Study With Intensity Modulated Radiation Therapy With Cisplatin to Treat Stage I-IVA Cervical Cancer

Inclusion Criteria:

• Biopsy-proven, invasive squamous cell carcinoma, adenocarcinoma, or adenosquamouscarcinoma of the cervix

• Biopsy result positive for carcinoma within 60 days prior to registration

• FIGO clinical stage I-IVA disease, based on standard diagnostic workup,including:History/physical examination and/or Examination under anesthesia (ifindicated)

• If the patient is status post hysterectomy, one or more of the following conditionsmust be present: positive lymph nodes, positive margins, parametrial invasion, ornon-radical surgery (i.e., simple hysterectomy).

• If the patient is inoperable, one or more of the following conditions must bepresent: clinical stage IB2-IVA, positive lymph nodes on nodal sampling or frozensection, and/or parametrial invasion

• Within 42 days prior to registration, the patient must have any of the following, ifclinically indicated: examination under anesthesia, cystoscopy, sigmoidoscopy, rigidproctoscopy, or colonoscopy.

• X-ray (PA and lateral), CT scan, or PET/CT scan of the chest within 42 days prior toregistration;

• CT scan, MRI, or PET/CT of the pelvis within 42 days prior to registration;

• Karnofsky Performance Status 60-100

• Absolute neutrophil count (ANC) ≥ 1500 cells/mm3; Platelets ≥ 100,000 cells/mm3;Hemoglobin ≥ 10.0 g/dl (Note: The use of transfusion or other intervention toachieve Hgb ≥ 10.0 g/dl is acceptable); Creatinine clearance ≥ 50 mg/dl; Bilirubin < 1.5 mg/dl; WBC ≥ 3,000/μl; ALT/AST < 3 x ULN; INR ≤ 1.5

• Negative serum pregnancy test for women of child-bearing potential

Exclusion Criteria:

• Prior invasive malignancy (except non-melanomatous skin cancer), unless disease freefor a minimum of 3 years;

• Prior systemic chemotherapy within the past three years

• Prior radiotherapy to the pelvis or abdomen that would result in overlap ofradiation therapy fields;

• Para-aortic, inguinal, or gross (unresected) pelvic nodal metastasis. Gross pelvicnodal metastasis is defined as either: Radiographic evidence of nodal metastasis onCT or MRI (node having short axis diameter > 1 cm)OR Radiographic evidence of nodalmetastasis on diagnostic FDG-PET or PET/CT scan (abnormally increased FDG uptake asdetermined and documented by the radiologist)OR Biopsy-proven metastasis (e.g.needle biopsy) in undissected node

• Distant metastasis

• Unstable angina and/or congestive heart failure requiring hospitalization within thepast 6 months

• Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects

• Uncontrolled diabetes, defined as diabetes mellitus, which in the opinion of any ofthe patient's physicians requires an immediate change in management;

• Uncompensated heart disease or uncontrolled high blood pressure

• Acquired Immune Deficiency Syndrome (AIDS) based upon current CDC definition