Reduction of Hematologic Toxicity in Locally Advanced Cervical Cancers

Inclusion Criteria: * Signed informed consent specific to the study. * Age ≥ 18 years. Patients aged over 70 must be screened using the G-8 geriatric assessment tool; if required (G-8 score ≤ 14), an onco-geriatric consultation is mandatory to confirm eligibility. * Histologically confirmed cervical cancer: squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma. * Locally advanced cervical cancer according to the FIGO 2018 classification, confirmed by clinical staging and/or imaging. * FIGO stage IB3 to IVA, for which definitive chemoradiotherapy with curative intent is planned. * No evidence of metastatic disease outside the para-aortic region at initial staging (clinical exam, pelvic MRI, FDG-PET, and/or para-aortic lymph node staging by laparoscopy if applicable). * Adequate hematologic and organ function, defined as laboratory results within 15 days prior to first study treatment: Absolute neutrophil count (ANC) ≥ 1,500/mm³ without G-CSF support Total white blood cells \> 2,000/mm³ Lymphocytes ≥ 500/mm³ Platelet count ≥ 100,000/mm³ without transfusion Hemoglobin ≥ 9.0 g/dL (transfusion allowed to meet this criterion) * Patients eligible to receive cisplatin or carboplatin-based concurrent chemotherapy, with or without prior carbo-taxol neoadjuvant chemotherapy (as discussed in the protocol comments). * Women of childbearing potential must have a negative pregnancy test (β-HCG) within 7 days before treatment and commit to highly effective contraception until 6 months after chemotherapy. Exclusion Criteria: * Histologic types of cervical cancer other than those listed in the inclusion criteria. * FIGO IB1, IB2, or IIA stages without regional lymph node metastasis (N0). * FIGO IVB cervical cancer with distant metastases beyond para-aortic lymph nodes. * Previous surgery for cervical cancer, except conization or para-aortic lymphadenectomy. * Previous pelvic radiotherapy, other radiotherapy, or immunotherapy, except allowed neoadjuvant chemotherapy. * Any malignancy other than the study disease within the past 5 years, except non-melanoma skin cancers (BCC, SCC). * Pregnant or breastfeeding women, or women planning pregnancy during the study. * For patients ≥70 with G-8 ≤14: non-confirmation of eligibility by the onco-geriatrician. * Contraindication to cisplatin and/or carboplatin. * Peripheral neuropathy ≥ grade 2. * Systemic corticosteroids or systemic immunosuppressive drugs within 2 weeks before randomization (inhaled corticosteroids and mineralocorticoids such as fludrocortisone are allowed). * Untreated osteoporosis (T-score ≤ -3) diagnosed on bone densitometry performed within 6 months prior to inclusion.