Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA.
Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Semin Radiat Oncol. 2024 Jul;34(3):351-364. doi: 10.1016/j.semradonc.2024.04.008.
The "FLASH effect" is an increased therapeutic index, that is, reduced normal tissue toxicity for a given degree of anti-cancer efficacy, produced by ultra-rapid irradiation delivered on time scales orders of magnitude shorter than currently conventional in the clinic for the same doses. This phenomenon has been observed in numerous preclinical in vivo tumor and normal tissue models. While the underlying biological mechanism(s) remain to be elucidated, a path to clinical implementation of FLASH can be paved by addressing several critical translational questions. Technological questions pertinent to each beam type (eg, electron, proton, photon) also dictate the logical progression of experimentation required to move forward in safe and decisive clinical trials. Here we review the available preclinical data pertaining to these questions and how they may inform strategies for FLASH cancer therapy clinical trials.
“FLASH 效应”是指在极短的时间尺度内（比目前临床常规治疗相同剂量的时间尺度短几个数量级）进行超快速照射，从而提高治疗指数，即降低给定抗癌疗效下的正常组织毒性。这一现象已在许多临床前体内肿瘤和正常组织模型中观察到。尽管其潜在的生物学机制尚待阐明，但通过解决几个关键的转化问题，可以为 FLASH 的临床实施铺平道路。与每种射束类型（例如电子、质子、光子）相关的技术问题也决定了进行安全而果断的临床试验所需的实验逻辑进展。在这里，我们回顾了与这些问题相关的现有临床前数据，以及它们如何为 FLASH 癌症治疗临床试验的策略提供信息。
