids 4994358, Michigan 5001836 49503
Grand Rapids 4994358, Michigan 5001836 49503
Grosse Pointe Woods 4994871, Michigan 5001836 48236
J. R. Liu
208-367-7954
Grosse Pointe Woods 4994871, Michigan 5001836 48236
J. R. Liu
208-367-7954
Grosse Pointe Woods 4994871, Michigan 5001836 48236
J. R. Liu
208-367-7954
Kalamazoo 4997787, Michigan 5001836 49007
Lansing 4998830, Michigan 5001836 48912
Philip J. Stella
734-712-4673
Livonia 4999837, Michigan 5001836 48154
J. R. Liu
208-367-7954
Livonia 4999837, Michigan 5001836 48154
Philip J. Stella
734-712-4673
Macomb 5000473, Michigan 5001836 48044
J. R. Liu
208-367-7954
Macomb 5000473, Michigan 5001836 48044
J. R. Liu
208-367-7954
Marlette 5000938, Michigan 5001836 48453
J. R. Liu
208-367-7954
Muskegon 5003132, Michigan 5001836 49444
Niles 5003514, Michigan 5001836 49120
Pontiac 5006166, Michigan 5001836 48341
J. R. Liu
208-367-7954
Pontiac 5006166, Michigan 5001836 48341
J. R. Liu
208-367-7954
Pontiac 5006166, Michigan 5001836 48341
J. R. Liu
208-367-7954
Pontiac 5006166, Michigan 5001836 48341
Philip J. Stella
734-712-4673
Reed City 5006946, Michigan 5001836 49677
Rochester Hills 5007402, Michigan 5001836 48309
J. R. Liu
208-367-7954
Saginaw 5007989, Michigan 5001836 48601
Philip J. Stella
734-712-4673
Saginaw 5007989, Michigan 5001836 48604
J. R. Liu
208-367-7954
Saint Joseph 5008327, Michigan 5001836 49085
Saint Joseph 5008327, Michigan 5001836 49085
Sterling Heights 5011148, Michigan 5001836 48312
J. R. Liu
208-367-7954
Tawas City 5011900, Michigan 5001836 48764
J. R. Liu
734-712-3671
Traverse City 5012495, Michigan 5001836 49684
Warren 5014051, Michigan 5001836 48088
J. R. Liu
208-367-7954
Warren 5014051, Michigan 5001836 48093
J. R. Liu
208-367-7954
Warren 5014051, Michigan 5001836 48093
J. R. Liu
208-367-7954
Warren 5014051, Michigan 5001836 48093
J. R. Liu
208-367-7954
Warren 5014051, Michigan 5001836 48093
J. R. Liu
208-367-7954
Warren 5014051, Michigan 5001836 48093
Philip J. Stella
734-712-4673
West Branch 5014413, Michigan 5001836 48661
J. R. Liu
208-367-7954
Wyoming 5015618, Michigan 5001836 49519
Ypsilanti 5015688, Michigan 5001836 48106
J. R. Liu
208-367-7954
Ypsilanti 5015688, Michigan 5001836 48197
J. R. Liu
208-367-7954
Bemidji 5017822, Minnesota 5037779 56601
Maria C. Bell
218-333-5000
Burnsville 5019767, Minnesota 5037779 55337
Coon Rapids 5022025, Minnesota 5037779 55433
Edina 5025264, Minnesota 5037779 55435
Fridley 5027482, Minnesota 5037779 55432
Maple Grove 5036493, Minnesota 5037779 55369
Maplewood 5036588, Minnesota 5037779 55109
Maplewood 5036588, Minnesota 5037779 55109
Minneapolis 5037649, Minnesota 5037779 55407
Minneapolis 5037649, Minnesota 5037779 55415
Minneapolis 5037649, Minnesota 5037779 55454
New Ulm 5039173, Minnesota 5037779 56073
Robbinsdale 5043439, Minnesota 5037779 55422
Saint Louis Park 5045021, Minnesota 5037779 55416
Saint Louis Park 5045021, Minnesota 5037779 55416
Saint Paul 5045360, Minnesota 5037779 55101
Saint Paul 5045360, Minnesota 5037779 55102
Shakopee 5046997, Minnesota 5037779 55379
Stillwater 5048814, Minnesota 5037779 55082
Waconia 5051640, Minnesota 5037779 55387
