Biophysics Department, GSI Helhmoltzzentrum für Schwerionenforschung, Darmstadt, Germany.
Istituto Nazionale di Fisica Nucleare (INFN), Trento Institute for Fundamental Physics and Applications (TIFPA), Trento, Italy.
Med Phys. 2022 Mar;49(3):1974-1992. doi: 10.1002/mp.15135. Epub 2021 Aug 14.
FLASH radiotherapy is considered a new potential breakthrough in cancer treatment. Ultra-high dose rates (>40 Gy/s) have been shown to reduce toxicity in the normal tissue without compromising tumor control, resulting in a widened therapeutic window. These high dose rates are more easily achievable in the clinic with charged particles, and clinical trials are, indeed, ongoing using electrons or protons. FLASH could be an attractive solution also for heavier ions such as carbon and could even enhance the therapeutic window. However, it is not yet known whether the FLASH effect will be the same as for sparsely ionizing radiation when densely ionizing carbons ions are used. Here we discuss the technical challenges in beam delivery and present a promising solution using 3D range-modulators in order to apply ultra-high dose rates (UHDR) compatible with FLASH with carbon ions. Furthermore, we will discuss the possible outcome of C-ion therapy at UHDR on the level of the radiobiological and radiation chemical effects.
FLASH 放疗被认为是癌症治疗的一个新的潜在突破。超高剂量率（>40 Gy/s）已被证明可以降低正常组织的毒性而不影响肿瘤控制，从而扩大治疗窗口。这些高剂量率在临床上更容易通过带电粒子来实现，并且确实正在使用电子或质子进行临床试验。FLASH 对于碳等重离子也可能是一个有吸引力的解决方案，甚至可以进一步扩大治疗窗口。然而，目前尚不清楚当使用密集电离的碳离子时，FLASH 效应是否与稀疏电离辐射相同。在这里，我们讨论了在束流传输方面的技术挑战，并提出了一种有前途的解决方案，即使用 3D 射程调制器，以便用碳离子实现与 FLASH 兼容的超高剂量率（UHDR）。此外，我们还将讨论在 UHDR 下碳离子治疗对放射生物学和辐射化学效应的可能结果。
