Abstract
Purpose
Flash radiotherapy (FLASH-RT) is currently being regarded as the next breakthrough in radiation treatment of cancer, delivering ultrahigh radiation doses in a very short time, and sparing normal tissues from detrimental injury. Here we review the current evidence on the preclinical findings as well as the radiobiological mechanisms underlying the FLASH effect. We also briefly examine the scenario of available technologies for delivering FLASH dose-rates for research and their implications for future clinical use.
Conclusions
Preclinical studies report that the FLASH-RT reduces radiation-induced toxicity whilst maintaining an equivalent tumor response across different animal models. However, the molecular radiobiology underlying FLASH effect is not fully understood and further experiments are necessary to understand the biological response. Future studies also includes the design of a FLASH delivery system able to produce beams appropriate for treatment of tumors with ultra-high dose rates. All these research activities will greatly benefit from a multidisciplinary collaboration across biology, physics and clinical oncology, increasing the potential of a rapid clinical translation of FLASH-RT.
Disclosure statement
The authors report no conflict of interest.
Additional information
Notes on contributors
Andrea Borghini
Andrea Borghini, MSc, PhD, is a Postodctoral Researcher at the Molecular Epidemiology and Genetics Unit, Institute of Clinical Physiology, National Research Council (CNR-IFC), Pisa, Italy
Cecilia Vecoli
Cecilia Vecoli, MSc, PhD, is a Researcher at the Molecular Epidemiology and Genetics Unit, Institute of Clinical Physiology, National Research Council (CNR-IFC), Pisa, Italy
Luca Labate
Luca Labate, MSc, PhD, is a Researcher at the Intense Laser Irradiation Laboratory, National Institute of Optics, National Research Council (CNR-INO), Pisa, Italy
Daniele Panetta
Daniele Panetta, MSc, MPE, is a Researcher at the Micro-PET/CT Imaging Laboratory of Institute of Clinical Physiology, National Research Council (CNR-IFC), Pisa, Italy
Maria Grazia Andreassi
Maria Grazia Andreassi, MSc, PhD, is a Research Director and Group Leader of the Molecular Epidemiology and Genetics Unit, Institute of Clinical Physiology, National Research Council (CNR-IFC), Pisa, Italy
Leonida A. Gizzi
Leonida A. Gizzi, MSc, PhD, is a Research Director and Group Leader of the Intense Laser Irradiation Laboratory at the National Institute of Optics, National Research Council (CNR-INO), Pisa, Italy