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Journal article

Ultra-high dose rate (FLASH) radiotherapy: silver bullet or fool’s gold?

Abstract:
Radiotherapy is a cornerstone of both curative and palliative cancer care. However, radiotherapy is severely limited by radiation-induced toxicities. If these toxicities could be reduced, a greater dose of radiation could be given therefore facilitating a better tumor response. Initial pre-clinical studies have shown that irradiation at dose rates far exceeding those currently used in clinical contexts reduce radiation-induced toxicities whilst maintaining an equivalent tumor response. This is known as the FLASH effect. To date, a single patient has been subjected to FLASH radiotherapy for the treatment of subcutaneous T-cell lymphoma resulting in complete response and minimal toxicities. The mechanism responsible for reduced tissue toxicity following FLASH radiotherapy is yet to be elucidated, but the most prominent hypothesis so far proposed is that acute oxygen depletion occurs within the irradiated tissue. This review examines the tissue response to FLASH radiotherapy, critically evaluates the evidence supporting hypotheses surrounding the biological basis of the FLASH effect, and considers the potential for FLASH radiotherapy to be translated into clinical contexts. Introduction
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3389/fonc.2019.01563

Authors

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Institution:
University of Oxford
Department:
Oncology
Role:
Author
More by this author
Institution:
University of Oxford
Department:
Oncology
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Oncology
Sub department:
CRUK/MRC Ox Inst for Radiation Oncology
Role:
Author
ORCID:
0000-0003-3072-909X
More by this author
Institution:
University of Oxford
Department:
Oncology
Role:
Author


Publisher:
Frontiers Media
Journal:
Frontiers in Oncology More from this journal
Volume:
9
Article number:
1563
Publication date:
2020-01-17
Acceptance date:
2019-12-24
DOI:
EISSN:
ESSN: 2234-943X


Language:
English
Keywords:
Pubs id:
pubs:1078926
UUID:
uuid:3e1d20c4-5ed8-466e-aa9a-af3af2c41f2e
Local pid:
pubs:1078926
Source identifiers:
1078926
Deposit date:
2019-12-24
ARK identifier:

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