Alhaddad Lina, Osipov Andreyan N, Leonov Sergey
Department of Environmental Sciences, Faculty of Science, Damascus University, Damascus P.O. Box 30621, Syria.
N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow 119991, Russia.
Int J Mol Sci. 2024 Nov 21;25(23):12506. doi: 10.3390/ijms252312506.
Radiotherapy (RT) has been shown to be a cornerstone of both palliative and curative tumor care. RT has generally been reported to be sharply limited by ionizing radiation (IR)-induced toxicity, thereby constraining the control effect of RT on tumor growth. FLASH-RT is the delivery of ultra-high dose rate (UHDR) several orders of magnitude higher than what is presently used in conventional RT (CONV-RT). The FLASH-RT clinical trials have been designed to examine the UHDR deliverability, the effectiveness of tumor control, the dose tolerance of normal tissue, and the reproducibility of treatment effects across several institutions. Although it is still in its infancy, FLASH-RT has been shown to have potential to rival current RT in terms of safety. Several studies have suggested that the adoption of FLASH-RT is very limited, and the incorporation of this new technique into routine clinical RT will require the use of accurate dosimetry methods and reproducible equipment that enable the reliable and robust measurements of doses and dose rates. The purpose of this review is to highlight the advantages of this technology, the potential mechanisms underpinning the FLASH-RT effect, and the major challenges that need to be tackled in the clinical transfer of FLASH-RT.
放射治疗（RT）已被证明是姑息性和根治性肿瘤治疗的基石。一般报道称，放射治疗受到电离辐射（IR）诱导的毒性的严重限制，从而限制了放射治疗对肿瘤生长的控制效果。FLASH-RT是指以比传统放射治疗（CONV-RT）目前使用的剂量率高出几个数量级的超高剂量率（UHDR）进行照射。FLASH-RT临床试验旨在研究超高剂量率照射的可行性、肿瘤控制的有效性、正常组织的剂量耐受性以及多个机构治疗效果的可重复性。尽管FLASH-RT仍处于起步阶段，但已显示出在安全性方面有潜力与当前的放射治疗相媲美。几项研究表明，FLASH-RT的应用非常有限，将这项新技术纳入常规临床放射治疗需要使用准确的剂量测定方法和可重复使用的设备，以便能够可靠且稳健地测量剂量和剂量率。本综述的目的是强调这项技术的优势、FLASH-RT效应背后的潜在机制以及在FLASH-RT临床应用中需要应对的主要挑战。
