Transformative Technology for FLASH Radiation Therapy

oleh: Reinhard Schulte, Carol Johnstone, Salime Boucher, Eric Esarey, Cameron G. R. Geddes, Maksim Kravchenko, Sergey Kutsaev, Billy W. Loo, François Méot, Brahim Mustapha, Kei Nakamura, Emilio A. Nanni, Lieselotte Obst-Huebl, Stephen E. Sampayan, Carl B. Schroeder, Ke Sheng, Antoine M. Snijders, Emma Snively, Sami G. Tantawi, Jeroen Van Tilborg

Format: Article
Diterbitkan: MDPI AG 2023-04-01

Deskripsi

The general concept of radiation therapy used in conventional cancer treatment is to increase the therapeutic index by creating a physical dose differential between tumors and normal tissues through precision dose targeting, image guidance, and radiation beams that deliver a radiation dose with high conformality, e.g., protons and ions. However, the treatment and cure are still limited by normal tissue radiation toxicity, with the corresponding side effects. A fundamentally different paradigm for increasing the therapeutic index of radiation therapy has emerged recently, supported by preclinical research, and based on the FLASH radiation effect. FLASH radiation therapy (FLASH-RT) is an ultra-high-dose-rate delivery of a therapeutic radiation dose within a fraction of a second. Experimental studies have shown that normal tissues seem to be universally spared at these high dose rates, whereas tumors are not. While dose delivery conditions to achieve a FLASH effect are not yet fully characterized, it is currently estimated that doses delivered in less than 200 ms produce normal-tissue-sparing effects, yet effectively kill tumor cells. Despite a great opportunity, there are many technical challenges for the accelerator community to create the required dose rates with novel compact accelerators to ensure the safe delivery of FLASH radiation beams.