Jean-Emmanuel Bibault

Assistance Publique – Hôpitaux de Paris | AP-HP · Department of Radiation Oncology

Purpose: SBRT is the standard of care for inoperable patients with early-stage lung cancer without lymph node involvement. Excellent local control rates have been reported in a large number of series. However, prescription doses and calculation algorithms vary to a great extent between studies, even if most teams prescribe to the D95 of the PTV. T...

Minimal Residual Disease (MRD) detection can be used for early intervention in relapse, risk stratification, and treatment guidance. FLT3 ITD is the most common mutation found in AML patients with normal karyotype. We evaluated the feasibility of NGS with high coverage (up to 2.4.106 PE fragments) for MRD monitoring on FLT3 ITD. We sequenced 37 adu...

Simple Summary We recently established a biological classification of head and neck cancers into hot and cold tumors, which were associated with different responses to immunotherapy (a type of cancer treatment helping the immune system fight cancer). Because this classification requires a tumor biopsy, the development of a non-invasive approach, ba...

Lung cancer is a significant cause of mortality worldwide, emphasizing the importance of early detection for improved survival rates. In this study, we propose a machine learning (ML) tool trained on data from the PLCO Cancer Screening Trial and validated on the NLST to estimate the likelihood of lung cancer occurrence within five years. The study...

Background Androgen deprivation therapy (ADT) in prostate cancer (PCa) is associated with an increased risk of bone fragility including bone loss, osteoporosis and fractures. Although international recommendations suggest performing dual-energy x-ray absorptiometry (DXA) at the initiation of treatment, less than 10% of patients do it. The implement...

Managing a malignant renal tumor requires, first of all, a reflection on the necessity of its treatment. It must consider the renal function, altered at the time of diagnosis in 50% of cases. The treatment method chosen depends on many factors, in particular, the predicted residual renal function, the risk of chronic kidney disease, the need for te...

Introduction: Prostate cancer is the most common cancer in men. Thirty to forty-seven percent of patients treated with exclusive radiotherapy for prostate cancer will experience intraprostate recurrence. The use of radiotherapy in stereotactic conditions allows millimetric accuracy in irradiation to the target zone that minimizes the dose to organ...

Radiation oncology is a field that heavily relies on new technology. Data science and artificial intelligence will have an important role in the entire radiotherapy workflow. A new paradigm of routine healthcare data reuse to automate treatments and provide decision support is emerging. This review will discuss the ethical aspects of the use of art...

This study aimed to describe patient characteristics, treatment efficacy, and safety in patients with hepatocellular carcinoma (HCC) undergoing stereotactic body radiation therapy (SBRT). We retrospectively analyzed data of 318 patients with 375 HCC treated between June 2007 and December 2018. Efficacy (overall survival [OS], relapse-free survival,...

Backround and purpose The relevance of metastasis-directed stereotactic body radiation therapy (SBRT) remains to be demonstrated through phase III trials. Multiple SBRT procedures have been published potentially resulting in a disparity of practices. Therefore, the french society of urological radiation oncolgists (GETUG) recognized the need for jo...

Introduction Bladder cancer occurs mainly in older adults and surgery is not always possible when there are geriatric conditions and comorbidities. Trimodal treatment (TMT) combining trans-urethral resection of bladder tumour (TURBT) followed by concurrent chemoradiation (CRT) would be a curative alternative in such patients. Materials and Methods...

Background: There are many scales for screening the impact of a disease. These scales are generally used to diagnose or assess the type and severity of a disease and are carried out by doctors. The chatbot helps patients suffering from primary headache disorders through personalized text messages. It could be used to collect patient-reported outco...

Purpose/Objective(s) To develop and evaluate a deep unsupervised learning (DUL) framework based on a regional deformable model for automated prostate contour propagation from planning computed tomography (pCT) to cone-beam CT (CBCT). Materials/Methods A DUL model was introduced to map the prostate contour from pCT to on-treatment CBCT. The DUL fra...

Objectifs Avec un âge médian de 73 ans au diagnostic, le cancer de vessie touche fréquemment les sujets âgés. Or leur prise en charge n’est pas consensuelle, la chirurgie n’étant pas toujours possible lorsqu’il existe des éléments de fragilité gériatrique. Le traitement trimodal (TMT) associant résection trans-urétrale (RTUV) puis radiochimiothérap...

