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超高剂量率 FLASH 放疗的生物学益处:睡美人苏醒。

Biological Benefits of Ultra-high Dose Rate FLASH Radiotherapy: Sleeping Beauty Awoken.

机构信息

Laboratory of Radiation Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Radiation Oncology/Department of Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Department of Medical Physics and Engineering, Christie Hospital, Manchester, UK.

出版信息

Clin Oncol (R Coll Radiol). 2019 Jul;31(7):407-415. doi: 10.1016/j.clon.2019.04.001. Epub 2019 Apr 19.

DOI:10.1016/j.clon.2019.04.001
PMID:31010708
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6850216/
Abstract

FLASH radiotherapy (FLASH-RT) is a technology that could modify the way radiotherapy is delivered in the future. This technique involves the ultra-fast delivery of radiotherapy at dose rates several orders of magnitude higher than those currently used in routine clinical practice. This very short time of exposure leads to the striking observation of relative protection of normal tissues that are exposed to FLASH-RT as compared with conventional dose rate radiotherapy. Here we summarise the current knowledge about the FLASH effect and provide a synthesis of the observations that have been reported on various experimental animal models (mice, zebrafish, pig, cats), various organs (lung, gut, brain, skin) and by various groups across 40 years of research. We also propose possible mechanisms for the FLASH effect, as well as possible paths for clinical application.

摘要

FLASH 放疗(FLASH-RT)是一种可能改变未来放疗方式的技术。该技术涉及以比目前常规临床实践中使用的剂量率高几个数量级的速度超快速输送放疗。这种极短的照射时间导致了一个惊人的观察结果,即与常规剂量率放疗相比,暴露于 FLASH-RT 的正常组织具有相对保护作用。在这里,我们总结了目前关于 FLASH 效应的知识,并综合了 40 年来各个实验动物模型(小鼠、斑马鱼、猪、猫)、各种器官(肺、肠道、大脑、皮肤)和不同研究小组报告的观察结果。我们还提出了 FLASH 效应的可能机制,以及临床应用的可能途径。

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Clinical translation of FLASH radiotherapy: Why and how?FLASH 放疗的临床转化:为何以及如何?
Radiother Oncol. 2019 Oct;139:11-17. doi: 10.1016/j.radonc.2019.04.008. Epub 2019 Jun 25.
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An integrated physico-chemical approach for explaining the differential impact of FLASH versus conventional dose rate irradiation on cancer and normal tissue responses.一种综合的物理化学方法,用于解释 FLASH 与常规剂量率照射对癌症和正常组织反应的差异影响。
Radiother Oncol. 2019 Oct;139:23-27. doi: 10.1016/j.radonc.2019.03.028. Epub 2019 Apr 19.
3
Modifying a clinical linear accelerator for delivery of ultra-high dose rate irradiation.
研究常氧或低氧条件下常规剂量率与超高剂量率质子辐照对斑马鱼胚胎多个发育终点的影响。
Cancers (Basel). 2025 Aug 3;17(15):2564. doi: 10.3390/cancers17152564.
4
FLASH radiotherapy: bridging revolutionary mechanisms and clinical frontiers in cancer treatment - a narrative review.FLASH放疗:连接癌症治疗中的革命性机制与临床前沿——一篇叙述性综述
Ewha Med J. 2024 Oct;47(4):e54. doi: 10.12771/emj.2024.e54. Epub 2024 Oct 31.
5
The evolution of FLASH radiotherapy: a bibliometric analysis.FLASH放疗的发展:一项文献计量学分析
Front Oncol. 2025 May 15;15:1580848. doi: 10.3389/fonc.2025.1580848. eCollection 2025.
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Combinational Radiotherapies Improve Brain Cancer Treatment at High Dose Rates In Vitro.联合放射疗法在高剂量率下体外改善脑癌治疗效果。
Cancers (Basel). 2025 May 20;17(10):1713. doi: 10.3390/cancers17101713.
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Gels. 2025 Apr 30;11(5):336. doi: 10.3390/gels11050336.
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Mimicking large spot-scanning radiation fields for proton FLASH preclinical studies with a robotic motion platform.使用机器人运动平台模拟用于质子FLASH临床前研究的大光斑扫描辐射场。
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为实现超高剂量率照射而对临床直线加速器进行改造。
Radiother Oncol. 2019 Oct;139:40-45. doi: 10.1016/j.radonc.2019.01.031. Epub 2019 Feb 10.
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