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Updated: Oct 20, 2025

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Published on: February 6, 2019

FLASH radiotherapy with photon beams.

Pierre Montay-Gruel^1,2, Stéphanie Corde^3,4,5, Jean A Laissue⁶

¹Department of Radiation Oncology, University of California, Irvine, California, USA.

Medical Physics

|September 14, 2021

Summary

Ultra-high-dose rate (FLASH) radiotherapy shows promise for reducing normal tissue damage. This review explores methods for generating FLASH X-rays and their potential for clinical use.

Keywords:

FLASH-RT X-rays radiotherapy

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Area of Science:

Medical Physics
Radiation Oncology
Biophysics

Background:

Ultra-high-dose rate (FLASH) radiotherapy (FLASH-RT) significantly reduces normal tissue toxicity while maintaining tumor efficacy.
Clinical translation of FLASH-RT has primarily utilized electron and proton beams.
X-ray-based radiation therapy is the most common modality, yet preclinical data on FLASH X-rays are scarce.

Purpose of the Study:

To review methods for generating ultra-high-dose rate X-rays.
To characterize the beam properties of ultra-high-dose rate X-ray sources.
To assess the biological effects of FLASH X-ray irradiation and its clinical potential.

Main Methods:

Review of existing literature on ultra-high-dose rate X-ray generation techniques.
Analysis of beam characteristics (e.g., dose rate, energy, penetration depth).
Evaluation of preclinical studies on FLASH X-ray effects on biological tissues.

Main Results:

Several methods exist for generating ultra-high-dose rate X-rays, though not widely studied.
Beam characteristics vary depending on the generation method.
Preclinical data suggest potential for reduced normal tissue toxicity with FLASH X-rays.

Conclusions:

Ultra-high-dose rate X-ray generation is feasible and warrants further investigation.
FLASH-RT with X-rays could offer a significant advancement in radiation oncology.
Further research is needed to optimize X-ray generation and validate clinical efficacy and safety.