FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge
Major strides have been made in the development of FLASH radiotherapy (FLASH RT) in the last ten years, but there are still many obstacles to overcome for transfer to the clinic to become a reality. Although preclinical and first-in-human clinical evidence suggests that ultra-high dose rates (UHDRs)...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/25/5/2546 |
| _version_ | 1797264434109874176 |
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| author | Andrea Borghini Luca Labate Simona Piccinini Costanza Maria Vittoria Panaino Maria Grazia Andreassi Leonida Antonio Gizzi |
| author_facet | Andrea Borghini Luca Labate Simona Piccinini Costanza Maria Vittoria Panaino Maria Grazia Andreassi Leonida Antonio Gizzi |
| author_sort | Andrea Borghini |
| collection | DOAJ |
| description | Major strides have been made in the development of FLASH radiotherapy (FLASH RT) in the last ten years, but there are still many obstacles to overcome for transfer to the clinic to become a reality. Although preclinical and first-in-human clinical evidence suggests that ultra-high dose rates (UHDRs) induce a sparing effect in normal tissue without modifying the therapeutic effect on the tumor, successful clinical translation of FLASH-RT depends on a better understanding of the biological mechanisms underpinning the sparing effect. Suitable in vitro studies are required to fully understand the radiobiological mechanisms associated with UHDRs. From a technical point of view, it is also crucial to develop optimal technologies in terms of beam irradiation parameters for producing FLASH conditions. This review provides an overview of the research progress of FLASH RT and discusses the potential challenges to be faced before its clinical application. We critically summarize the preclinical evidence and in vitro studies on DNA damage following UHDR irradiation. We also highlight the ongoing developments of technologies for delivering FLASH-compliant beams, with a focus on laser-driven plasma accelerators suitable for performing basic radiobiological research on the UHDR effects. |
| first_indexed | 2024-04-25T00:28:50Z |
| format | Article |
| id | doaj.art-5cb9b6bf96f04d598f5b01519cc2fd5d |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-04-25T00:28:50Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-5cb9b6bf96f04d598f5b01519cc2fd5d2024-03-12T16:45:24ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672024-02-01255254610.3390/ijms25052546FLASH Radiotherapy: Expectations, Challenges, and Current KnowledgeAndrea Borghini0Luca Labate1Simona Piccinini2Costanza Maria Vittoria Panaino3Maria Grazia Andreassi4Leonida Antonio Gizzi5CNR Institute of Clinical Physiology, 56124 Pisa, ItalyIntense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, ItalyIntense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, ItalyIntense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, ItalyCNR Institute of Clinical Physiology, 56124 Pisa, ItalyIntense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, ItalyMajor strides have been made in the development of FLASH radiotherapy (FLASH RT) in the last ten years, but there are still many obstacles to overcome for transfer to the clinic to become a reality. Although preclinical and first-in-human clinical evidence suggests that ultra-high dose rates (UHDRs) induce a sparing effect in normal tissue without modifying the therapeutic effect on the tumor, successful clinical translation of FLASH-RT depends on a better understanding of the biological mechanisms underpinning the sparing effect. Suitable in vitro studies are required to fully understand the radiobiological mechanisms associated with UHDRs. From a technical point of view, it is also crucial to develop optimal technologies in terms of beam irradiation parameters for producing FLASH conditions. This review provides an overview of the research progress of FLASH RT and discusses the potential challenges to be faced before its clinical application. We critically summarize the preclinical evidence and in vitro studies on DNA damage following UHDR irradiation. We also highlight the ongoing developments of technologies for delivering FLASH-compliant beams, with a focus on laser-driven plasma accelerators suitable for performing basic radiobiological research on the UHDR effects.https://www.mdpi.com/1422-0067/25/5/2546FLASH radiotherapyFLASH effectultra-high dose ratevery high-energy electronsnormal tissue responsetumor response |
| spellingShingle | Andrea Borghini Luca Labate Simona Piccinini Costanza Maria Vittoria Panaino Maria Grazia Andreassi Leonida Antonio Gizzi FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge International Journal of Molecular Sciences FLASH radiotherapy FLASH effect ultra-high dose rate very high-energy electrons normal tissue response tumor response |
| title | FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge |
| title_full | FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge |
| title_fullStr | FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge |
| title_full_unstemmed | FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge |
| title_short | FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge |
| title_sort | flash radiotherapy expectations challenges and current knowledge |
| topic | FLASH radiotherapy FLASH effect ultra-high dose rate very high-energy electrons normal tissue response tumor response |
| url | https://www.mdpi.com/1422-0067/25/5/2546 |
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