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FLASH radiotherapy preserves systemic and tissue homeostasis while maintaining antitumor efficacy
Giulia Furini1, Eduarda Mota da Silva1, Alice Usai1
1National Research Council, Institute of Clinical Physiology, Pisa, Italy.
BMC Medicine
|February 25, 2026
Summary
Ultra-high dose rate radiotherapy (FLASH-RT) effectively controls melanoma tumors while preserving normal tissues. Conventional radiotherapy (CONV-RT) causes significant skin and muscle damage, unlike FLASH-RT.
Area of Science:
- Oncology
- Radiation Oncology
- Molecular Biology
Background:
- Conventional radiotherapy (CONV-RT) efficacy is limited by toxicity to healthy tissues.
- Ultra-high dose rate radiotherapy (FLASH-RT) shows promise for sparing normal tissues.
- Melanoma's radioresistance and deep-seated lesions cause significant skin and muscle damage.
Purpose of the Study:
- Compare CONV-RT and FLASH-RT efficacy and side effects in melanoma.
- Investigate molecular and systemic mechanisms of normal tissue toxicity.
- Utilize melanoma as a model for tumor response and skin-muscle for toxicity.
Main Methods:
- Employed a novel linear accelerator for ultra-high dose rate electron delivery.
- Administered CONV-RT and FLASH-RT to a syngeneic melanoma mouse model.
- Analyzed tumor growth, tissue integrity, transcriptional changes, and systemic homeostasis.
Main Results:
- Both CONV-RT and FLASH-RT achieved comparable tumor suppression.
- FLASH-RT preserved skin and muscle integrity and systemic balance.
- CONV-RT induced significant transcriptional changes, fibrosis, and inflammation, unlike FLASH-RT.
Conclusions:
- FLASH-RT offers effective tumor control with substantial normal tissue sparing.
- CONV-RT and FLASH-RT elicit distinct biological responses.
- Dose rate is a critical factor influencing biological outcomes in radiotherapy.