Willmar 5052916, Minnesota 5037779 56201
Woodbury 5053358, Minnesota 5037779 55125
Wyoming 5053526, Minnesota 5037779 55092
Jackson 4431410, Mississippi 4436296 39216
Donald P. Seago
601-200-3300
Bonne Terre 4377913, Missouri 4398678 63628
James L. Wade
309-243-3605
Cape Girardeau 4379966, Missouri 4398678 63703
James L. Wade
309-243-3605
Cape Girardeau 4379966, Missouri 4398678 63703
James L. Wade
309-243-3605
Jefferson City 4392388, Missouri 4398678 65109
James L. Wade
309-243-3605
Sainte Genevieve 4407294, Missouri 4398678 63670
James L. Wade
309-243-3605
Springfield 4409896, Missouri 4398678 65807
Jay W. Carlson
888-221-4849
St Louis 4407066, Missouri 4398678 63110
St Louis 4407066, Missouri 4398678 63110
St Louis 4407066, Missouri 4398678 63131
James L. Wade
309-243-3605
Sullivan 4410669, Missouri 4398678 63080
James L. Wade
309-243-3605
Sunset Hills 4410836, Missouri 4398678 63127
James L. Wade
309-243-3605
Anaconda 5637146, Montana 5667009 59711
Billings 5640350, Montana 5667009 59101
Billings 5640350, Montana 5667009 59102
Benjamin T. Marchello
800-648-6274
Bozeman 5641727, Montana 5667009 59715
Great Falls 5655240, Montana 5667009 59405
Great Falls 5655240, Montana 5667009 59405
Helena 5656882, Montana 5667009 59601
Kalispell 5660340, Montana 5667009 59901
Missoula 5666639, Montana 5667009 59802
Missoula 5666639, Montana 5667009 59804
Grand Island 5069297, Nebraska 5073708 68803
Mehmet S. Copur
501-622-2100
Kearney 5071348, Nebraska 5073708 68845
Mehmet S. Copur
501-622-2100
Kearney 5071348, Nebraska 5073708 68847
Mehmet S. Copur
501-622-2100
Lincoln 5072006, Nebraska 5073708 68510
Mehmet S. Copur
501-622-2100
Omaha 5074472, Nebraska 5073708 68114
Peter C. Morris
402-354-5144
Omaha 5074472, Nebraska 5073708 68122
Mehmet S. Copur
501-622-2100
Omaha 5074472, Nebraska 5073708 68122
Mehmet S. Copur
501-622-2100
Omaha 5074472, Nebraska 5073708 68124
Mehmet S. Copur
501-622-2100
Omaha 5074472, Nebraska 5073708 68130
Mehmet S. Copur
501-622-2100
Omaha 5074472, Nebraska 5073708 68131
Mehmet S. Copur
501-622-2100
Papillion 5074792, Nebraska 5073708 68046
Mehmet S. Copur
501-622-2100
Las Vegas 5506956, Nevada 5509151 89169
Dover 5085520, New Hampshire 5090174 03820
Henry L. Sonneborn
603-740-2150
Lebanon 5088597, New Hampshire 5090174 03756
Manchester 5089178, New Hampshire 5090174 03102
Nashua 5090046, New Hampshire 5090174 03063
Camden 4501018, New Jersey 5101760 08103
David P. Warshal
856-325-6757
Mount Holly 4503134, New Jersey 5101760 08060
Randolph B. Deger
609-914-6762
Voorhees Township 5105860, New Jersey 5101760 08043
David P. Warshal
856-325-6757
Voorhees Township 5105860, New Jersey 5101760 08043
Randolph B. Deger
609-914-6762
Manhasset 5125766, New York 5128638 11030
Mineola 5127134, New York 5128638 11501
Eva Chalas
516-663-3115
New Hyde Park 5128514, New York 5128638 11040
New Hyde Park 5128514, New York 5128638 11040
New York 5128581, New York 5128638 10021
Stony Brook 5139865, New York 5128638 11794
Michael L. Pearl
800-862-2215
Syracuse 5140405, New York 5128638 13210
Mary J. Cunningham
315-464-5476
