Cancer is one of the leading causes of death worldwide, responsible for nearly 10 million deaths in 2020, with approximately 50% of patients receiving radiation therapy as part of their treatment (Baskar et al 2012). Preclinical investigations studies have shown that FLASH radiotherapy (FLASH-RT), delivering radiation in ultra-high dose rates (UHDR), preserves healthy tissue integrity and reduces toxicity, all while maintaining an effective tumor response compared to conventional radiotherapy (CONV-RT), the combined biological benefit was termed as FLASH effect. This article comprehensively surveys pertinent research conducted within FLASH-RT, explores the facilities used in this realm, delves into hypothesized mechanism perspectives, and addresses the challenges to trigger the FLASH effect. In addition, we discuss the potential prospects of FLASH-RT and examine the obstacles that require resolution before its clinical implementation can become a reality.
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FLASH Radiotherapy: Technical Advances, Evidence of the FLASH Effect and Mechanistic Insights.
Biomed Phys Eng Express
March 2025
Universite Mohammed V de Rabat, Avenue des Nations Unies, Agdal, Rabat Maroc B.P:8007.N.U, Rabat, 10090, MOROCCO.
Cancer is one of the leading causes of death worldwide, responsible for nearly 10 million deaths in 2020, with approximately 50% of patients receiving radiation therapy as part of their treatment (Baskar et al 2012). Preclinical investigations studies have shown that FLASH radiotherapy (FLASH-RT), delivering radiation in ultra-high dose rates (UHDR), preserves healthy tissue integrity and reduces toxicity, all while maintaining an effective tumor response compared to conventional radiotherapy (CONV-RT), the combined biological benefit was termed as FLASH effect. This article comprehensively surveys pertinent research conducted within FLASH-RT, explores the facilities used in this realm, delves into hypothesized mechanism perspectives, and addresses the challenges to trigger the FLASH effect.
View Article and Find Full Text PDFThe Appropriate Conditions for the Cell Sparing (FLASH) Effect Exist in Ultra-high Dose Rate Carbon Ion Irradiation.
Anticancer Res
March 2025
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Background/aim: Ultra-high dose rate irradiation (uHDR) (>40 Gy/s), commonly referred to as FLASH, has garnered attention in radiation therapy research due to its potential to mitigate damage to normal tissues while maintaining tumoricidal effects. Research on FLASH therapy using electron beams, X-rays, and proton beams has preceded studies using carbon ion beams. However, the clinical potential of FLASH carbon ion irradiation is increasingly being recognized, similar to other radiation modalities.
View Article and Find Full Text PDFStructural plasticity of pyramidal cell neurons measured after FLASH and conventional dose-rate irradiation.
Brain Struct Funct
March 2025
Department of Radiation Oncology, University of California, Irvine School of Medicine, Irvine, CA, USA.
Evidence shows that ultra-high dose-rate FLASH-radiotherapy (FLASH-RT) provides relative protection against normal tissue complications and functional decrements in the irradiated brain. Past work has shown that radiation-induced cognitive impairment, neuroinflammation and reduced structural complexity ofgranule cell neurons were not observed to the same extent after FLASH-RT (> MGy/s) compared to conventional dose-rate (CONV, 0.1 Gy/s) delivery.
View Article and Find Full Text PDFReal-time radiation beam imaging on an MR linear accelerator using quantitative T mapping.
Med Phys
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Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada.
Background: Direct three-dimensional imaging of radiation beams could enable more accurate radiation dosimetry. It has been previously reported that changes in T-weighted magnetic resonance imaging (MRI) intensity could be observed during radiation due to radiochemical oxygen depletion. Quantitative T mapping could increase sensitivity for dosimetry applications.
View Article and Find Full Text PDFPlasmid DNA Strand Breaks Are Dose Rate Independent at Clinically Relevant Proton Doses and Under Biological Conditions.
Radiat Res
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Sector of Radiobiology Applied to Radiotherapy, Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland.
We investigated the effect of proton FLASH radiation on plasmid DNA. Purified supercoiled pBR322 plasmids were irradiated with clinical doses (≤10 Gy) of protons at ultra-high and conventional dose rates using the Paul Scherrer Institute (PSI) isochronous cyclotron. The proton beam in this clinical facility has been validated to produce the FLASH effect in preclinical models.
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