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FLASH Radiotherapy: A FLASHing Idea to Preserve Neurocognitive Function
Hye-Ju Jo1, Taerim Oh1, Ye-Rim Lee1
1College of Veterinary Medicine, Seoul National University, Seoul, Korea.
Brain Tumor Research and Treatment
|November 12, 2023
Summary
FLASH radiotherapy (FLASH RT) delivers ultra-high dose rates, sparing normal tissues from toxicity. Optimizing parameters and understanding the FLASH effect mechanism are key for its advancement.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Conventional radiotherapy (RT) often causes normal tissue toxicity.
- FLASH radiotherapy (FLASH RT) uses ultra-high dose rates to potentially reduce this toxicity.
- The "FLASH effect" suggests normal tissue sparing, but mechanisms are unclear.
Purpose of the Study:
- To review the current understanding of FLASH RT.
- To highlight recent findings, particularly in neurocognitive protection.
- To discuss challenges and future directions for FLASH RT.
Main Methods:
- Overview of ionization events and RT history.
- Review of experimental animal models and FLASH RT studies.
- Focus on whole-brain irradiation in rodent models.
Main Results:
- FLASH RT shows potential for sparing normal tissues like lung, GI tract, and brain.
- Multiple parameters (dose rate, pulse characteristics, duration) require optimization.
- Hypotheses for the FLASH effect involve oxygen depletion and reduced reactive oxygen species (ROS).
Conclusions:
- The molecular mechanisms of the FLASH effect require further elucidation.
- Standardization of FLASH RT parameters and overcoming electron beam penetration depth are critical.
- Despite challenges like tumor hypoxia, advancements in FLASH RT are anticipated.