Asheboro 4453035, North Carolina 4482348 27203
Vinay K. Gudena
336-832-0821
Asheville 4453066, North Carolina 4482348 28816
Burlington 4458228, North Carolina 4482348 27215
Vinay K. Gudena
336-832-0821
Chapel Hill 4460162, North Carolina 4482348 27599
Charlotte 4460243, North Carolina 4482348 28204
John M. McDonald
704-384-5369
Charlotte 4460243, North Carolina 4482348 28207
John M. McDonald
704-342-9577
Charlotte 4460243, North Carolina 4482348 28262
Durham 4464368, North Carolina 4482348 27710
Laura J. Havrilesky
888-275-3853
Greensboro 4469146, North Carolina 4482348 27403
Vinay K. Gudena
336-832-0821
Huntersville 4472370, North Carolina 4482348 28078
Huntersville 4472370, North Carolina 4482348 28078
John M. McDonald
704-384-5369
Huntersville 4472370, North Carolina 4482348 28078
Kernersville 4474221, North Carolina 4482348 27284
Joshua S. Trinidad
336-277-8887
Matthews 4478334, North Carolina 4482348 28105
Mebane 4478877, North Carolina 4482348 27302
Vinay K. Gudena
336-832-0821
Mooresville 4480125, North Carolina 4482348 28117
John M. McDonald
704-799-3946
Mount Airy 4480378, North Carolina 4482348 27030
Joshua S. Trinidad
336-277-8887
Pinehurst 4485272, North Carolina 4482348 28374
John W. Byron
910-715-2200
Reidsville 4487682, North Carolina 4482348 27320
Vinay K. Gudena
336-832-0821
Thomasville 4494942, North Carolina 4482348 27360
Joshua S. Trinidad
336-277-8887
Wilkesboro 4499138, North Carolina 4482348 28659
Joshua S. Trinidad
336-277-8887
Winston-Salem 4499612, North Carolina 4482348 27103
Joshua S. Trinidad
336-277-8887
Winston-Salem 4499612, North Carolina 4482348 27103
Joshua S. Trinidad
336-277-8887
Bismarck 5688025, North Dakota 5690763 58501
Maria C. Bell
218-333-5000
Fargo 5059163, North Dakota 5690763 58122
Maria C. Bell
218-333-5000
Fargo 5059163, North Dakota 5690763 58122
Maria C. Bell
218-333-5000
Fargo 5059163, North Dakota 5690763 58122
Maria C. Bell
218-333-5000
Belpre 4506187, Ohio 5165418 45714
Canton 5149222, Ohio 5165418 44710
Michael P. Hopkins
888-293-4673
Chillicothe 4828890, Ohio 5165418 45601
Cincinnati 4508722, Ohio 5165418 45220
Mehmet S. Copur
501-622-2100
Cincinnati 4508722, Ohio 5165418 45242
Mehmet S. Copur
501-622-2100
Cincinnati 4508722, Ohio 5165418 45247
Mehmet S. Copur
501-622-2100
Cincinnati 4508722, Ohio 5165418 45255
Mehmet S. Copur
501-622-2100
Cleveland 5150529, Ohio 5165418 44111
Peter G. Rose
866-223-8100
Cleveland 5150529, Ohio 5165418 44195
Peter G. Rose
866-223-8100
Columbus 4509177, Ohio 5165418 43210
Columbus 4509177, Ohio 5165418 43213
Columbus 4509177, Ohio 5165418 43214
Columbus 4509177, Ohio 5165418 43214
Columbus 4509177, Ohio 5165418 43215
Columbus 4509177, Ohio 5165418 43219
Columbus 4509177, Ohio 5165418 43222
Columbus 4509177, Ohio 5165418 43228
Delaware 5151891, Ohio 5165418 43015
Delaware 5151891, Ohio 5165418 43015
Delaware 5151891, Ohio 5165418 43015
Lancaster 4516233, Ohio 5165418 43130
Mansfield 5161723, Ohio 5165418 44903
Marietta 4517586, Ohio 5165418 45750
Marion 5161902, Ohio 5165418 43302
Mayfield Heights 5162188, Ohio 5165418 44124
Peter G. Rose
866-223-8100
Mount Vernon 5163799, Ohio 5165418 43050
