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A Critical Analysis of Possible Mechanisms for the Oxygen Effect in Radiation Therapy with FLASH.

作者信息

Swartz Harold M, Vaupel Peter, Flood Ann Barry

机构信息

Geisel School of Medicine, Dartmouth College, Hanover, NH, USA.

Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

出版信息

Adv Exp Med Biol. 2023;1438:127-133. doi: 10.1007/978-3-031-42003-0_21.


DOI:10.1007/978-3-031-42003-0_21
PMID:37845451
Abstract

The aim of this review is to stimulate readers to undertake appropriate investigations of the mechanism for a possible oxygen effect in FLASH. FLASH is a method of delivery of radiation that empirically, in animal models, appears to decrease the impact of radiation on normal tissues while retaining full effect on tumors. This has the potential for achieving a significantly increased effectiveness of radiation therapy. The mechanism is not known but, especially in view of the prominent role that oxygen has in the effects of radiation, investigations of mechanisms of FLASH have often focused on impacts of FLASH on oxygen levels. We and others have previously shown that simple differential depletion of oxygen directly changing the response to radiation is not a likely mechanism. In this review we consider how time-varying changes in oxygen levels could account for the FLASH effect by changing oxygen-dependent signaling in cells. While the methods of delivering FLASH are still evolving, current approaches for FLASH can differ from conventional irradiation in several ways that can impact the pattern of oxygen consumption: the rate of delivery of the radiation (40 Gy/s vs. 0.1 Gy/s), the time over which each fraction is delivered (e.g., <0.5 s. vs. 300 s), the delivery in pulses, the number of fractions, the size of the fractions, and the total duration of treatment. Taking these differences into account and recognizing that cell signaling is an intrinsic component of the need for cells to maintain steady-state conditions and, therefore, is activated by small changes in the environment, we delineate the potential time dependent changes in oxygen consumption and overview the cell signaling pathways whose differential activation by FLASH could account for the observed biological effects of FLASH. We speculate that the most likely pathways are those involved in repair of damaged DNA.

摘要

相似文献

[1]
A Critical Analysis of Possible Mechanisms for the Oxygen Effect in Radiation Therapy with FLASH.

Adv Exp Med Biol. 2023

[2]
Quantification of Oxygen Depletion During FLASH Irradiation In Vitro and In Vivo.

Int J Radiat Oncol Biol Phys. 2021-9-1

[3]
A Radiation Biological Analysis of the Oxygen Effect as a Possible Mechanism in FLASH.

Adv Exp Med Biol. 2022

[4]
Deciphering Time-Dependent DNA Damage Complexity, Repair, and Oxygen Tension: A Mechanistic Model for FLASH-Dose-Rate Radiation Therapy.

Int J Radiat Oncol Biol Phys. 2021-6-1

[5]
Oxygen Monitoring in Model Solutions and In Vivo in Mice During Proton Irradiation at Conventional and FLASH Dose Rates.

Radiat Res. 2022-8-1

[6]
Modeling the impact of tissue oxygen profiles and oxygen depletion parameter uncertainties on biological response and therapeutic benefit of FLASH.

Med Phys. 2024-1

[7]
Ultra-High Dose-Rate, Pulsed (FLASH) Radiotherapy with Carbon Ions: Generation of Early, Transient, Highly Oxygenated Conditions in the Tumor Environment.

Radiat Res. 2020-12-1

[8]
FLASH irradiation induces lower levels of DNA damage ex vivo, an effect modulated by oxygen tension, dose, and dose rate.

Br J Radiol. 2022-5-1

[9]
Modeling the impact of spatial oxygen heterogeneity on radiolytic oxygen depletion during FLASH radiotherapy.

Phys Med Biol. 2022-6-2

[10]
A computational model of radiolytic oxygen depletion during FLASH irradiation and its effect on the oxygen enhancement ratio.

Phys Med Biol. 2019-9-11

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本文引用的文献

[1]
A Radiation Biological Analysis of the Oxygen Effect as a Possible Mechanism in FLASH.

Adv Exp Med Biol. 2022

[2]
Changes in Radical Levels as a Cause for the FLASH effect: Impact of beam structure parameters at ultra-high dose rates on oxygen depletion in water.

Radiother Oncol. 2022-10

[3]
Quantifying the DNA-damaging Effects of FLASH Irradiation With Plasmid DNA.

Int J Radiat Oncol Biol Phys. 2022-6-1

[4]
Radiobiology of the FLASH effect.

Med Phys. 2022-3

[5]
Quantification of Oxygen Depletion During FLASH Irradiation In Vitro and In Vivo.

Int J Radiat Oncol Biol Phys. 2021-9-1

[6]
Ultra-High Dose Rate (FLASH) Radiotherapy: Silver Bullet or Fool's Gold?

Front Oncol. 2020-1-17

[7]
Oxygen-dependent regulation of immune checkpoint mechanisms.

Int Immunol. 2018-7-24

[8]
Response to radioimmunotherapy correlates with tumor pO2 measured by EPR oximetry in human tumor xenografts.

Radiat Res. 2001-3

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