Left panel: The setup of a canine cancer patient (a), overlayed with the resulting surface image (b). Right panel: Position (mm) relative to reference surface over time (min); red bars indicate motion exceeding tolerance and the grey bar indicates the time for beam on.
Why is there an interest in FLASH-RT?
As stated earlier, if high doses of precise radiation can target tumors effectively, while reducing side effects, could higher doses produce even better results in fewer treatments?
Take for example, delivering radiation therapy to a lung tumor. The standard radiobiological model used to predict the effectiveness and toxicities of a radiation therapy course of treatment tells us that the cumulative effective dose of the treatment determines the effect on the tumor while an increasing number of individual treatment fractions reduces the toxic effects of radiation – mostly due to radiation delivered to normal tissue.
As technology has improved – giving us the ability to deliver higher doses of radiation, more accurately, and with greater precision, while reducing the dose to normal tissue – clinicians have been confident that they could achieve the same clinical results in fewer treatments.
The early research that has been done to date shows that FLASH-RT could lead to an improvement in the effectiveness of radiation therapy. It appears that delivering radiation therapy at extremely high dose rates in fewer treatments with FLASH-RT actually delivers better results with better local control of the tumor and reduced toxic side effects. More research is underway and precise positioning with animal models (and humans) with a system like Catalyst is critical to ensure accurate and safe radiation delivery, especially with these high doses.
Parts of the research team at Lund University and Skåne University Hospital, Lund, Sweden inside the bunker with the linac used for the FLASH studies. From left: Annika Mannerberg, Sofie Ceberg, Michael Lempart, Kristoffer Petersson, Tommy Knöös, Elise Konradsson, Börje Blad, Gabriel Adrian and Crister Ceberg.
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