Newark 5164466, Ohio 5165418 43055
Newark 5164466, Ohio 5165418 43055
Portsmouth 4521816, Ohio 5165418 45662
Westerville 5176472, Ohio 5165418 43081
Zanesville 4528923, Ohio 5165418 43701
Oklahoma City 4544349, Oklahoma 4544379 73104
Tulsa 4553433, Oklahoma 4544379 74146
Baker City 5712169, Oregon 5744337 97814
J. R. Liu
208-367-7954
Bend 5713587, Oregon 5744337 97701
Clackamas 5719308, Oregon 5744337 97015
Clackamas 5719308, Oregon 5744337 97015
Coos Bay 5720495, Oregon 5744337 97420
Newberg 5742726, Oregon 5744337 97132
Ontario 5744166, Oregon 5744337 97914
J. R. Liu
208-367-7954
Portland 5746545, Oregon 5744337 97213
Portland 5746545, Oregon 5744337 97225
Abington 5177773, Pennsylvania 6254927 19001
Mark S. Shahin
215-481-2402
Allentown 5178127, Pennsylvania 6254927 18103
Philip J. Stella
734-712-4673
Bethlehem 5180225, Pennsylvania 6254927 18015
Bethlehem 5180225, Pennsylvania 6254927 18017
Philip J. Stella
734-712-4673
Danville 5186327, Pennsylvania 6254927 17822
Radhika P. Gogoi
570-271-5251
Gettysburg 4558183, Pennsylvania 6254927 17325
Mark A. Miller
877-441-7957
Hazleton 5193011, Pennsylvania 6254927 18201
Radhika P. Gogoi
570-271-5251
Monroeville 5201734, Pennsylvania 6254927 15146
Thomas C. Krivak
877-284-2000
Natrona Heights 5202903, Pennsylvania 6254927 15065
Thomas C. Krivak
877-284-2000
Philadelphia 4560349, Pennsylvania 6254927 19104
Robert A. Burger
800-474-9892
Philadelphia 4560349, Pennsylvania 6254927 19107
Robert A. Burger
800-474-9892
Pittsburgh 5206379, Pennsylvania 6254927 15224
Thomas C. Krivak
877-284-2000
Pittsburgh 5206379, Pennsylvania 6254927 15232
Alexander B. Olawaiye
412-647-8073
Scranton 5211303, Pennsylvania 6254927 18510
Radhika P. Gogoi
570-271-5251
State College 5213681, Pennsylvania 6254927 16801
Radhika P. Gogoi
570-271-5251
West Chester 4562144, Pennsylvania 6254927 19380
William E. Luginbuhl
610-431-5297
Wexford 5219062, Pennsylvania 6254927 15090
Thomas C. Krivak
877-284-2000
Wilkes-Barre 5219488, Pennsylvania 6254927 18711
Radhika P. Gogoi
570-271-5251
York 4562407, Pennsylvania 6254927 17403
Mark A. Miller
877-441-7957
Providence 5224151, Rhode Island 5224323 02905
Paul A. DiSilvestro
401-274-1122
Charleston 4574324, South Carolina 4597040 29425
Whitney S. Graybill
843-792-9321
Easley 4577263, South Carolina 4597040 29640
Jeffrey W. Elder
864-679-3966
Gaffney 4579418, South Carolina 4597040 29341
Carlton L. Schwab
800-486-5941
Greenville 4580543, South Carolina 4597040 29605
Jeffrey W. Elder
864-679-3966
Greenville 4580543, South Carolina 4597040 29605
Jeffrey W. Elder
864-679-3966
Greenville 4580543, South Carolina 4597040 29615
Jeffrey W. Elder
864-679-3966
Greer 4580599, South Carolina 4597040 29650
Jeffrey W. Elder
864-679-3966
Greer 4580599, South Carolina 4597040 29651
Carlton L. Schwab
800-486-5941
Seneca 4595346, South Carolina 4597040 29672
Jeffrey W. Elder
864-679-3966
Spartanburg 4597200, South Carolina 4597040 29303
Carlton L. Schwab
800-486-5941
Spartanburg 4597200, South Carolina 4597040 29307
Jeffrey W. Elder
864-679-3966
Sioux Falls 5231851, South Dakota 5769223 57104
