Radiotherapy Program


Board

Pr. Catherine Durdux
Physician
Dr. Sarah Kreps
Physician
Dr. Jean- Emmanuel
Physician Bibault


Steering Committee

Dr. Antoine Dautruche - Physician
Dr. Emmanuelle Fabiano - Physician
Dr. Thomas Feutren - Physician
Dr. Safia Maaradji - Physician
Stéphane Dupont - Physicist
Françoise Jaffre - Physicist
Damien Moreau - Physicist
Déborah Om - Physicist
Maximilien Scius - Physicist
Sandra Toublanc - Physicist
C. Bourgeois - Technical Manager
N. Guillemont Technical Manager

Radiation therapy department is located at the European Georges Pompidou (HEGP) hospital.

The radiotherapy team includes 4 seniors’ radiotherapy oncologists MD (Pr C. Durdux, head of the unit, Pr Ph. Giraud (MD, PhD), Dr J.E. Bibault (MD, PhD), Dr S. Kreps (MD)). Four fellowships and 5 residents complete the clinical team. The team includes also six senior physicists (5 MS, 1 PhD).

The radiotherapy unit takes care of adult patients with solid tumors (gastrointestinal and urologic cancers, head and neck cancers, lung cancers, breast cancers, gynecological and skin tumors) and Hodgkin lymphomas.

Since its opening in 2000, the radiotherapy unit has been developing innovative techniques in medical imaging, dosimetry and treatment devices: intensity modulated radiotherapy, irradiation with respiratory gating, stereotactic radiotherapy with a Cyberknife® and a Novalis® STX linac. All these various innovations are designed to achieve a high precision radiotherapy to better adapt irradiation fields to the tumor in order to protect organs at risk. Medical, scientific and educational projects fit into the development and assessment of these new technologies as well as in their routine deployment.

The external radiotherapy unit consists of 3 modern Clinac with a multileaf collimator (MLC), portal imaging, including a new generation linac (Novalis® STX) with a dedicated MLC for intensity modulation deliverance or stereotactic radiotherapy and a 3D image guided radiotherapy system, and a dedicated Light Speed RT CT scanner with deep inspiration breath hold techniques or with a 4D synchronized device. A Cyberknife®, an image-guided robotic radiosurgery system, completes the technical offer. The radiotherapy unit has a surgical subunit for high dose rate brachytherapy performed in gynecological and prostate cancers, and all hardware required for prostate brachytherapy with iode125 and implementation of gold markers.

This unit includes a hospitalization unit (8 beds for >24hr-hospitalization) which allow concurrent radiochemotherapy, management of complications and supportive care. Radiochemotherapy is also possible within the mutualized cancer day hospital.

All these activities are structured around multiple weekly cancer multidisciplinary team meetings including systematically at least one radiation oncologist

  • 6 in Cochin hospital : Thoracic oncology (Pr C Durdux, Dr S Maaradji), digestive oncology (Dr JE Bibault, Dr A Dautruche), urologic oncology (Pr P Giraud), gynecologic oncology (Pr C Durdux, Dr E Fabiano), Sarcomas (Dr S Kreps, Dr T Feutren), dermatologic oncology (Dr T Feutren)
  • 6 in EGP hospital : Thoracic oncology (Pr P Giraud), Senology (Pr C Durdux, Dr A Dautruche), gynecologic oncology (Pr C Durdux, Dr E Fabiano), Head and neck cancers (Dr S Kreps), urologic oncology (Dr JE Bibault, Dr S Maaradji), digestive oncology (Dr T Feutren)

 

Clinical & translational research

Physicians and Physicists of this program are strongly involved in clinical and translational research in oncology and radiotherapy.

Since the opening of HEGP (2000), 291 papers have been published on indexed journals. Particularly, we coordinate or participate in several innovative technologies projects (National Research Program) and clinical research programs: National STIC (Expensive Diagnostic and Therapeutic Innovation Support Program) on “gated radiotherapy techniques”, INCa national programs on “patient safety during radiotherapy” and “medico-economic evaluation on advanced radiotherapy techniques” (ART-ORL, ART-PELVIS), clinical trials in advanced lung, bladder, head and neck cancers (RTEP7-IFCT 14-01, LUNG ART study, Alimta-RT phase II study, Pravastatine-RT PHRC study, Androgenic alopecia and Prostate Cancer study, A multicentric prospective randomized open-label phase IIB study to evaluate radiofrequency ablation with or without stereotactic radiotherapy for non-operable hepatocellular carcinoma (HCC) INCa study, Amifostine-RT study…).

For 2 years, thanks to the collaboration with the unit of Anita Burgun (Information Science and Personalized Medicine), the service has been implementing several research topics on radiotherapy and artificial intelligence.

The Radiotherapy Program integrates 10 interns and 3 fellows each year. Physicist team will host 2 physicist students (DQPRM) in 2020.

