Andrée Dutreix, "Madame Dutreix", as she was usually called, deceased in the Ile d'Yeu on October 29, 2023, had greatly contributed to the birth and development of medical physics in France.
First medical physicist in France (1952-1962)
At a time when radiotherapy was practiced exclusively with x-ray tubes (mainly 200 kV) and radium sources, Andrée Sigonneau, aged 25 and holder of a "certificate in electronics and radioactivity" (with Irène Joliot-Curie as teacher), was recruited in 1953 at the Institut Gustave Roussy (IGR) in Villejuif to help with the dosimetry of the first electron accelerator for medical use installed in France, a betatron. She thus became the first non-doctor scientist to occupy a position in a hospital environment, with a specialization on the physical aspects of the medical use of ionizing radiation (radiophysics).
She was immediately integrated into the dynamic young medical team responsible for implementing the betatron. With this device producing high-energy x-rays (24 MV), everything had to be invented. This team, led by Professor Maurice Tubiana who was joined by Bernard Pierquin and Jean Dutreix, was immediately positioned at the highest international level. In 1954, Andrée married Jean Dutreix, an engineer originally graduated from the Electrotechnical Institute of Grenoble (today IMP-UGA), and then having completed his training in medical studies with a specialization in electroradiology. Andrée and Jean would form an exemplary couple of high-level scientists, succeeding in harmoniously combining family and professional life.
Head of the radiophysics unit at Institut Gustave Roussy (1963-1988)
In 1962, an embryonic radiophysics unit was created at the IGR with the recruitment of Jean Chavaudra*, a young engineer who graduated from the Ecole Supérieure d'Electricité. With the exception of the Caen cancer center which had just recruited José Bloquel, there was no other radiophysicist position in France. In 1963 the book “Bases Physiques de la Radiothérapie et de la Radiobiologie” was published, with Maurice Tubiana, Jean and Andrée Dutreix as main authors. It was a reference book, which would become the “bible” for subsequent generations of radiophysicists.
Over the following years, within the “radiation department” headed by Maurice Tubiana, the “radiophysics unit” gradually developed and was structured. Andrée Dutreix, who had acquired indisputable knowledge and skills in everything related to dosimetry, had total responsibility. “Madame Dutreix” said what she thought and knew how to be respected, while remaining attentive to everyone's concerns and insisting on the priority being given to patients. She participated in international meetings – particularly in conjunction with the International Atomic Energy Agency (IAEA) – where she was listened to and appreciated.
Although the more evident needs were in the field of radiation therapy, the IGR radiation department was also concerned by diagnostic radiology and nuclear medicine. Thanks to the combined efforts of Maurice Tubiana and Andrée Dutreix, the first full-time position of medical physicist specialized in nuclear medicine in France was opened in 1975, leading to the recruitment of Bernard Aubert.
Implementation of an educational and training program for hospital physicists (1970)
With the development of high-energy radiation (linear accelerators and telecobalt devices) the need for "hospital physicists" was becoming more and more pressing. At the end of the 1960s a few positions were created. In 1969 a national decree required that, for any accelerator (> 1 MeV), a full-time “specialist physicist approved by the ministry” must be hired; but no structured training existed. University physicists considered that physics applied to medicine was not worthy of interest, and medical faculties were reluctant to call on non-medical scientists for their teaching. In Toulouse, a laboratory at the Center for Atomic Physics, created in 1957 and directed by Professor Daniel Blanc, was involved in the detection and dosimetry of radiation. Its researchers used the IGR betatron beam to perform measurements. There was therefore in this university a pool of young students available to occupy positions in a medical environment, but they were insufficiently trained. It was with enthusiasm that Andrée Dutreix responded favorably to Daniel Blanc's proposal to create a Diploma of Advanced Studies (DEA) specialized in "radiological physics". This was completed in 1970 with the theoretical part taught in Toulouse, and the medical and practical part taught in Paris – in particular in the premises of the IGR – with the prominent nvolvement of Jean Chavaudra. This shaky arrangement, much criticized but resulting from a pragmatic choice, held up, thanks to the personalities of the two founders. It lasted until the disappearance of the DEA, replaced in 2003 by two-year master's degrees. Around 600 physicists would be trained over these 33 years, half of whom would occupy positions in a medical environment.
Scientific contribution in medical physics at the international level
Andrée Dutreix was involved in practically all aspects of medical physics and it is impossible to cite everything. In 1967 she herself had developed a brachytherapy dose computation program, which constituted the starting point of the so-called Paris system developed with Bernard Pierquin. This comprehensive system was published in several papers, and its description was included in a reference book entitled "brachytherapy dosimetry", which published in 1982 with Ginette Marinello and André Wambersie as co-authors.
In external radiotherapy Andrée Dutreix was involved in the first protocols for determining the reference dose and published original articles about precision in radiotherapy. She played a very important role in the creation in 1980 of the European Society for Therapeutic Radiology and Oncology (ESTRO) with which she collaborated closely (although being never officially included in its board), organizing courses, emphasizing the importance of bringing together doctors and physicists in the same society, and promoting the contribution of women to science and medicine.
Professor in Belgium at Leuven University (1988-1998)
In 1988, Jean Dutreix retired from the IGR. Andrée was then 60 years old. She also left the IGR but remained active by accepting a part-time position as visiting professor at the Leuven University (she had never obtained an official professorship in France). She supervised the work of local physicists, helping them with their publications and was at the forefront to continue engaging with ESTRO, the secretariat of which was in Leuven. In particular, she coordinated booklet n°3 (1997) devoted to the calculation of monitor units in high-energy beams. In 1998, she was very upset by the death, at the age of 54, of Emmanuel Van der Schueren, the main founder of ESTRO, who had offered her the position in Leuven. She then took a step back and retired, with her husband, to the Île d’Yeu, which they had fallen in love with at first sight.
Retirement in the Ile d'Yeu
Andrée and Jean would continue to enjoy their retirement and have great pleasure in keeping in touch and inviting their former colleagues, who had become true friends, to “their” island. They used to be very homely and Andrée's hospitality did not weaken after Jean's death in 2019.
Honours
Andrée Dutreix's contribution to medical physics has been widely recognized nationally and internationally. She was named Chevalier de la Légion d'Honneur in 1981, and then promoted to Officier in 2009, a French distinction reserved to a few eminent personalities who contributed significantly to national causes. Among other distinctions, she received the prestigious Breur Award from ESTRO in 1984, was named honorary member of the American Association of Physicists in Medicine (AAPM) in 1991 and received the Antoine Béclère medal in 1993. A cancer institute in Dunkerque, in the north of France, inaugurated in her presence in 2013, was named after her.
The numerous testimonials from those who knew her, reflect to what extent her role was decisive for the careers of many physicists trained between 1970 and 1990.
Jean-Claude Rosenwald
November 3, 2023
* Jean Chavaudra passed away in April 2020 (see his biography)