1. Bring a large pot of salted water to a boil and cook penne pasta until al dente.
2. In a large skillet, heat olive oil over medium heat and sauté finely chopped onions until translucent.
3. Add minced garlic and cook for another minute until fragrant.
4. If using pancetta or bacon, cook it until crispy before adding other ingredients.
5. Stir in tomato paste and cook for a couple of minutes to deepen its flavor.
6. Add canned tomatoes, breaking them up with a spoon, and let the sauce simmer for about 10 minutes.
7. Pour in vodka and continue simmering for a few more minutes to let the alcohol cook down while preserving its flavor-enhancing effects.
8. Reduce the heat and stir in heavy cream, mixing until the sauce turns a smooth pink color.
9. Season with salt, black pepper, and optional red pepper flakes for a slight kick.
10. Add grated Parmesan cheese and stir until melted and fully incorporated into the sauce.
11. If the sauce is too thick, add some reserved pasta cooking water to achieve the desired consistency.
12. Drain the pasta and add it to the sauce, stirring well to coat each piece evenly.
13. Simmer the pasta in the sauce for a minute to allow the flavors to meld.
14. Garnish with freshly chopped basil and extra Parmesan before serving.
15. Serve immediately and enjoy your creamy, flavorful penne alla vodka.