Intensity-Modulated Radiation Therapy, Cisplatin, and Gemcitabine Hydrochloride in Treating Patients with Stage IB-IVA Cervical Cancer

Inclusion Criteria

• Histologically-proven, invasive primary carcinoma of the cervix
• Locally advanced high-risk carcinoma of the uterine cervix, i.e.: intact cervix (i.e. non-operative) with International Federation of Gynecology and Obstetrics (FIGO) stage at least IB2 OR post-hysterectomy with either: residual gross disease or para-aortic nodal involvement (either resected or unresected) based upon standard diagnostic workup, including: * History/physical examination * Examination under anesthesia (if indicated) * Biopsy * Intravenous pyelogram and/or cystoscopy (if indicated) * Colonoscopy, sigmoidoscopy, or rigid proctoscopy (if indicated) * Posteroanterior (PA) and lateral chest x-ray or chest computed tomography (CT) * CT or magnetic resonance imaging (MRI) of the pelvis * Positron emission tomography (PET), PET/CT, or PET/CT simulation (encouraged)
• Karnofsky performance status >= 60
• Peripheral absolute neutrophil count (ANC) >= 1500/uL
• Platelet count >= 100,000/uL (transfusion independent)
• Hemoglobin (Hgb) >= 8.0 g/dL (note: the use of transfusion or other intervention to achieve Hgb >= 8.0 g/dL is acceptable)
• Serum creatinine =< 1.5 mg/dl
• Bilirubin (sum of conjugated + unconjugated) < 1.5 x upper limit of normal (ULN)
• Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 1.5 x upper limit of normal (ULN) for age
• Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) < 1.5 x ULN for age
• All subjects must sign a written informed consent

Exclusion Criteria

• Pregnant or breast-feeding women will not be entered on this study; (note: serum pregnancy tests must be obtained in women of child bearing potential); sexually active females may not participate unless they have agreed to use an effective contraceptive method (such as abstinence, diaphragm, condom, or intrauterine device) to prevent pregnancy for the duration of the study
• Concomitant medications, if taken within the last 28 days
• Growth factors that support platelet or white cell number or function must not have been administered within the past 28 days
• Erythropoietin or related hormones must not have been administered within the past 28 days
• Patients who have an uncontrolled infection
• Evidence of distant metastases (excluding para-aortic nodes)
• Prior invasive malignancy (except non-melanomatous skin cancer), unless disease free for a minimum of 3 years
• Prior systemic chemotherapy within the last three years
• Prior radiotherapy to the pelvis (or abdomen if para-aortic nodes are involved)