Flash radiotherapy as new perspective in radiotherapy technology

Kuralt, Matej (author), Žager Marciuš, Valerija (author)

Purpose: The purpose of this article is to present FLASH radiotherapy (FLASH-RT) as a new radiation therapy method, to explain its mechanisms of action, to present possible sources and devices of radiation and to identify its advantages and disadvantages compared to conventional radiotherapy (CONV-RT). Methods: Numerous articles were reviewed for this study in a scientific research online database (PubMed) that were published in the last 10 years (2012-2022). We used PRISMA model to simplify our research and we gathered 14 articles that described the basic features of FLASH-RT. Results and Discussion: Most studies have found that FLASH-RT reduces toxicity to healthy tissues adjacent to the tumour. The majority of studies showed the same anti-tumour effect as CONV-RT, some even better. At present, there is a lack of suitable radiation devices for the use of FLASH-RT, and it will be necessary to adapt existing devices. Conclusion: FLASH-RT could be used in highly radioresistant tumours where CONV-RT would cause too much damage to healthy tissue with increase in radiation dose. It could also be useful in tumours where CONV-RT is successful but too toxic for healthy tissue adjacent to the tumour. A lot of research is needed before clinical implementation of FLASH-RT, to find out an optimal: dose rate, dose for different types of cancer and with most favourable effect/toxicity ratio, and technical solution (i.e. radiation source).

• Language: English
• Keywords: FLASH radiotherapy, conventional radiotherapy, toxicity to healthy tissues, antitumour effect
• Work type: Article
• Typology: 1.02 - Review Article
• Organization: ZF - Faculty of Health Sciences
• Publication status: Published
• Publication version: Version of Record
• Publication date: 01.01.2022
• Year: 2022
• Number of pages: Str. 12-17
• Numbering: Vol. 39, no. 1
• PID: 20.500.12556/RUL-144315
• UDC: 615.849
• ISSN on article: 2712-2492
• DOI: 10.47724/MIRTJ.2022.i01.a002
• COBISS.SI-ID: 141645059
• Publication date in RUL: 14.02.2023

Record is a part of a journal

• Title: Medical imaging and radiotherapy journal
• Shortened title: Med. imaging radiother. j.
• Publisher: Društvo radioloških inženirjev Slovenije, Društvo radioloških inženirjev Slovenije, Strokovno združenje radioloških inženirjev Slovenije
• ISSN: 2712-2492
• COBISS.SI-ID: 303286272

Licences

• License: CC BY-NC-SA 4.0, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
• Link: http://creativecommons.org/licenses/by-nc-sa/4.0/
• Description: A Creative Commons license that bans commercial use and requires the user to release any modified works under this license.
• Licensing start date: 15.12.2022

Secondary language

• Language: Slovenian
• Title: Flash radioterapija kot nova možnost v radioterapevtski tehnologiji

Abstract

Namen: Namen članka je predstaviti FLASH radioterapijo (FLASH-RT) kot novo obsevalno metodo, pojasniti do sedaj znane mehanizme delovanja, predstaviti možne vire in naprave sevanja ter ugotoviti kakšne so njene prednosti in pomanjkljivosti v primerjavi s konvencionalno radioterapijo (CONV-RT). Metode in materiali: Za raziskavo so bili pregledani članki, objavljeni v zadnjih desetih letih (2012-2022) v spletni bazi podatkov. Za sistematični pregled literature in metaanalizo je bil uporabljen diagram za lažji izbor člankov, ki opisujejo značilnosti FLASH-RT. Rezultati in razprava: Pri večini študij je bilo ugotovljeno, da FLASH-RT zmanjša toksičnost na zdrava tkiva ob tumorju. Trenutno je premalo primernih obsevalnih naprav za uporabo FLASH-RT in bo zato potrebno prilagoditi obstoječe naprave. Zaključek: FLASH-RT bi lahko uporabili pri zelo radiorezistentnih tumorjih, kjer bi pri CONV-RT z višjo obsevalno dozo preveč poškodovali zdravo tkivo. Uporabna bi bila tudi pri tumorjih, kjer je CONV-RT uspešna, a ima preveč stranskih učinkov na zdrava tkiva ob tumorju. Pred klinično uporabo bo potrebno napraviti še veliko raziskav in ugotoviti: hitrost doze, dozni odmerek za različne vrste raka in najugodnejše razmerje med učinkom in toksičnostjo ter tehnično rešitev (vir sevanja).

• Keywords: FLASH radioterapija, konvencionalna radioterapija, toksičnost za zdrava tkiva, protitumorski učinek