Clinical translation of FLASH radiotherapy: Why and how?

Jean Bourhis; Pierre Montay-Gruel; Patrik Gonçalves Jorge; Claude Bailat; Benoît Petit; Jonathan Ollivier; Wendy Jeanneret-Sozzi; Mahmut Ozsahin; François Bochud; Raphaël Moeckli; Jean-François Germond; Marie-Catherine Vozenin

doi:10.1016/j.radonc.2019.04.008

Clinical translation of FLASH radiotherapy: Why and how?

Radiother Oncol. 2019 Oct:139:11-17. doi: 10.1016/j.radonc.2019.04.008. Epub 2019 Jun 25.

Affiliations

¹ Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland; Radiation Oncology Laboratory, Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland. Electronic address: jean.bourhis@chuv.ch.
² Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland; Radiation Oncology Laboratory, Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland.
³ Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland; Radiation Oncology Laboratory, Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland; Institute of Radiation Physics, Lausanne University Hospital Lausanne University, Switzerland.
⁴ Institute of Radiation Physics, Lausanne University Hospital Lausanne University, Switzerland.
⁵ Department of Radiation Oncology, Department of Oncology, Lausanne University Hospital and Lausanne University, Switzerland.

PMID: 31253466
DOI: 10.1016/j.radonc.2019.04.008

Abstract

Over the past decades, technological advances have transformed radiation therapy (RT) into a precise and powerful treatment for cancer patients. Nevertheless, the treatment of radiation-resistant tumors is still restricted by the dose-limiting normal tissue complications. In this context, FLASH-RT is emerging in the field. Consisting of delivering doses within an extremely short irradiation time, FLASH-RT has been identified as a promising new tool to enhance the differential effect between tumors and normal tissues. Indeed, preclinical studies on various animal models and a veterinarian clinical trial have recently shown that compared to conventional dose-rate RT, FLASH-RT could control tumors while minimizing normal tissue toxicity. In the present review, we summarize the main data supporting the clinical translation of FLASH-RT and explore its feasibility, the key irradiation parameters and the potential technologies needed for a successful clinical translation.

Keywords: Clinical trial; Differential effect; FLASH-radiotherapy; Normal tissue protection.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Animals
Humans
Neoplasms / radiotherapy*
Radiotherapy / methods*
Radiotherapy Dosage