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RecruitingNCT04567771Updated Aug 19, 2026

Comparison of Proton or Intensity Modulated Radiation Therapy After Surgery for Endometrial or Cervical Cancer

An interventional study of Quality-of-Life Assessment and Questionnaire Administration in Cervical Carcinoma, Endometrial Carcinoma and Endometriosis, sponsored by Mayo Clinic. Recruiting at 3 sites in United States. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Mayo Clinic · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
121
Allocation
Not applicable
Ages
18 Years and older
Sex
Female
01

Study summary

This early phase I trial compares the side effects between patients treated with proton radiation therapy versus intensity modulated radiation therapy after surgery for the treatment of endometrial or cervical cancer. Radiation therapy uses high energy protons or x-rays to kill tumor cells and shrink tumors. Using quality of life questionnaires and adverse event assessments may help doctors learn whether proton radiation therapy is associated with lower acute gastrointestinal toxicities at the end of treatment compared to intensity modulated radiation therapy in patients with endometrial or cervical cancer.

Read the detailed description

PRIMARY OBJECTIVE:

I. To assess whether proton radiation therapy (RT) is associated with lower acute gastrointestinal toxicities at the end of treatment compared to intensity modulated radiation therapy (IMRT) as measured with the Expanded Prostate Cancer Index Composite (EPIC) bowel domain.

SECONDARY OBJECTIVES:

I. To examine the association of bowel and bladder dose-volume histogram (DVH) with bowel and bladder toxicities, respectively.

II. To assess whether urinary toxicity rate is improved with proton RT compared to IMRT as measured with the EPIC urinary domain.

III. To determine if well-being is improved with proton RT compared to IMRT as measured by the Functional Assessment of Cancer Therapy (FACT) cervix domain.

IV. To determine if proton RT reduces grade 2+ hematologic toxicities (Common Terminology Criteria for Adverse Events [CTCAE] version [v] 4.0) compared to IMRT.

V. Evaluate progression-free and overall survival between patients receiving proton RT and IMRT.

VI. To determine if proton RT improves overall patient quality of life compared to IMRT using the European Quality of Life Five Dimension (EQ-5D) questionnaire.

EXPLORATORY OBJECTIVES:

I. Evaluate ability to tolerate chemotherapy concurrent or after RT. II. Correlate bone marrow DVH with blood marrow function, and ability to tolerate chemotherapy concurrently or after RT.

III. Correlate bowel and skin DVH with acute toxicity. IV. To evaluate patient-reported gastrointestinal (GI) toxicities as a predictor of assigned treatment regimen, as well as physician-reported GI toxicities as a predictor of assigned treatment regimen.

V. Confirm the validity of the EPIC bowel and urinary domains when referencing the last 7 days.

OUTLINE:

Patients undergo standard of care proton or intensity modulated radiation therapy. Patients also complete quality of life questionnaires and adverse event assessments over 10-15 minutes each at baseline, at the end of radiation therapy, and at 1 month, 1 year, and 3 years post-radiation therapy.

02

Conditions studied

  • Cervical Carcinoma
  • Endometrial Carcinoma
  • Endometriosis
  • Pelvic Inflammatory Disease
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

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 any 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

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
  • 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
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
121 participants (estimated)

Study arms

  • Experimental
    Treatment (radiation therapy, questionnaires)

    Patients undergo standard of care proton or intensity modulated radiation therapy. Patients also complete quality of life questionnaires and adverse event assessments over 10-15 minutes each at baseline, at the end of radiation therapy, and at 1 month, 1 year, and 3 years post-radiation therapy.

    Other: Quality-of-Life Assessment · Other: Questionnaire Administration · Radiation: Radiation Therapy

Interventions

  • OtherQuality-of-Life Assessment

    Complete quality of life questionnaires

    Also known as: Quality of Life Assessment

  • OtherQuestionnaire Administration

    Complete adverse event assessments

  • RadiationRadiation Therapy

    Undergo proton or intensity modulated radiation therapy

    Also known as: Cancer Radiotherapy, ENERGY_TYPE, Irradiate, Irradiated, Irradiation, Radiation, Radiation Therapy, NOS, Radiotherapeutics, Radiotherapy, RT, Therapy, Radiation

05

What researchers measure

Primary outcomes

  1. Change in Expanded Prostate Cancer Index Composite (EPIC) Bowel score

    Will be examined using analysis of covariance.

    Time frame: Baseline up to 3 years post-radiation therapy (RT)

Secondary outcomes

  1. Bowel and bladder dose-volume histogram (DVH) parameters

    Will be examined in association with the change in EPIC Bowel and Urinary scores using analysis of covariance, considering the DVH variables as model covariates.

    Time frame: Up to 3 years post-RT

  2. Change in EPIC Urinary score

    Will be examined using analysis of covariance.

    Time frame: Baseline up to 5 weeks

  3. Well-being

    Measured by the Functional Assessment of Cancer Therapy cervix domain. Will be examined using analysis of covariance.

    Time frame: Up to 3 years post-RT

  4. Incidence of grade 2+ hematologic toxicities

    Measured by Common Terminology Criteria for Adverse Events version 4.0. Will be examined using logistic regression.

    Time frame: Up to 3 years post-RT

  5. Progression-free survival

    Will be examined using survival methods. Cumulative probability of progression rates will be calculated treating death as a competing risk. Cox models will be used to assess the association of treatment received (proton RT versus intensity modulated radiation therapy \[IMRT\]).

    Time frame: Up to 3 years post-RT

  6. Overall survival (OS)

    Will be examined using survival methods. Estimates of OS will be calculated using the Kaplan Meier method. Cox models will be used to assess the association of treatment received (proton RT versus IMRT).

    Time frame: Up to 3 years post-RT

  7. Change in overall patient quality of life

    Measured by the European Quality of Life Five Dimension Five Level Scale Questionnaire. Will be examined using analysis of covariance.

    Time frame: Baseline up to 3 years post-RT

06

Study locations

1 of 3 sites recruiting
  • Mayo Clinic in Arizona
    Scottsdale, Arizona 85259, United States
    Active, not recruiting
  • Mayo Clinic in Florida
    Jacksonville, Florida 32224-9980, United States
    Active, not recruiting
  • Mayo Clinic in Rochester
    Rochester, Minnesota 55905, United States
    Recruiting
07

References and documents

08

Registry details

Key details

Study ID
NCT04567771
Lead sponsor
Mayo Clinic
Responsible party
Sponsor
First posted
Sep 28, 2020
Start date
Dec 4, 2020
Primary completion
Apr 1, 2029 (estimated)
Completion
Apr 1, 2029 (estimated)
Last update
Aug 19, 2026

Study contacts

Clinical Trials Referral Office
Contact
mayocliniccancerstudies@mayo.edu
855-776-0015
Allison E. Garda, M.D.
principal investigator · Mayo Clinic in Rochester

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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