Whole Pelvis Proton Radiation for Gynecologic Cancer (GynWPProton)

This is a single institution, multi-center, Phase II, single-arm study, using Whole Pelvis (WP) Pencil Beam Scanning Proton Radiation (PBS PRT) in the post-surgical, adjuvant setting for definitive treatment of gynecologic cancers. The purpose of this study is to estimate rate of acute clinician-reported gastrointestinal (GI) toxicity using WP PBS PRT in the definitive treatment of gynecologic cancers in the post-surgical, adjuvant setting.

Study Population: This is a single institution, multi-site study, and thus will include patients from geographic locations with Penn proton centers in the Philadelphia, Lancaster and South New Jersey area. Description of Sites/Facilities: The study will be conducted at the University of Pennsylvania Department of Radiation Oncology and associated Clinical facilities. Enrolling Sites: Enrolling sites are within the Penn institution and have proton capabilities. They include the following facilities: Penn Medicine Abramson Center in Philadelphia, PA Penn Medicine Lancaster General Health in Lancaster, PA Penn Medicine Virtua Voorhees in South New Jersey Description of Study Intervention: Patients will be treated with PBS PRT with doses of 45 or 50.4Gy relative biological effectiveness (RBE) in 1.8Gy daily fractions. Study Duration: The duration of the study will be 6 months after the last patient was treated. The recruitment period is planned over 24 months. Thus, estimated time from when study opens to completion of data analysis is 36 months. Participant Duration: 6 months from end of treatment, which including treatment time is approximately 7.5 months

The study intervention is Whole Pelvis (WP) Pencil Beam Scanning Proton Radiation (PBS PRT) as part of the definitive treatment of gynecologic cancers in the post-hysterectomy, adjuvant setting. Patients will be treated with doses of 45 or 50.4 Gy in 1.8 Gy daily fractions. The volume treated will include the whole pelvis according to Radiation Therapy Oncology Group post-hysterectomy pelvis guidelines.

The study intervention is Whole Pelvis (WP) Pencil Beam Scanning Proton Radiation (PBS PRT) as part of the definitive treatment of gynecologic cancers in the post-hysterectomy, adjuvant setting. Patients will be treated with doses of 45 or 50.4 Gy in 1.8 Gy daily fractions. The volume treated will include the whole pelvis according to Radiation Therapy Oncology Group post-hysterectomy pelvis guidelines.

Determine the rate of acute clinician-reported gastrointestinal (GI), with the Common Terminology Criteria for Adverse Events (CTCAE v5.0) criteria.

Determine the rate of the acute patient-reported gastrointestinal (GI) and genitourinary (GU), with the Common Terminology Criteria for Adverse Events (CTCAE v5.0) criteria.

Determine the rate of acute patient-reported gastrointestinal (GI) and genitourinary (GU) toxicity and quality of life using the EPIC urinary and bowel score (expanded prostate cancer index composite) and FACT-Cx.

Inclusion Criteria: Histologically confirmed cervical or endometrial cancer Indication for adjuvant whole pelvic radiation therapy, with or without systemic therapy Age of 18 years or older Written informed consent ECOG of 0-2 Exclusion Criteria: Prior course of pelvic radiation Metastatic disease outside of the pelvis Active inflammatory bowel disease Incapacity to provide informed consent