Treatment planning considerations for the development of FLASH proton therapy.
Treatment planning considerations for the development of FLASH proton therapy.
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DOI：
10.1016/j.radonc.2022.08.003
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发表时间：
2022-10
期刊：
影响因子：
--
通讯作者：
Schuemann J
中科院分区：
文献类型：
--
作者：
Rothwell B;Lowe M;Traneus E;Krieger M;Schuemann J
随着人们越来越关注将观察到的闪光效应转化为临床实践，本文提出了利用质子疗法开发闪光效应的治疗计划考虑因素。讨论了诱发闪光效应的潜在要求，以及现有质子治疗输送系统的特性，以及满足这些先决条件所需的规划和输送方法的变化。为了探索闪光的治疗计划方法，需要开发治疗计划系统。在这样一个不断发展的领域，适应新信息的灵活性将是重要的。定义、阈值和假设的差异可能会使比较不同的已发表研究和在新信息的背景下解释以前的研究变得困难。再加上闪光效应背后的潜在机制还有许多有待理解的地方，鼓励对信息存储采取系统和全面的方法。收集和保留关于计划和已实现剂量提供的更详细信息，并报告在规划研究中作出的假设，使研究有可能根据未来对理解的改进而重新审视和重新评估。在研究发展时的前瞻性思维有助于回顾分析。我们希望，这将增加可用的证据，并加速将闪光效应转化为临床益处。
With increasing focus on the translation of the observed FLASH effect into clinical practice, this paper presents treatment planning considerations for its development using proton therapy. Potential requirements to induce a FLASH effect are discussed along with the properties of existing proton therapy delivery systems and the changes in planning and delivery approaches required to satisfy these prerequisites. For the exploration of treatment planning approaches for FLASH, developments in treatment planning systems are needed. Flexibility in adapting to new information will be important in such an evolving area. Variations in definitions, threshold values and assumptions can make it difficult to compare different published studies and to interpret previous studies in the context of new information. Together with the fact that much is left to be understood about the underlying mechanism behind the FLASH effect, a systematic and comprehensive approach to information storage is encouraged. Collecting and retaining more detailed information on planned and realised dose delivery as well as reporting the assumptions made in planning studies creates the potential for research to be revisited and re-evaluated in the light of future improvements in understanding. Forward thinking at the time of study development can help facilitate retrospective analysis. This, we hope, will increase the available evidence and accelerate the translation of the FLASH effect into clinical benefit.
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