Maria C. Bell
218-333-5000
Sioux Falls 5231851, South Dakota 5769223 57117-5134
Maria C. Bell
218-333-5000
Chattanooga 4612862, Tennessee 4662168 37404
Mehmet S. Copur
501-622-2100
Hixson 4629825, Tennessee 4662168 37343
Mehmet S. Copur
501-622-2100
Knoxville 4634946, Tennessee 4662168 37920
Larry C. Kilgore
865-544-9773
Nashville 4644585, Tennessee 4662168 37236
Michael P. Stany
301-319-2100
Ooltewah 4647313, Tennessee 4662168 37363
Mehmet S. Copur
501-622-2100
Bryan 4677008, Texas 4736286 77802
Fort Sam Houston 7267736, Texas 4736286 78234
Caela R. Miller
210-916-4837
Houston 4699066, Texas 4736286 77030
Karen H. Lu
713-792-3245
Houston 4699066, Texas 4736286 77030
Aparna A. Kamat
713-790-2700
Houston 4699066, Texas 4736286 77070
Aparna A. Kamat
713-790-2700
Sugar Land 4734825, Texas 4736286 77479
Aparna A. Kamat
713-790-2700
American Fork 5844096, Utah 5549030 84003
Craig R. Nichols
253-403-2394
Cedar City 5536630, Utah 5549030 84720
Craig R. Nichols
253-403-2394
Farmington 5774662, Utah 5549030 84025
Logan 5777544, Utah 5549030 84321
Craig R. Nichols
253-403-2394
Murray 5778755, Utah 5549030 84107
Craig R. Nichols
253-403-2394
Ogden 5779206, Utah 5549030 84403
Craig R. Nichols
253-403-2394
Provo 5780026, Utah 5549030 84604
Craig R. Nichols
253-403-2394
Salt Lake City 5780993, Utah 5549030 84106
Craig R. Nichols
253-403-2394
Salt Lake City 5780993, Utah 5549030 84112
Salt Lake City 5780993, Utah 5549030 84143
Craig R. Nichols
253-403-2394
St. George 5546220, Utah 5549030 84770
Craig R. Nichols
253-403-2394
Charlottesville 4752031, Virginia 6254928 22908
Susan C. Modesitt
859-257-3379
Portsmouth 4779999, Virginia 6254928 23708-2197
Andrew S. Camarata
757-953-5939
Richmond 4781708, Virginia 6254928 23298
Sarah M. Temkin
804-200-7062
Roanoke 4782167, Virginia 6254928 24016
Janet L. Osborne
540-985-8510
Aberdeen 5785243, Washington 5815135 98520
Auburn 5785965, Washington 5815135 98001
John A. Keech
907-458-5380
Bainbridge Island 5816320, Washington 5815135 98110
John A. Keech
907-458-5380
Bellevue 5786882, Washington 5815135 98004
John A. Keech
907-458-5380
Bellingham 5786899, Washington 5815135 98225
Burien 5788516, Washington 5815135 98166
Centralia 5789683, Washington 5815135 98531
Edmonds 5793427, Washington 5815135 98026
Enumclaw 5793822, Washington 5815135 98022
Mehmet S. Copur
501-622-2100
Everett 5793933, Washington 5815135 98201
Federal Way 5794245, Washington 5815135 98002
John A. Keech
907-458-5380
Federal Way 5794245, Washington 5815135 98003
Mehmet S. Copur
501-622-2100
Gig Harbor 5795440, Washington 5815135 98332
John A. Keech
907-458-5380
Gig Harbor 5795440, Washington 5815135 98335
John A. Keech
907-458-5380
Issaquah 5798487, Washington 5815135 98029
Kennewick 5799610, Washington 5815135 99336
Lacey 5800112, Washington 5815135 98503
Lakewood 5800420, Washington 5815135 98499
Mehmet S. Copur
501-622-2100
Longview 5801617, Washington 5815135 98632
Lynnwood 5802049, Washington 5815135 98036
John A. Keech
907-458-5380
Mount Vernon 5804127, Washington 5815135 98273
Heidi J. Gray
425-899-3181
Mount Vernon 5804127, Washington 5815135 98274