Medical teams are widely involved in the university teaching of various tumor pathologies in Paris University and in several national teaching degrees/master’s degrees in the field of oncology :

  • coordination of interns in radiotherapy for Ile-de-France (Pr P Giraud)
  • participation in Oncology DES / DESC in oncology
  • coordination of DIU of High Technicity Radiotherapy (Pr P Giraud)
  • participation in several DIU (thoracic oncology, Pr Le Pimpec-Barthes; digestive oncology, Pr Taieb; gynecological and breast tumors, Pr Lecuru)
  • coordination of DU of psycho-oncology (Pr Catherine Durdux).

The Radiotherapy program propose several clinical and research perspectives:

1) Clinical perspectives:

  • Development of VMAT in breast cancer
  • Development of adaptive radiotherapy
  • Development of stereotactic radiotherapy with immunotherapy
  • Improvement of Inclusion in therapeutic trials till an inclusion rate to 10% of patients
  • Database for stereotactic treatments

2) Research perspectives:

  • Industrial research for automatic delineation for organs at risk and GTV (gross tumor volume) in lung stereotactic radiotherapy
  • Translational research on additional dose by IGRT in radiotherapy in collaboration with Doseo platform
Name Surname Title/Position Speciality Research Unit Resarch Team
Catherine Durdux Full Prof Radiation Oncologist HEGP
Philippe Giraud Full Prof Radiation Oncologist HEGP
Sarah Kreps Full time physician Radiation Oncologist HEGP
Jean-Emmanuel Bibault Full time physician Radiation Oncologist UMRS 1138, Centre de Recherche des Cordeliers Information Science and Personalized Medicine
Antoine Dautruche Full time physician Radiation Oncologist HEGP
Emmanuelle Fabiano Full time physician Radiation Oncologist HEGP
Thomas Feutren Full time  physician Radiation Oncologist HEGP
Safia Maaradji Partial time physician Radiation Oncologist HEGP
Dupont Stéphane Full time physicist Medical Physicist HEGP
Jaffre Françoise Full time physicist Medical Physicist HEGP
Moreau Damien Full time physicist Medical Physicist HEGP
Om Déborah Full time physicist Medical Physicist HEGP
Scius Maximilien Full time physicist Medical Physicist HEGP
Toublanc Sandra Full time physicist Medical Physicist HEGP

The selected following publications highlight the strength of clinical and translational research developed in the radiotherapy program:

  1. Boldrini L ; Bibault JE ; Masciocchi C ; Shen Y ; Bittner MI.  Deep Learning: A Review for the Radiation Oncologist, Front Oncol. 2019; 9: 977
  2. Giraud P, Gasnier A, El Ayachy R, Kreps S, Foy JP, Durdux C, Huguet F, Burgun A, Bibault JE. Radiomics and Machine Learning for Radiotherapy in Head and Neck Cancers. Front Oncol. 2019; 9:174
  3. Laccourreye O; Marret G, Giraud PA vicious enemy in head and neck oncology: Delay! Eur Ann Otorhinolaryngol Head Neck Dis. 2019; 136: 61-62
  4. Zapletal E, Bibault JE, Giraud P, Burgun, A.  Integrating Multimodal Radiation Therapy Data into i2b2. Appl Clin Inform. 2018; 9: 377-390
  5. Foy JP ; Durdux C ; Giraud P ; Bibault JE. The Rise of Radiomics and Implications for Oncologic Management. J Natl Cancer Inst. 2018; 110: 1275-1276
  6. Bibault JE, Zapletal E, Rance B, Giraud P, Burgun A. Labeling for Big Data in radiation oncology: The Radiation Oncology Structures ontology. PLoS One.  2018 ;13(1) : e0191263
  7. Meillan N, Bibault JE, Vautier J, Daveau-Bergerault C, Kreps S, Tournat H, Durdux C, Giraud P. Automatic Intracranial Segmentation : Is the Clinician Still Needed ? Technol Cancer Res Treat. 2018;17:1533034617748839.
  8. Bibault JE, Tinhofer I. The role of Next-Generation Sequencing in tumoral radiosensitivity prediction.Clin Transl Radiat Oncol. 2017. 3:16-20.
  9. Giroux M, Ladjal H, Beuve M ; Giraud, P ; Shariat, B.  Patient-Specific Biomechanical Modeling of the Lung Tumor for Radiation Therapy. Comput Methods Biomech Biomed Engin. 2017; 20: 95-96
  10. Bibault JE, Dussart S ; Pommier P ; Morelle M ; Huguet M ; Boisselier P & al. Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score-Weighted Analysis., Int J Radiat Oncol Biol Phys. 2017; 99: 929-937
  11. Laccourreye O, Bonfils P,  Malinvaud  D,  Ménard M ; Giraud P , Survival and laryngeal preservation tradeoff in advanced laryngeal cancer: From the otorhinolaryngology patient to the managing physician. Head Neck. 2017; 39: 1984-1989
  12. Laccourreye  O, Castelnau-Marchand  P, Rubin  F,  Badoual C,  Halimi  P ; Giraud P. The keys to conservative treatment of early-stage squamous cell carcinoma of the tonsillar region., Eur Ann Otorhinolaryngol Head Neck Dis. 2017; 134: 259-264
  13. Kreps S, Berges O, Belin L;  Zefkili S,  Petras S,  Giraud  P. Salivary gland-sparing helical tomotherapy for head and neck cancer: Preserved salivary function on quantitative salivary gland scintigraphy after tomotherapy. Eur Ann Otorhinolaryngol Head Neck Dis. 2016; 133: 257-62
  14. Bibault JE, Giraud P, Burgun A. Big Data and machine learning in radiation oncology: State of the art and future prospects. Cancer Lett. 2016; 382:110-117
  15. Garrido P, Engel-Riedel W, Serke M, Giraud P, Ricardi U, Vallejo C & al. Final results from a Phase II study of pemetrexed and cisplatin with concurrent thoracic radiation after Pem-Cis induction in patients with unresectable locally advanced non-squamous non-small cell lung cancer (NSCLC). Lung Cancer. 2015; 88: 160-6

