通过系统性审查,对临床FLASH质子疗法的当前知识缺口和缓解策略的影响评估
Anne H Zur Horst1,2, Steven J M Habraken1,3, Marta Rovituso1
1HollandPTC, Delft, Netherlands.
Frontiers in oncology
|September 29, 2025
概括
在FLASH质子疗法 (FLASH-PT) 的不确定性显著影响临床翻译,特别是在患者选择和剂量率评估方面. 进一步的研究应侧重于现象学见解,以克服这些障碍.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 临床前研究 临床前研究
背景情况:
- 闪光质子疗法 (FLASH-PT) 是有前途的,但由于不确定的物理和生物基础,它面临着挑战.
- 临床开发正在进行中,需要对影响治疗转换的不确定性进行评估.
研究的目的:
- 系统地评估FLASH-PT中的不确定性对临床翻译的影响.
- 为了确定关键的FLASH条件和知识差距,阻碍广泛的临床采用.
主要方法:
- 对临床前研究和治疗规划方法的系统文献综述.
- 一个影响评估框架,评估七个FLASH条件的关键性,知识和缓解策略.
- 评分系统用于量化不确定性对临床FLASH-PT的影响.
主要成果:
- 由于未知因素,对患者选择 (放射生物学的不确定性) 和剂量速率评估确定了严重的影响.
- 对于分成和交付方式而言,影响中度至微不足道,提供缓解策略.
- 剂量要求,多个字段和剂量速率条件是关键因素.
结论:
- 在FLASH条件的不确定性限制了FLASH-PT的临床潜力.
- 未来的临床前研究应该优先考虑现象学的见解,而不是纯粹的机械的见解.
- 解决这些不确定性是成功临床翻译FLASH-PT的关键.
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