Heidi J. Gray
425-899-3181
Port Townsend 5807239, Washington 5815135 98368
John A. Keech
907-458-5380
Poulsbo 5807337, Washington 5815135 98370
John A. Keech
907-458-5380
Puyallup 5807575, Washington 5815135 98372
John A. Keech
907-458-5380
Puyallup 5807575, Washington 5815135 98372
John A. Keech
907-458-5380
Seattle 5809844, Washington 5815135 98101
John A. Keech
907-458-5380
Seattle 5809844, Washington 5815135 98104
Seattle 5809844, Washington 5815135 98107
Seattle 5809844, Washington 5815135 98109
Heidi J. Gray
425-899-3181
Seattle 5809844, Washington 5815135 98109
Heidi J. Gray
425-899-3181
Seattle 5809844, Washington 5815135 98112
Seattle 5809844, Washington 5815135 98122-4307
Seattle 5809844, Washington 5815135 98122-5711
Seattle 5809844, Washington 5815135 98133
Heidi J. Gray
425-899-3181
Seattle 5809844, Washington 5815135 98133
Heidi J. Gray
425-899-3181
Seattle 5809844, Washington 5815135 98195
Heidi J. Gray
425-899-3181
Shelton 5810176, Washington 5815135 98584
Spokane 5811696, Washington 5815135 99204
Spokane 5811696, Washington 5815135 99208
Heidi J. Gray
425-899-3181
Spokane 5811696, Washington 5815135 99216
Spokane 5811696, Washington 5815135 99218
Spokane Valley 5811729, Washington 5815135 99216
Tacoma 5812944, Washington 5815135 97405
John A. Keech
907-458-5380
Tacoma 5812944, Washington 5815135 98405
Mehmet S. Copur
501-622-2100
Tacoma 5812944, Washington 5815135 98405
John A. Keech
907-458-5380
Tacoma 5812944, Washington 5815135 98405
Mehmet S. Copur
501-622-2100
Tacoma 5812944, Washington 5815135 98405
John A. Keech
253-403-2394
Tacoma 5812944, Washington 5815135 98405
John A. Keech
907-458-5380
Vancouver 5814616, Washington 5815135 98664
Walla Walla 5814916, Washington 5815135 99362
Wenatchee 5815342, Washington 5815135 98801
Heidi J. Gray
425-899-3181
Yelm 5816656, Washington 5815135 98597
Morgantown 4815352, West Virginia 4826850 26505
Jamie L. Lesnock
304-598-6560
Burlington 5247214, Wisconsin 5279468 53105
Elizabeth L. Dickson Michelson
414-649-5717
Chippewa Falls 5248511, Wisconsin 5279468 54729
Anthony C. Evans
800-347-0673
Eau Claire 5251436, Wisconsin 5279468 54701
Anthony C. Evans
800-924-8515
Fond du Lac 5253352, Wisconsin 5279468 54937
Elizabeth L. Dickson Michelson
414-649-5717
Germantown 5254218, Wisconsin 5279468 53022
Elizabeth L. Dickson Michelson
414-649-5717
Grafton 5254739, Wisconsin 5279468 53024
Elizabeth L. Dickson Michelson
414-649-5717
Green Bay 5254962, Wisconsin 5279468 54301-3526
Green Bay 5254962, Wisconsin 5279468 54301
Green Bay 5254962, Wisconsin 5279468 54303
Green Bay 5254962, Wisconsin 5279468 54303
Green Bay 5254962, Wisconsin 5279468 54311
Elizabeth L. Dickson Michelson
414-649-5717
Kenosha 5258393, Wisconsin 5279468 53142
Elizabeth L. Dickson Michelson
414-649-5717
La Crosse 5258957, Wisconsin 5279468 54601
Ladysmith 5259048, Wisconsin 5279468 54848
Anthony C. Evans
800-347-0673
Madison 5261457, Wisconsin 5279468 53792
David M. Kushner
800-622-8922
Manitowoc 5261585, Wisconsin 5279468 54221
Marinette 5261852, Wisconsin 5279468 54143
Marinette 5261852, Wisconsin 5279468 54143
