Adaptive Daily MR-Guided Adjuvant Pelvic Therapy-Endometrial Cancer

Inclusion Criteria:

1. Histologically confirmed endometrial carcinoma (endometrioid, serous, clear cell, carcinosarcoma, or dedifferentiated histology).
2. Indication for adjuvant pelvic radiotherapy (± vaginal brachytherapy) for HIR defined by the ASTRO guidelines and GOG-99(7, 9) :
3. Age
4. High-grade histology (grade 2-3)
5. Depth of myometrial invasion
6. LVSI
7. Positive pelvic nodes
8. Cervical stromal invasion
9. Presence of poor prognostic molecular markers
10. Age ≥18 years.
11. Ability to provide informed consent.
12. Eligible to receive adjuvant systemic therapy, if indicated, with a minimum 3-week interval between chemotherapy and radiotherapy.
13. Willing and able to complete EORTC QLQ-C30 and EN-24 questionnaires in a validated language version.

Exclusion Criteria:

1. Prior pelvic radiotherapy.
2. Contraindication to pelvic radiotherapy (e.g., active connective tissue disorder or inflammatory bowel disease).
3. Presence of a hip prosthesis that would compromise treatment planning or delivery.

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