Favaudon V
Institut Curie, centre universitaire, bâtiment 110, 91405 Orsay cedex, France; Inserm U1021, centre universitaire, bâtiment 110, 91405 Orsay cedex, France; CNRS UMR 3347, centre universitaire, bâtiment 110, 91405 Orsay cedex, France; Université Paris Saclay, centre universitaire, bâtiment 110, 91405 Orsay cedex, France.
Cancer Radiother. 2019 Oct;23(6-7):674-676. doi: 10.1016/j.canrad.2019.07.127. Epub 2019 Aug 13.
In the last decade, major advances in high precision treatment delivery and multimodal imaging allowed radiotherapy to be more efficient and better tolerated. However, the technology of the accelerators used to generate X-ray beams is outdated and does not allow to explore the tolerance to novel approaches in terms of dose-rate. We have been the first to propose a completely novel modality of irradiation, named Flash radiotherapy, in which the dose per pulse and the instant dose-rate during the pulses is 10 to 10 higher than those used in conventional facilities. Flash has been shown to spare mouse lung from radio-induced fibrosis, whilst leaving unchanged the antitumor potential. Other teams have shown that the advantage of Flash in terms of reduced complications extends to normal brain and intestinal crypts. The goal of this paper is to review the progress of studies dealing with very high dose-rate "Flash" irradiation, describe the theoretical models proposed to explain the underlying mechanisms, and discuss the prospects for clinical applications of this emerging technique.
在过去十年中，高精度治疗输送和多模态成像方面的重大进展使放射治疗更高效且耐受性更好。然而，用于产生X射线束的加速器技术已过时，无法在剂量率方面探索对新方法的耐受性。我们率先提出了一种全新的照射方式，称为闪光放疗，其中每个脉冲的剂量以及脉冲期间的瞬时剂量率比传统设备中使用的剂量率高10到100倍。闪光放疗已被证明可使小鼠肺部免受放射性纤维化影响，同时不改变抗肿瘤潜力。其他团队表明，闪光放疗在减少并发症方面的优势也适用于正常脑组织和肠隐窝。本文的目的是回顾关于超高剂量率“闪光”照射的研究进展，描述为解释其潜在机制而提出的理论模型，并讨论这种新兴技术的临床应用前景。