Elizabeth L. Dickson Michelson
414-649-5717
Marshfield 5261969, Wisconsin 5279468 54449
Anthony C. Evans
800-347-0673
Milwaukee 5263045, Wisconsin 5279468 53209
Elizabeth L. Dickson Michelson
414-649-5717
Milwaukee 5263045, Wisconsin 5279468 53215
Elizabeth L. Dickson Michelson
414-649-5717
Milwaukee 5263045, Wisconsin 5279468 53226
William H. Bradley
414-805-4380
Milwaukee 5263045, Wisconsin 5279468 53233
Elizabeth L. Dickson Michelson
414-649-5717
Minocqua 5263156, Wisconsin 5279468 54548
Anthony C. Evans
800-347-0673
New Richmond 5264475, Wisconsin 5279468 54017
Oshkosh 5265838, Wisconsin 5279468 54904
Elizabeth L. Dickson Michelson
414-649-5717
Racine 5268249, Wisconsin 5279468 53406
Elizabeth L. Dickson Michelson
414-649-5717
Rice Lake 5268798, Wisconsin 5279468 54868
Anthony C. Evans
800-347-0673
Sheboygan 5272893, Wisconsin 5279468 53081
Elizabeth L. Dickson Michelson
414-649-5717
Stevens Point 5274644, Wisconsin 5279468 54482
Summit, Wisconsin 5279468 53066
Elizabeth L. Dickson Michelson
414-649-5717
Two Rivers 5276609, Wisconsin 5279468 54241
Elizabeth L. Dickson Michelson
414-649-5717
Wausau 5278120, Wisconsin 5279468 54401
Anthony C. Evans
800-347-0673
Wauwatosa 5278159, Wisconsin 5279468 53226
Elizabeth L. Dickson Michelson
414-649-5717
West Allis 5278420, Wisconsin 5279468 53227
Elizabeth L. Dickson Michelson
414-649-5717
Weston 5278693, Wisconsin 5279468 54476
Anthony C. Evans
800-347-0673
Wisconsin Rapids 5279436, Wisconsin 5279468 54494
Anthony C. Evans
800-347-0673
Cheyenne 5821086, Wyoming 5843591 82001
Cody 5821593, Wyoming 5843591 82414
More Details
- NCT ID
- NCT00719303
- Status
- Unknown status
- Sponsor
- Gynecologic Oncology Group
Detailed Description
PRIMARY OBJECTIVES: I. To determine if women who are disease-free after successfully completing primary and potential consolidation/maintenance, therapy for stage II-IV ovarian, fallopian tube or primary peritoneal cancer and who are randomized to a healthy lifestyle intervention, will have significantly increased progression-free survival compared to similar women who are randomized to a usual care comparison group. SECONDARY OBJECTIVES: I. To determine if women who are randomized to the study intervention will have improved general quality of life as measured by the General Health subscale of Research and Development (RAND) 36-Item Health Survey (RAND-36). II. To determine if women who are randomized to the study intervention will have improved physical and bowel functioning as measured by the Physical Functioning subscale of RAND-36 and the Gastrointestinal Symptom Rating Scale (GSRS)-Irritable Bowel Syndrome (IBS), compared to women who are randomized to usual care. TERTIARY OBJECTIVES: I. To assess patient compliance with the healthy lifestyle intervention by analyzing biomarkers (e.g., total carotenoid) at baseline, 6, 12, and 24 months. II. To explore the relationship between carotenoid exposure and progression free survival from ovarian cancer. III. To examine patient compliance with the healthy lifestyle intervention and to assess which types of patients are more likely to