Marc A. Bollet

Background: The Evaluation of Digital Addiction (EVADD) study investigates problematic smartphone use in the digital age, as global smartphone users reached 55.88 million in France in 2023. With increased screen time from digital devices, especially smartphones, the study highlights adult use issues and associated risks. Objective: The aim of the study is to assess the prevalence of compulsive smartphone use among French adults and identify patterns of problematic behaviors, including their impact on daily activities, sleep, and safety. Methods: The EVADD study used a cross-sectional, nonprobability sample design, conducted from May 3 to June 5, 2023. Participants were recruited through the French mutual insurance company PRO-BTP. Data were collected anonymously via a digital questionnaire, including the Smartphone Compulsive Use Test, capturing information on social network engagement, device ownership, and daily screen use. Results: A total of 21,244 adults (average age 53, SD 15 years; 9844 female participants) participated. Among 21,244 participants, 8025 of 12,034 (66.7%) respondents exhibited compulsive smartphone use (P<.001). Additionally, 7,020 (36.7%) participants scored ≥8 on the Smartphone Compulsion Test, indicating addiction. Younger participants (18‐39 years) were significantly more likely to show signs of addiction (2504/4394, 57%; odds ratio 2.5, 95% CI 1.9‐3.2) compared to participants aged ≥60 years. Problematic behaviors included unsafe smartphone use while driving (5736/12,953, 44.3%), frequent smartphone use before bedtime (9136/21,244, 43%), and using smartphones in the bathroom (7659/21,244, 36.1%). Sleep disturbances and risky behaviors correlated strongly with higher compulsion scores (P<.01). Conclusions: The EVADD study highlights the complex relationship between adults and smartphones, revealing the prevalence of compulsive behaviors and their impact on daily life, sleep, and safety. These findings emphasize the need for public awareness campaigns, preventive strategies, and therapeutic interventions to mitigate health risks associated with excessive smartphone use.

Objective: Our objective was to report our experience and to evaluate the feasibility and toxicity of focal salvage stereotactic body radiation therapy (SBRT) in patients with post-radiation local recurrence of prostate cancer. Methods: We retrospectively reviewed medical records of patients treated with Cyberknife ^® between October 2014 and April 2017 at our institution for a focal reirradiation delivered to the prostate/prostatic bed for local recurrence after radical or adjuvant radiotherapy. All patients underwent prostate biopsies at recurrence at the time of fiducial markers placement, had choline PET/CT and pelvic MRI. The treatment consisted in 36 Gy in six fractions delivered every other day. Post reirradiation toxicities were assessed according to the CTCAE v4 (Common Terminology Criteria for Adverse Events). Results: 42 patients were treated with followed with a median follow-up of 21 months (range 3 – 31). 34 patients had biopsy proven recurrence. The initial treatment was radical prostatectomy and radiation therapy for 9 patients and radiation therapy alone for 33 patients. 23 patients from the group of prostate reirradiation had placement of rectal spacers. No Grade 4 or 5 toxicity were observed. 27 acute urinary events were recorded: 18 patients experienced Grade 1, 9 patients experienced Grade 2 toxicity and 1 patient experienced Grade 3 urinary toxicity, namely cystitis and/or dysuria. No Grade 2 or more digestive toxicity was observed. Rectal doses were significantly lower with rectal spacers. Conclusion: Salvage focal Cyberknife ^® seems feasible and show promising results. Advances in knowledge: SBRT for local prostate cancer recurrence after initial radiotherapy is well tolerated with short follow-up.

L’inhibition de PARP est une voie thérapeutique prometteuse pour certains cancers solides de l’adulte présentant un défaut des voies de réparation des lésions double-brin de l’ADN. Elle pourrait aussi apporter un bénéfice clinique en association à la radiothérapie. Cet article présente une revue des données mécanistiques, précliniques et cliniques disponibles pour étayer cette hypothèse ainsi que pour évoquer les risques théoriques d’une telle association. PARP inhibition is a promising therapeutic approach for solid cancers that present defects in DNA double-strand break repair. It could also serve as a clinically meaningful aid to radiotherapy. This article presents an overview of mechanistic, pre-clinical and clinical data that substantiate this hypothesis but also could help determine its potential pitfalls.