Cheng Chingyun, Xu Liming, Jing Hao, Selvaraj Balaji, Lin Haibo, Pennock Michael, Chhabra Arpit M, Hasan Shaakir, Zhai Huifang, Zhang Yin, Nie Ke, Bakst Richard L, Kabarriti Rafi, Choi J Isabelle, Lee Nancy Y, Simone Charles B, Kang Minglei, Wu Hui
Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA.
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
Cancers (Basel). 2024 Sep 24;16(19):3249. doi: 10.3390/cancers16193249.
Ultrahigh-dose-rate therapy, also known as FLASH radiotherapy (RT), is an emerging technique that is garnering significant interest in cancer treatment due to its potential to revolutionize therapy. This method can achieve comparable tumor control to conventional-dose-rate RT while offering the enhanced protection of normal tissue through the FLASH-sparing effect. This innovative technique has demonstrated promising results in preclinical studies involving animals and cell lines. Particularly noteworthy is its potential application in treating head and neck (HN) cancers, especially in patients with challenging recurrent tumors and reirradiation cases, where the toxicity rates with conventional radiotherapy are high. Such applications aim to enhance tumor control while minimizing side effects and preserving patients' quality of life. In comparison to electron or photon FLASH modalities, proton therapy has demonstrated superior dosimetric and delivery characteristics and is a safe and effective FLASH treatment for human malignancies. Compared to the transmission proton FLASH, single-energy Bragg peak FLASH is a novel delivery method that allows highly conformal doses to targets and minimal radiation doses to crucial OARs. Proton Bragg peak FLASH for HN cancer has still not been well studied. This review highlights the significance of proton FLASH in enhancing cancer therapy by examining the advantages and challenges of using it for HN cancer reirradiation.
超高剂量率疗法，也称为FLASH放射疗法（RT），是一种新兴技术，因其有可能彻底改变癌症治疗方法而在癌症治疗领域引起了广泛关注。该方法能够在实现与传统剂量率放疗相当的肿瘤控制效果的同时，通过FLASH保护效应增强对正常组织的保护。这种创新技术在涉及动物和细胞系的临床前研究中已显示出有前景的结果。特别值得注意的是其在治疗头颈部（HN）癌症方面的潜在应用，尤其是在复发性肿瘤和再照射情况具有挑战性的患者中，传统放疗的毒性率很高。此类应用旨在增强肿瘤控制，同时将副作用降至最低并保留患者的生活质量。与电子或光子FLASH模式相比，质子疗法已显示出优越的剂量学和输送特性，是一种治疗人类恶性肿瘤的安全有效的FLASH疗法。与透射质子FLASH相比，单能布拉格峰FLASH是一种新颖的输送方法，可实现对靶区的高度适形剂量和对关键危及器官的最小辐射剂量。质子布拉格峰FLASH用于HN癌症的研究仍不够充分。本综述通过研究质子FLASH用于HN癌症再照射的优势和挑战，强调了质子FLASH在增强癌症治疗方面的重要性。
