Comparison of Acute Toxicities Between Patients Treated With Protons or Intensity Modulated Radiation Therapy After Surgery for the Treatment of Endometrial or Cervical Cancer

Inclusion Criteria:

Histologically confirmed diagnosis of cervical or endometrial cancer
Must have undergone an open or robotic hysterectomy (total abdominal, vaginal, radical, or total laparoscopic) for carcinoma of the cervix or endometrium
History and physical prior to registration

Documentation of history of:

Smoking status
Pelvic infection
Pelvic inflammatory disease
Endometriosis
Planned to receive either proton or IMRT radiation treatment, with use of rectal balloon, at an Institutional Review Board (IRB)-approved Mayo Clinic site
Plan for RT to pelvis with or without para-aortic lymph node irradiation
If received high-dose chemotherapy prior to registration, last dose must have been given >= 21 days prior to start of RT
Complete blood count (CBC) performed within 21 days prior to registration
Computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, or PET/MRI for staging before registration; may be pre-operative (op) or post-op
Eastern Cooperative Oncology Group (ECOG) performance score 0-2
Provide written informed consent
Willing to complete quality of life (QOL) questionnaires

Exclusion Criteria:

Receiving external beam boost dose during RT
Distant metastases
Gross disease at time of RT
Histology of endometrial stromal sarcoma, leiomyosarcoma, melanoma or small cell carcinomas
Patients who exceed the weight/size limits of the treatment table
Patients with active and/or inflammatory irritable bowel disease
Positive or close surgical margins (=< 3 mm)
Prior RT to the pelvis
Planned to receive inguinal node RT
Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects
Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note that human immunodeficiency virus (HIV) testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be immunosuppressive
Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years

Severe, active co-morbidity defined as follows:

Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
Transmural myocardial infarction within the last 6 months
Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
Other major medical illness which requires hospitalization or precludes study therapy at the time of registration
Patients unwilling to have rectal balloon placed on a daily basis during RT