scholarly journals Translational Research in FLASH Radiotherapy—From Radiobiological Mechanisms to In Vivo Results

Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 181
Author(s):  
Loredana G. Marcu ◽  
Eva Bezak ◽  
Dylan D. Peukert ◽  
Puthenparampil Wilson
Keyword(s):  
Dose Rate ◽  
High Dose Rate ◽  
Current Status ◽  
Therapeutic Window ◽  
High Dose ◽  
Linear Accelerators ◽  
Radiation Delivery ◽  
Tissue Sparing

FLASH radiotherapy, or the administration of ultra-high dose rate radiotherapy, is a new radiation delivery method that aims to widen the therapeutic window in radiotherapy. Thus far, most in vitro and in vivo results show a real potential of FLASH to offer superior normal tissue sparing compared to conventionally delivered radiation. While there are several postulations behind the differential behaviour among normal and cancer cells under FLASH, the full spectra of radiobiological mechanisms are yet to be clarified. Currently the number of devices delivering FLASH dose rate is few and is mainly limited to experimental and modified linear accelerators. Nevertheless, FLASH research is increasing with new developments in all the main areas: radiobiology, technology and clinical research. This paper presents the current status of FLASH radiotherapy with the aforementioned aspects in mind, but also to highlight the existing challenges and future prospects to overcome them.

scholarly journals FLASH Radiotherapy: Current Knowledge and Future Insights Using Proton-Beam Therapy

2020 ◽  
Vol 21 (18) ◽  
pp. 6492 ◽  
Author(s):  
Jonathan R. Hughes ◽  
Jason L. Parsons
Keyword(s):  
Dose Rate ◽  
Proton Beam ◽  
Current Knowledge ◽  
Proton Beam Therapy ◽  
High Dose Rate ◽  
Tumor Control ◽  
High Dose ◽  
The Future

FLASH radiotherapy is the delivery of ultra-high dose rate radiation several orders of magnitude higher than what is currently used in conventional clinical radiotherapy, and has the potential to revolutionize the future of cancer treatment. FLASH radiotherapy induces a phenomenon known as the FLASH effect, whereby the ultra-high dose rate radiation reduces the normal tissue toxicities commonly associated with conventional radiotherapy, while still maintaining local tumor control. The underlying mechanism(s) responsible for the FLASH effect are yet to be fully elucidated, but a prominent role for oxygen tension and reactive oxygen species production is the most current valid hypothesis. The FLASH effect has been confirmed in many studies in recent years, both in vitro and in vivo, with even the first patient with T-cell cutaneous lymphoma being treated using FLASH radiotherapy. However, most of the studies into FLASH radiotherapy have used electron beams that have low tissue penetration, which presents a limitation for translation into clinical practice. A promising alternate FLASH delivery method is via proton beam therapy, as the dose can be deposited deeper within the tissue. However, studies into FLASH protons are currently sparse. This review will summarize FLASH radiotherapy research conducted to date and the current theories explaining the FLASH effect, with an emphasis on the future potential for FLASH proton beam therapy.

PO-1632 3D-Printed template to perform in vivo dosimetry in breast high dose rate brachytherapy treatments

2021 ◽  
Vol 161 ◽  
pp. S1353-S1354
Author(s):  
M. Gutiérrez Ruiz ◽  
R. Astudillo Olalla ◽  
A.L. Rivero ◽  
P. érez ◽  
J.T. Anchuelo Latorre ◽  
...  
Keyword(s):  
Dose Rate ◽  
High Dose Rate ◽  
In Vivo Dosimetry ◽  
High Dose ◽  
High Dose Rate Brachytherapy ◽  
3D Printed

Characterization of microMOSFET detectors for in vivo dosimetry in high‐dose‐rate brachytherapy with 192 Ir

2020 ◽  
Vol 47 (5) ◽  
pp. 2242-2253 ◽  
Author(s):  
Samuel Ruiz‐Arrebola ◽  
Rosa Fabregat‐Borrás ◽  
Eduardo Rodríguez ◽  
Manuel Fernández‐Montes ◽  
Mercedes Pérez‐Macho ◽  
...  
Keyword(s):  
Dose Rate ◽  
High Dose Rate ◽  
In Vivo Dosimetry ◽  
High Dose ◽  
High Dose Rate Brachytherapy

scholarly journals The FLASH effect depends on oxygen concentration

2020 ◽  
Vol 93 (1106) ◽  
pp. 20190702 ◽  
Author(s):  
Gabriel Adrian ◽  
Elise Konradsson ◽  
Michael Lempart ◽  
Sven Bäck ◽  
Crister Ceberg ◽  
...  
Keyword(s):  
Oxygen Concentration ◽  
Underlying Mechanism ◽  
Oxygen Depletion ◽  
Therapeutic Window ◽  
High Dose ◽  
Dose Rates ◽  
Conventional Dose ◽  
Oxygen Concentrations

Objective: Recent in vivo results have shown prominent tissue sparing effect of radiotherapy with ultra-high dose rates (FLASH) compared to conventional dose rates (CONV). Oxygen depletion has been proposed as the underlying mechanism, but in vitro data to support this have been lacking. The aim of the current study was to compare FLASH to CONV irradiation under different oxygen concentrations in vitro. Methods: Prostate cancer cells were irradiated at different oxygen concentrations (relative partial pressure ranging between 1.6 and 20%) with a 10 MeV electron beam at a dose rate of either 600 Gy/s (FLASH) or 14 Gy/min (CONV), using a modified clinical linear accelerator. We evaluated the surviving fraction of cells using clonogenic assays after irradiation with doses ranging from 0 to 25 Gy. Results: Under normoxic conditions, no differences between FLASH and CONV irradiation were found. For hypoxic cells (1.6%), the radiation response was similar up to a dose of about 5–10 Gy, above which increased survival was shown for FLASH compared to CONV irradiation. The increased survival was shown to be significant at 18 Gy, and the effect was shown to depend on oxygen concentration. Conclusion: The in vitro FLASH effect depends on oxygen concentration. Further studies to characterize and optimize the use of FLASH in order to widen the therapeutic window are indicated. Advances in knowledge: This paper shows in vitro evidence for the role of oxygen concentration underlying the difference between FLASH and CONV irradiation.

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