Introduction et but de l’étude Le but de cette étude était de décrire la population, ainsi que l’efficacité et la toxicité chez tous les patients atteints d’un carcinome hépatocellulaire traité par irradiation en conditions stéréotaxiques depuis les débuts de la technique dans notre centre. Cette étude avait également pour objectif de déterminer le...

Prostate cancer treatment strategies are guided by risk-stratification. This stratification can be difficult in some patients with known comorbidities. New models are needed to guide strategies and determine which patients are at risk of prostate cancer mortality. This article presents a gradient-boosting model to predict the risk of prostate cance...

Résumé Contexte En réponse à la crise sanitaire causée par le Sars-CoV-2, de nombreux pays ont pris la décision de confiner leur population. Il a été démontré que des événements traumatisants peuvent être responsables d’altérations de la santé telles qu’une détresse péritraumatique ou un syndrome de stress post-traumatique. Cependant, l’étendue de...

Résumé L’intelligence artificielle permet d’analyser de grandes quantités de données très rapidement. Elle peut être utilisée pour interpréter des images ou des données textuelles afin de déterminer l’épidémiologie de certaines maladies, telles que le cancer. Dans cet article, nous présentons et discutons de ses applications dans ce domaine.

Purpose: Lung cancer represents the first cause of cancer-related death in the world. Radiomics studies arise rapidly in this late decade. The aim of this review is to identify important recent publications to be synthesized into a comprehensive review of the current status of radiomics in lung cancer at each step of the patients' care. Methods:...

Purpose: To evaluate trimodal conservative treatment as an alternative to radical surgery for urothelial muscle-invasive bladder cancer (MIBC). Patients and methods: This retrospective study reported the carcinologic and functional results of patients (pts) presenting a cT2/T3 N0M0 operable MIBC and fit for surgery, treated by a conservative str...

Objectives: Adenocarcinomas of the esophagus and of the gastric cardia are regarded as a same clinical entity in oncology. For endoscopic resection however, endoscopic mucosal resection is recommended for esophageal adenocarcinoma, while endoscopic submucosal dissection (ESD) is advocated for gastric adenocarcinomas. Our aim was to compare the out...

The immunogenic cell death (ICD) is defined as a regulated cell death able to induce an adaptive immunity. It depends on different parameters including sufficient antigenicity, adjuvanticity and favorable microenvironment conditions. Radiation therapy (RT), a pillar of modern cancer treatment, is being used in many tumor types in curative, (neo) ad...

Purpose: To develop and evaluate a deep unsupervised learning (DUL) framework based on a regional deformable model for automated prostate contour propagation from planning computed tomography (pCT) to cone-beam CT (CBCT). Methods: We introduce a DUL model to map the prostate contour from pCT to on-treatment CBCT. The DUL framework used a regiona...

Background and purpose Cancer care can be taxing. Alexithymia, a personality construct characterized by difficulties in identifying and describing feeling and emotions, an externally-oriented thinking style and scarcity of imagination and fantasy, is significantly correlated with higher levels of both secondary traumatic stress (STS) and burnout an...

Medical decisions can rely on a very large number of parameters, but it is traditionally considered that our cognitive capacity can only integrate up to five factors in order to take a decision. Oncologists will need to combine vast amount of clinical, biological, and imaging data to achieve state-of-the-art treatments. Data science and artificial...

Background: There is no evidence to support surgery or radiotherapy as the best treatment for resectable oropharyngeal cancers with a negative HPV status. Predictive algorithms may help to decide which strategy to choose, but they will only be accepted by caregivers and European authorities if they are interpretable. As a proof of concept, we deve...

The worldwide growth of cancer incidence can be explained in part by changes in the prevalence and distribution of risk factors. There are geographical gaps in the estimates of cancer prevalence, which could be filled with innovative methods. We used deep learning (DL) features extracted from satellite images to predict cancer prevalence at the cen...

Background: Esophagectomy is recommended after endoscopic resection of an early esophageal cancer when pejorative histoprognostic criteria indicate a high risk of lymph node involvement. Our aim was to analyze the clinical outcomes of a non-surgical, organ preserving management in this clinical setting. Patients and Methods: This retrospective stud...

Introduction More than 2.5 billion people in the world are currently in lockdowns to limit the spread of the novel coronavirus disease 2019 (COVID-19). Psychological Distress (PD) and Post-Traumatic Stress Disorder have been reported after traumatic events, but the specific effect of pandemics is not well known. The aim of this study was to assess...

