Possible mechanisms and simulation modeling of FLASH radiotherapy.

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiological Physics and Technology Pub Date : 2024-03-01 Epub Date: 2024-01-06 DOI:10.1007/s12194-023-00770-x

Yuta Shiraishi, Yusuke Matsuya, Hisanori Fukunaga

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Abstract

FLASH radiotherapy (FLASH-RT) has great potential to improve patient outcomes. It delivers radiation doses at an ultra-high dose rate (UHDR: ≥ 40 Gy/s) in a single instant or a few pulses. Much higher irradiation doses can be administered to tumors with FLASH-RT than with conventional dose rate (0.01-0.40 Gy/s) radiotherapy. UHDR irradiation can suppress toxicity in normal tissues while sustaining antitumor efficiency, which is referred to as the FLASH effect. However, the mechanisms underlying the effects of the FLASH remain unclear. To clarify these mechanisms, the development of simulation models that can contribute to treatment planning for FLASH-RT is still underway. Previous studies indicated that transient oxygen depletion or augmented reactions between secondary reactive species produced by irradiation may be involved in this process. To discuss the possible mechanisms of the FLASH effect and its clinical potential, we summarized the physicochemical, chemical, and biological perspectives as well as the development of simulation modeling for FLASH-RT.

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FLASH 放射治疗的可能机制和模拟模型。

闪烁放疗（FLASH-RT）在改善患者疗效方面具有巨大潜力。它以超高剂量率（UHDR：≥ 40 Gy/s）在一瞬间或几个脉冲中提供放射剂量。与传统的剂量率（0.01-0.40 Gy/s）放疗相比，FLASH-RT 可为肿瘤提供更高的照射剂量。超高剂量放射治疗可以抑制正常组织的毒性，同时保持抗肿瘤效率，这被称为FLASH效应。然而，FLASH效应的机制仍不清楚。为了阐明这些机制，目前仍在开发有助于制定 FLASH-RT 治疗计划的模拟模型。以往的研究表明，辐照产生的瞬时氧耗竭或二次反应物之间的反应增强可能参与了这一过程。为了讨论FLASH效应的可能机制及其临床潜力，我们总结了物理化学、化学和生物学角度以及FLASH-RT模拟模型的开发情况。

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来源期刊

Radiological Physics and Technology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.00

自引率

12.50%

发文量

期刊介绍： The purpose of the journal Radiological Physics and Technology is to provide a forum for sharing new knowledge related to research and development in radiological science and technology, including medical physics and radiological technology in diagnostic radiology, nuclear medicine, and radiation therapy among many other radiological disciplines, as well as to contribute to progress and improvement in medical practice and patient health care.