The Advantage of FLASH Radiotherapy Confirmed in Mini-pig and Cat-cancer Patients
The Advantage of FLASH Radiotherapy Confirmed in Mini-pig and Cat-cancer Patients
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DOI：
10.1158/1078-0432.ccr-17-3375
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发表时间：
2019-01-01
影响因子：
11.5
通讯作者：
Bourhis, Jean
中科院分区：
文献类型：
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作者：
Vozenin, Marie-Catherine;De Fornel, Pauline;Bourhis, Jean
目的：之前在小鼠中使用 PLASH 放射治疗 (RI) 的研究表明，正常组织和肿瘤之间的差异效应显着增加。为了刺激临床转移，我们评估了这种效应是否也可能发生在高等哺乳动物中。实验设计：使用猪皮来研究以称为“FLASH-RT”的超高剂量率照射和以称为“Cony -R1”的常规剂量率照射之间的潜在毒性差异，在 6 名患有局部晚期 T2/T3NOMO 方形肌病的猫患者中进行了临床 I 期单剂量递增试验（25-41 Gy）鼻扁平细胞癌以确定单剂量 FLAS H-RT 的最大耐受剂量和无进展生存期 (PPS)，结果：分别使用脱毛和纤维坏死作为急性和晚期终点，观察到 FLASH-RT 的保护作用（与 Conv-RT 相比，剂量当量差异>20%），三只猫没有出现急性毒性，而 3 只表现出中度/轻度短暂性粘膜炎，所有猫都出现脱毛。 inetliaii 随访 13.5 个月，16 个月时的 PFS 为 84%，结论：Clur 结果证实了 FLASH-RT 的潜在优势，并为在人类患者中进一步评估 FLASH-RI 提供了强有力的理由，请参阅 Harrington 的相关评论，第 3 页。
Purpose: Previous studies using PLASH radiotherapy (RI) in mice showed a marked increase of the differential effect between normal tissue and tumors. To stimulate clinical transfer, we evaluated whether this effect could also occur in higher mammals.Expetirnental Design: Pig skin was used to investigate a potential difference in toxicity between irradiation delivered at an ultrahigh dose rate called "FLASH-RT" and irradiation delivered at a conventional dose rate called "Cony -R1',' A clinical, phase I, single -dose escalation trial (25-41 Gy) was performed in 6 cat patients with locally advanced T2/T3NOMO squarnatis cell carcinoma of the nasal planum to determine the maximal tolerated dose and progression-free survival (PPS) of single-dose FLAS H-RT,Results: Using. respectively, depilation and fibronecrosis as acute and late endpoints, a protective effect of FLASH-RT was observed (>20% dose-equivalent difference vs. Conv-RT), Three cats experienced no acute toxicity whereas 3 exhibited moderate/mild transient mucositis, and all cats had depilation. With a inetliaii follow-up of 13.5 months, the PFS at 16 months was 84%,Conclusions: Clur results confirmed the potential advantage of FLASH-RT and provide a strong rationale for further evaluating FLASH-RI in human patients. See related commentary by Harrington, p, 3