Ultra-high dose rate electron beams and the FLASH effect: From preclinical evidence to a new radiotherapy paradigm.
Ultra-high dose rate electron beams and the FLASH effect: From preclinical evidence to a new radiotherapy paradigm.
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作者：
在2014年的开创性论文中，Fauvadon等人创造了术语FLASH辐照，以描述剂量率大于40戈伊/s的超高剂量率辐照，其导致的输送时间为几分之一秒。该论文中提出的实验是用高剂量每脉冲4.5 MeV电子束进行的，其结果是现代FLASH放射治疗（RT）领域的基础。在这篇文章中，我们回顾了这些早期实验后发表的研究，证明了FLASH RT在临床前模型中对正常组织保护的强大作用。我们还概述了已使用的各种辐照参数。虽然已经建立了生物反应的鲁棒性，但FLASH效应背后的机制目前正在许多实验室进行研究。然而，不同实验室的实验之间的FLASH效应的幅度差异已被报道。即使在相同的动物模型中，这些差异的原因目前尚不清楚，但可能与所用辐照参数设置的显著差异有关。在这里，我们发现这些参数通常没有报告，这使得大型多研究比较复杂化。为此，我们提出了一个新的射束参数报告标准，并讨论了FLASH放射治疗临床转化的系统路径。
In their seminal paper from 2014, Fauvadon et al. coined the term FLASH irradiation to describe ultra-high-dose-rate irradiation with dose rates greater than 40 Gy/s, which results in delivery times of fractions of a second. The experiments presented in that paper were performed with a high-dose-per-pulse 4.5-MeV electron beam, and the results served as the basis for the modern-day field of FLASH radiation therapy (RT). In this article, we review the studies that have been published after those early experiments, demonstrating the robust effects of FLASH RT on normal tissue sparing in preclinical models. We also outline the various irradiation parameters that have been used. Although the robustness of the biological response has been established, the mechanisms behind the FLASH effect are currently under investigation in a number of laboratories. However, differences in the magnitude of the FLASH effect between experiments in different labs have been reported. Reasons for these differences even within the same animal model are currently unknown, but likely has to do with the marked differences in irradiation parameter settings used. Here we show that these parameters are often not reported, which complicates large multi-study comparisons. For this reason, we propose a new standard for beam parameter reporting and discuss a systematic path to the clinical translation of FLASH radiation therapy.
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DOI：
10.1016/j.ijrobp.2021.03.056
发表时间：
2021-09-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Cao X;Zhang R;Esipova TV;Allu SR;Ashraf R;Rahman M;Gunn JR;Bruza P;Gladstone DJ;Williams BB;Swartz HM;Hoopes PJ;Vinogradov SA;Pogue BW
通讯作者：
Pogue BW
DOI：
10.1016/0360-3016(82)90455-2
发表时间：
1982-01-01
影响因子：
7
作者：
DEWHIRST, MW;CONNOR, WG;SIM, DA
通讯作者：
SIM, DA
DOI：
10.1016/s0168-583x(99)00909-x
发表时间：
2000-03-01
影响因子：
1.3
作者：
Gabriel, F;Gippner, P;Wünsch, R
通讯作者：
Wünsch, R
影响因子：
3.8
作者：
Ashraf, Muhammad Ramish;Bruza, Petr;Gladstone, David J.
通讯作者：
Gladstone, David J.
影响因子：
5.2
作者：
Alaghband, Yasaman;Cheeks, Samantha N.;Limoli, Charles L.
通讯作者：
Limoli, Charles L.