Annex 1:  Main indicators of clinical activities in 2018

  • Number of new patients: 1350

  • Number of radiotherapy sessions: 27023 (cyberknife: 1518 sessions)

  • Number of brachytherapy sessions: 368

  • Number de consultations: about 7500

  • Number of hospitalization sessions: 298

  • Number of cancer day sessions : 867

Annex 2:  Ongoing Clinical Trials

Trial Name Sponsor Title Principal investigators, sponsors Radiotherapy Program investigator
RTEP7 Randomized phase II-III study of personalizedradiotherapy dose redistribution in patients withinoperable stage III non-small cell lung cancerand a persistent FDG uptake at 42 Gy duringconcomitant radio-chemotherapy radiotherapy dose redistribution in patients with inoperable stage III non-small cell lung cancer and a persistent FDG uptake at 42 Gy during concomitant radio-chemotherapy P. Giraud, P. Ver,  IFCT P. Giraud
OSAGE Phase I-II of chemoradiation in esophagus cancer in elderly S. Servagi, Vernat, CHRU Besançon JE Bibault
NICOL A phase-I study of nivolumab in association with radiotherapy and cisplatin in locally advanced cervical cancers followed by adjuvant nivolumab for up to 6 months E Romano, Curie Institute C Durdux
GETUG V04 Phase II randomized trial evaluating chemoradiotherapy (cisplatin versus cisplatin plus gemcitabine) as conservative treatment in operable bladder cancer D. Azria, GETUG C Durdux
GETUG 30 Post-operative adjuvant radiotherapy in locally advanced bladder cancer : phase II randomized trial P Sargos, GETUG S Kreps
PEACE 2 A Phase III of Cabazitaxel and Pelvic Radiotherapy, in localized Prostate Cancer and High-risk Features of relapse J L Deville, Unicancer S Kreps, JE Bibault
SALTORL Trial of Laryngeal Preservation Comparing  induced CT followed by RT vs CT Concomitant to RT G Calais, GORTEC S Kreps
ImmuneBOOST Feasibility and Tolerance of Nivolumab Neoadjuvant immunotherapy in High Risk HPV Driven Oropharynx Cancer H Mirghani, Unicancer S Kreps
NORAD1 Phase III randomized trial comparing neoadjuvant chemotherapy to chemoradiation in locally advanced rectal cancers S Benoist, GRECCAR E Fabiano
PACIFIC4 Phase III randomised double-blind placebo-controlled multicenter International study of Durvalumab following stereotactic body radiation therapy (SBRT) for the treatment of patients with stage I-II NSCLC E Fabre, Astra Zeneca P Giraud
KEYNOTE 867 A Phase 3, Randomized, Placebo-Controlled clinical Study to evaluate the safety and efficacy of Stereotactic Body Radiotherapy (SBRT) with or without Pembrolizumab in participants with Medically Inoperable Stages I or IIA NSCLC (KEYNOTE-867) M Wislez, Merck C Durdux, A Dautruche
CHECKMATE L73 A Phase 3, Randomized, Open Label Study to Compare Nivolumab plus Concurrent Chemoradiotherapy (CCRT) followed by Nivolumab plus Ipilimumab or Nivolumab plus CCRT Followed by Nivolumab vs CCRT followed by Durvalumab in Previously Untreated, Locally Advanced Non-small Cell Lung Cancer (LA NSCLC) M Wislez, BMS C Durdux, A Dautruche
PRISME Phase II trial evaluating the efficacy of stromal mesenchymal cells in late side effects of pelvic radiotherapy in failure of conventional strategies M Mohty, APHP C Durdux
If you are interested by this program and want to candidate to a PhD, post doctoral position, contact the leader
Pr. Philippe Giraud

Contact us

Centre Universitaire des Saints-Pères Etage 4 – Pièce 446B 45 rue des Saints-Pères -75006 Paris

Carina Binet : Secrétaire Général du CARPEM
Tél. : 01 76 53 43 85 – carina.binet@carpem.fr

Aurore Hattabi, PhD : Coordinatrice Scientifique du CARPEM
Tél : 01 76 53 43 85 – aurore.hattabi@carpem.fr

contact@carpem.fr