Hypofractionated Radiotherapy for the Treatment of Locally Advanced Cervical Cancer in Uganda

Inclusion Criteria: * Females aged 18 years or older * Histologically confirmed squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the uterine cervix without prior treatment * Federation of Gynecology and Obstetrics (FIGO) 2018 stage IB3, IIA, IIB, IIIA, IIIB, or IIIC * Able to provide written informed consent in English, Luganda, Runyankole, or Lango * Willing to attend post-treatment follow-up for up to 12 months * Fit for concurrent chemotherapy with cisplatin * Eastern Cooperative Oncology Group (ECOG) performance status (PS) of ≤ 2 * Absolute neutrophil count ≥ 1,500 cells/mm\^3 (1.5 x 10\^9/L) * Platelets ≥ 100,000 cells/mm\^3 (100 x 10\^9/L) * Hemoglobin ≥ 9.0 g/dL * Leukocyte count ≥ 4,000 cells/mm\^3 (4.0 x 10\^9/L) * Creatinine clearance \> 60 mL/mins, calculated using the Cockcroft-gault equation for women * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3 times the upper limit of normal (ULN) * Total bilirubin \< 2 x ULN unless attributed to the use of antiretroviral therapy (ART) * HIV-positive participants must be on a stable ART regimen for at least 6 weeks prior to enrollment Exclusion Criteria: * Prior hysterectomy. Women with previous total or subtotal hysterectomy have no cervix, and hence the anatomical changes have an impact on the radiotherapy field, and dose prescriptions because they tend to have a higher risk for bowel toxicity from pelvic radiotherapy. Therefore, these women will be excluded due to the l…