be compliant with the healthy lifestyle intervention and whether progression-free survival is better among compliant individuals. IV. To explore the impact of the intervention on other aspects of quality of life such as pain, role limitations due to physical health and emotional problems, mental health, vitality, and social functioning as measured by the corresponding subscales of the RAND-36. V. To explore the impact of the intervention on bowel functioning as measured with the GSRS-IBS subscales. VI. To assess the association between subjectively measured sleep duration/quality (using the Pittsburgh Sleep Quality Scale), anthropometric measurements, and self-reported dietary energy intake among women previously treated for stage II-IV ovarian or primary peritoneal cancer. VII. To assess and compare telomere length and rate of telomere shortening between ovarian cancer survivors randomized to lifestyle intervention versus standard of care. VIII. To assess effects of the intervention on biomarkers of metabolic health as measured by changes in circulating insulin and related insulin resistance, lipids and inflammation. IX. To determine if the intervention effect on the biomarkers listed above is modified by baseline central adiposity. X. To determine if the intervention effect on biomarkers listed above is mediated by change in central adiposity. XI. To evaluate changes in central adiposity using computerized tomography (CT) scan data from regularly scheduled, routine surveillance CT scans to determine if change in CT-specific visceral adiposity is associated with changes in biomarkers of metabolic deregulation and inflammation in a random subsample. OUTLINE: Participants are randomized to 1 of 2 groups. GROUP 1 (LIFESTYLE INTERVENTION): Participants receive a dietary intervention designed to promote increased levels of plasma carotenoids, control weight, and to ensure adequacy of micronutrient intake. Participants also undergo a physical activity intervention comprising a moderately low aerobic regimen to raise the usual activity level. Participants also undergo face-to-face counseling, receive educational materials and counseling focused on how to read food labels to estimate grams of fat per serving and serving size, and undergo telephone counseling by a lifestyle intervention counselor twice a week for 4 weeks, then weekly for 2 weeks, twice a month for 5 months, monthly for the subsequent 6 months, and then once every other month for 12 months. Participants complete daily fat gram and step diaries at least three times per week. GROUP 2 (COMPARISON LIFESTYLE): Participants receive a study notebook containing general study-related information. Participants are not asked to record diet or physical activity but are provided a single sample diary in their study notebook. Participants receive telephone contact on a sliding scale similar to the intervention group, but at less frequent intervals (22 versus 33 calls over the course of the intervention). After completion of study, participants are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.