Democratizing FLASH Radiotherapy

IF 2.6 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology Pub Date : 2024-06-14 DOI:10.1016/j.semradonc.2024.05.001

Michele Moreau PhD , Serena Mao MD, PhD , Uriel Ngwa , Sayeda Yasmin-Karim MD, PhD , Debarghya China PhD , Hamed Hooshangnejad PhD , Daniel Sforza PhD , Kai Ding PhD , Heng Li PhD , Mohammad Rezaee PhD , Amol K. Narang MD , Wilfred Ngwa PhD

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引用次数: 0

Abstract

FLASH radiotherapy (RT) is emerging as a potentially revolutionary advancement in cancer treatment, offering the potential to deliver RT at ultra-high dose rates (>40 Gy/s) while significantly reducing damage to healthy tissues. Democratizing FLASH RT by making this cutting-edge approach more accessible and affordable for healthcare systems worldwide would have a substantial impact in global health. Here, we review recent developments in FLASH RT and present perspective on further developments that could facilitate the democratizing of FLASH RT. These include upgrading and validating current technologies that can deliver and measure the FLASH radiation dose with high accuracy and precision, establishing a deeper mechanistic understanding of the FLASH effect, and optimizing dose delivery conditions and parameters for different types of tumors and normal tissues, such as the dose rate, dose fractionation, and beam quality for high efficacy. Furthermore, we examine the potential for democratizing FLASH radioimmunotherapy leveraging evidence that FLASH RT can make the tumor microenvironment more immunogenic, and parallel developments in nanomedicine or use of smart radiotherapy biomaterials for combining RT and immunotherapy. We conclude that the democratization of FLASH radiotherapy represents a major opportunity for concerted cross-disciplinary research collaborations with potential for tremendous impact in reducing radiotherapy disparities and extending the cancer moonshot globally.

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FLASH 放射治疗的民主化

FLASH放射治疗（RT）正在成为癌症治疗领域潜在的革命性进步，它提供了以超高剂量率（40 Gy/s）进行放射治疗的潜力，同时显著减少了对健康组织的损伤。通过让全世界的医疗系统更容易获得和负担得起这种前沿方法，实现 FLASH RT 的民主化，将对全球健康产生重大影响。在此，我们回顾了 FLASH RT 的最新发展，并展望了可促进 FLASH RT 民主化的进一步发展。这些发展包括升级和验证当前能够高精度、高准确度地提供和测量 FLASH 放射剂量的技术，建立对 FLASH 效应更深层次的机理理解，以及针对不同类型的肿瘤和正常组织优化剂量提供条件和参数，如剂量率、剂量分次和射束质量，以实现高疗效。此外，我们还研究了 FLASH 放射免疫疗法的平民化潜力，利用 FLASH RT 可以使肿瘤微环境更具免疫原性的证据，以及纳米医学或使用智能放疗生物材料结合 RT 和免疫疗法的平行发展。我们的结论是，FLASH 放射治疗的平民化是跨学科研究合作的一个重大机遇，有可能对减少放射治疗的不均衡和在全球范围内推广癌症 "登月计划 "产生巨大影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Radiation Oncology 医学-核医学

CiteScore

5.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Each issue of Seminars in Radiation Oncology is compiled by a guest editor to address a specific topic in the specialty, presenting definitive information on areas of rapid change and development. A significant number of articles report new scientific information. Topics covered include tumor biology, diagnosis, medical and surgical management of the patient, and new technologies.