Whole Pelvic Hypofractionated Radiotherapy for the Treatment of Non-Metastatic Cervical and Endometrial Cancer, RT-PACE Trial

Inclusion Criteria

• Diagnosis of primary cervical cancer or uterine cancer of any histology
• Age >= 18 years
• Non-metastatic (Federation of Gynecology and Obstetrics [FIGO] stage I-IIIC1 if uterine primary, FIGO Stage I-IVA if cervical primary)
• Must have been treated with definitive intent, including standard-of-care hysterectomy, without any gross residual disease post-operatively. Nodal dissection is not required
• Recommended to undergo whole pelvic radiotherapy without concurrent chemotherapy or para-aortic radiation. Chemotherapy before or after radiotherapy is acceptable. Concurrent targeted therapy (i.e., trastuzumab, etc.) is permitted
• Eastern Cooperative Oncology Group (ECOG) Performance Score (PS) =< 2
• Able to provide informed consent and willingness to sign an approved consent form that conforms to federal and institutional guidelines

Exclusion Criteria

• Distant metastases as determined clinically or radiographically based upon standard-of-care work-up for endometrial cancer
• Concurrent cytotoxic chemotherapy
• Gross residual disease post-operatively and/or at the time of radiation based upon pre-op or post-op imaging, intra-operative findings, and gynecologic oncologists’ judgment
• History of small bowel obstruction, inflammatory bowel disease, irritable bowel syndrome, connective tissue disorder requiring ongoing active medical management, or prior radiation therapy directed to the pelvis
• Unresolved grade 2 or higher chemotherapy-associated diarrhea or abdominopelvic pain requiring medication prior to the initiation of radiation
• Recommendation to undergo para-aortic nodal irradiation