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Review

FLASH Radiotherapy: Current Knowledge and Future Insights Using Proton-Beam Therapy

1
Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, 200 London Road, Liverpool L3 9TA, UK
2
Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington CH63 4JY, UK
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(18), 6492; https://doi.org/10.3390/ijms21186492
Received: 31 July 2020 / Revised: 1 September 2020 / Accepted: 2 September 2020 / Published: 5 September 2020
(This article belongs to the Special Issue Radiation Damage in Biomolecules and Cells)
FLASH radiotherapy is the delivery of ultra-high dose rate radiation several orders of magnitude higher than what is currently used in conventional clinical radiotherapy, and has the potential to revolutionize the future of cancer treatment. FLASH radiotherapy induces a phenomenon known as the FLASH effect, whereby the ultra-high dose rate radiation reduces the normal tissue toxicities commonly associated with conventional radiotherapy, while still maintaining local tumor control. The underlying mechanism(s) responsible for the FLASH effect are yet to be fully elucidated, but a prominent role for oxygen tension and reactive oxygen species production is the most current valid hypothesis. The FLASH effect has been confirmed in many studies in recent years, both in vitro and in vivo, with even the first patient with T-cell cutaneous lymphoma being treated using FLASH radiotherapy. However, most of the studies into FLASH radiotherapy have used electron beams that have low tissue penetration, which presents a limitation for translation into clinical practice. A promising alternate FLASH delivery method is via proton beam therapy, as the dose can be deposited deeper within the tissue. However, studies into FLASH protons are currently sparse. This review will summarize FLASH radiotherapy research conducted to date and the current theories explaining the FLASH effect, with an emphasis on the future potential for FLASH proton beam therapy. View Full-Text
Keywords: FLASH; ionizing radiation; proton beam therapy; radiotherapy; radiobiology FLASH; ionizing radiation; proton beam therapy; radiotherapy; radiobiology
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MDPI and ACS Style

Hughes, J.R.; Parsons, J.L. FLASH Radiotherapy: Current Knowledge and Future Insights Using Proton-Beam Therapy. Int. J. Mol. Sci. 2020, 21, 6492. https://doi.org/10.3390/ijms21186492

AMA Style

Hughes JR, Parsons JL. FLASH Radiotherapy: Current Knowledge and Future Insights Using Proton-Beam Therapy. International Journal of Molecular Sciences. 2020; 21(18):6492. https://doi.org/10.3390/ijms21186492

Chicago/Turabian Style

Hughes, Jonathan R., and Jason L. Parsons 2020. "FLASH Radiotherapy: Current Knowledge and Future Insights Using Proton-Beam Therapy" International Journal of Molecular Sciences 21, no. 18: 6492. https://doi.org/10.3390/ijms21186492

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