Background Lockdowns were implemented to limit the spread of COVID-19. Peritraumatic distress (PD) and post-traumatic stress disorder have been reported after traumatic events, but the specific effect of the pandemic is not well known. Aim The aim of this study was to assess PD in France, a country where COVID-19 had such a dramatic impact that it...

Introduction et but de l’étude Le traitement du cancer de prostate peut occasionner des effets secondaires urinaires, digestifs et sexuels qui peuvent significativement modifier la qualité de vie. Certains patients ne tireront par ailleurs aucun bénéfice du traitement car ils sont en réalité atteints d’une forme indolente ou parce qu’ils décèderont...

Objective: The success of treatment planning relies critically on our ability to predict the potential benefit of a therapy. In colorectal cancer (CRC), several nomograms are available to predict different outcomes based on the use of tumour specific features. Our objective is to provide an accurate and explainable prediction of the risk to die wi...

Background and purpose: Physical and mental well-being are crucial for oncology professionals as they affect performance at work. Personality traits, as alexithymia and empathy, may influence professional quality of life. Alexithymia involves diminished skills in emotion processing and awareness. Empathy is pertinent to the ability to understand a...

Résumé De nouveaux concepts de consultations sont actuellement en train de profondément changer la façon d’exercer la médecine. L’utilisation de questionnaires standardisés, des questionnaires patients (PRO, patient-reported outcome, et son application informatique, ePRO) ont déjà fait irruption dans nos consultations. En parallèle, la télémédecine...

Purpose to determine how ESTRO can collaborate with Radiation Oncology National Societies (NS) according to its mission and values, and to define the new roadmap to strengthen the NS network role in the forthcoming years. Materials and methods the ESTRO NS committee launched a survey addressed to all European National Societies, available online f...

Standard of care is defined by the therapeutic intervention that significantly improved the outcome of a cohort of patients, ideally in a randomized trial. It means that for patients on the fringe of the general population, the standard of care could actually not be the best treatment. In order to better personalize treatments, new approaches are r...

Background and purpose: The professional quality of life of radiation oncology professionals can be influenced by different contributing factors, including personality traits. Alexithymia involves deficits in emotion processing and awareness. Empathy is the ability to understand another's 'state of mind/emotion'. We investigated professional quali...

Background and Purpose Different factors may influence the professional quality of life of oncology professionals. Among them, personality traits, as alexithymia and empathy, are underinvestigated. Alexithymia is about deficits in emotion processing and awareness. Empathy is the ability to understand another’s ‘state of mind’/emotion. The PROject o...

Recently, the Heart Rhythm Society published recommendations on management of patients with cardiac implantable electronic device (CIED) who require radiotherapy (RT). We aimed to report the experience of a tertiary multidisciplinary teaching hospital, and discuss our practice in the context of recently published guidelines. We identified all conse...

BACKGROUND There are many scales for screening or assessing the impact of a disease. These scales are generally used to diagnose or assess the severity of a disease and are carried out by doctors. The Vik Migraine chatbot helps patients suffering from headaches through personalized text messages, it could be used to collect patient-reported outcome...

Purpose Radiomics are a set of methods used to leverage medical imaging and extract quantitative features that can characterize a patient's phenotype. All modalities can be used with several different software packages. Specific informatics methods can then be used to create meaningful predictive models. In this review, we will explain the major st...

Objectif : Le chatbot est un logiciel qui utilise l’apprentissage statistique et a pour objectif de simuler une conversation par message textuel ou vocal. Le chatbot Vik a été développé dans le but d’améliorer la qualité de vie des patients atteints d’un cancer ou d’une maladie chronique. L’objectif de cette étude pilote est de mesurer l’humeur de...

Background The data regarding the use of conversational agents in oncology are scarce. Objective The aim of this study was to verify whether an artificial conversational agent was able to provide answers to patients with breast cancer with a level of satisfaction similar to the answers given by a group of physicians. Methods This study is a blind,...

Introduction: Deep Learning (DL) is a machine learning technique that uses deep neural networks to create a model. The application areas of deep learning in radiation oncology include image segmentation and detection, image phenotyping, and radiomic signature discovery, clinical outcome prediction, image dose quantification, dose-response modeling,...

Introduction: In 2017 it was decided to revise the European Core Curriculum for Radiation Oncology/Radiotherapy to produce a 4th edition. The aims of the ESTRO curriculum are to develop comparable standards for training across Europe and to facilitate free movement of specialists across borders. It is also hoped that it will improve the level of t...

