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. 2018 Feb;91(1082):20170628.
doi: 10.1259/bjr.20170628. Epub 2017 Dec 15.

Faster and safer? FLASH ultra-high dose rate in radiotherapy

Marco Durante  1 , Elke Bräuer-Krisch  2 , Mark Hill  3
Affiliations

Faster and safer? FLASH ultra-high dose rate in radiotherapy

Marco Durante et al. Br J Radiol. 2018 Feb.

Abstract

Recent results from the Franco-Swiss team of Institute Curie and Centre Hospitalier Universitaire Vaudois demonstrate a remarkable sparing of normal tissue after irradiation at ultra-high dose rate (>40 Gy s-1). The "FLASH" radiotherapy maintains tumour control level, suggesting that ultra-high dose rate can substantially enhance the therapeutic window in radiotherapy. The results have been obtained so far only with 4-6 MeV electrons in lung and brain mouse model. Nevertheless, they have attracted a great attention for the potential clinical applications. Oxygen depletion had been discussed many years ago as a possible mechanism for reduction of the damage after exposure to ultra-high dose rate. However, the mechanism underlying the effect observed in the FLASH radiotherapy remains to be elucidated.

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Figures

Figure 1.
Figure 1.
Time dependence of pulmonary fibrosis in C57BL/6J mice after thoracic irradiation at conventional (circles) or ultra-high dose rate (squares). Data points and all details in reference Favaudon et al lines are guides for the eye.
Figure 2.
Figure 2.
DREF as a function of the dose rate. Different exposure scenarios at different dose-rate levels are shown in the circles. DREF, dose-rate effectiveness factor; HDR-BT, high dose-rate brachytherapy; IMRT, intensity modulated radiotherapy; IORT, intraoperatory radiotherapy; LDR-BT, low dose-rate brachytherapy; MRT, microbeam radiotherapy; SBRT-FFF, stereotactic body radiotherapy flattening filter free; SRS, stereotactic radiosurgery.
See this image and copyright information in PMC

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