BACKGROUND The data regarding the use of conversational agents in oncology are scarce. OBJECTIVE The aim of this study was to verify whether an artificial conversational agent was able to provide answers to patients with breast cancer with a level of satisfaction similar to the answers given by a group of physicians. METHODS This study is a blind...

Résumé La radiothérapie en conditions stéréotaxiques des oligométastases, non fractionnée ou hypofractionnée, représente un changement fondamental dans la pratique de la spécialité telle qu’elle a été développée depuis un peu plus d’un siècle. Malgré la très grande hétérogénéité de sites, de techniques, de doses, la plupart des études retrouve un t...

Résumé La radiothérapie en conditions stéréotaxiques représente un changement fondamental dans la pratique de la radiothérapie des cancers pulmonaires. Malgré la très grande hétérogénéité de sites, de techniques, de doses, la plupart des études retrouve un taux de contrôle local élevé, autour de 70 à 90 % à 2 ans, et une toxicité réduite, de grade...

Purpose The main goal of palliative radiotherapy is to reduce patient's discomfort. But sometimes patients do not receive any benefits from this treatment because of rapid worsening of their general condition. This prospective monocentric study assessed the effective delivery of palliative radiotherapy. Materials and methods From 1st December 2015...

Résumé Objectif de l’étude Évaluer la fatigue et la qualité de vie chez les patients traités par irradiation en conditions stéréotaxiques et en déterminer les facteurs prédictifs. Matériel et méthodes La fatigue a été évaluée avec le questionnaire Brief Fatigue Inventory (BFI) et la qualité de vie par le QLQ-C30, à la première séance (T1), la der...

Chatbots, also known as conversational agents or digital assistants, are artificial intelligence–driven software programs designed to interact with people in a conversational manner. They are often used for user-friendly customer-service triaging. In healthcare, chatbots can create bidirectional information exchange with patients, which could be le...

Introduction: An increasing number of parameters can be considered when making decisions in oncology. Tumor characteristics can also be extracted from imaging through the use of radiomics and add to this wealth of clinical data. Machine learning can encompass these parameters and thus enhance clinical decision as well as radiotherapy workflow. Meth...

Background The recent development of endoscopic resection for superficial gastrointestinal cancers could justify the need for a dedicated oncological multidisciplinary meeting (MDM). The aim of our study was to evaluate the impact of the dedicated MDM on the management of superficial cancers of the digestive tract. Methods A dedicated MDM was devel...

BACKGROUND Chatbots are softwares that interact with users by simulating a human conversation through text or voice via smartphones or computers. They could be a solution to follow-up with patients during their disease while saving time for healthcare providers. OBJECTIVE To evaluate 1 year of conversations between patients with breast cancer and...

Background: A chatbot is a software that interacts with users by simulating a human conversation through text or voice via smartphones or computers. It could be a solution to follow up with patients during their disease while saving time for health care providers. Objective: The aim of this study was to evaluate one year of conversations between...

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Objectif de l’étude Évaluer une stratégie alternative à la chirurgie radicale par traitement trimodal conservateur dans les carcinomes urothéliaux de la vessie localisés infiltrants le muscle. Matériel et méthode Il s’agissait d’une étude rétrospective rapportant les résultats carcinologiques et fonctionnels des patients atteints d’un carcinome ur...

Objectif de l’étude Évaluer l’épuisement professionnel dans le service de radiothérapie de l’hôpital européen Georges-Pompidou (Paris), pour améliorer l’organisation et la qualité de vie au travail. Matériel et méthode Toutes les personnes travaillant dans le service de radiothérapie depuis plus de 3 mois ont été sollicitées pour remplir anonymeme...

Objectif de l’étude Évaluer la fatigue et la qualité de vie au cours d’une radiothérapie en conditions stéréotaxiques et déterminer les facteurs prédictifs de la dégradation de ces deux éléments. Matériel et méthode Tous les patients traités par irradiation stéréotaxique par CyberKnife® étaient éligibles. La fatigue a été évaluée avec le questionn...

Objectif de l’étude La chimioradiothérapie préopératoire est le traitement standard du cancer du rectum localement évolué. Jusqu’à 30 % des patients sont en situation de réponse complète à l’issue de cette étape. Dans ce groupe de patients, certaines équipes proposent de ne pas réaliser d’exérèse complète du mésorectum afin de diminuer les séquelle...