ArticleInternational journal of radiation oncology, biology, physics2020
Design, Implementation, and in Vivo Validation of a Novel Proton FLASH Radiation Therapy System.
Article in International journal of radiation oncology, biology, physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 239 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
239 citing papers in PubMed, 4 syntheses or guidelines pooled it, 454 citations in OpenAlex.
- Global clinical landscape and multidisciplinary translational frontiers of FLASH radiotherapy: a systematic review and visualized bibliometric mapping based on WoSCC and PubMed (2014-2025).Frontiers in medicine · 2026Pooled it
- The evolution of FLASH radiotherapy: a bibliometric analysis.Frontiers in oncology · 2025Pooled it
- The FLASH effect-an evaluation of preclinical studies of ultra-high dose rate radiotherapy.Frontiers in oncology · 2024Pooled it
- The current status of FLASH particle therapy: a systematic review.Physical and engineering sciences in medicine · 2023Pooled it
- X‑ray FLASH RT inhibits lung cancer bone metastasis via activating CD4⁺ T-cell‑mediated antitumor immunity with modulation of Th17 cell response.Oncoimmunology · 2026Article
- Basis and prospects of radiotherapy combined with high-intensity focused ultrasound ablation (Review).Oncology letters · 2026Review
- Development of in situ dosimetry for FLASH proton radiotherapy via organic scintillating fibers.The British journal of radiology · 2026Article
- Expanding dose and dose-rate capabilities of a synchrotron-based pre-clinical proton FLASH irradiation platform.Medical physics · 2026Article
- Harnessing Particle Ions for FLASH Radiotherapy.Cells · 2026Review
- Commissioning and Validation of a Synchrocyclotron - Based Ultra-High-Dose-Rate Beamline for FLASH.International journal of particle therapy · 2026Article
- Structural and Functional Characteristics of the Liver After Fractionated Local Electron Irradiation and Against the Background of Ascorbic Acid Administration.Journal of personalized medicine · 2026Review
- Harnessing the sparing effect of FLASH-RT: From phenomenon observation, radiophysical determinants to molecular mechanisms and synergistic strategies.Materials today. Bio · 2026Review
- Radiotherapy and tertiary lymphoid structures: balancing immune activation and immune damage in cancer immunotherapy.Molecular cancer · 2026Review
- Article
- Volumetric FLASH dosimetryPhysics in medicine and biology · 2026Article
- Conditional sparing in FLASH radiotherapy: Conformal dosimetry and ALARA remain essential.Journal of applied clinical medical physics · 2026Review
- Spatially fractionated radiation therapy (SFRT): a scoping review of dosimetric and biological evidence supporting a valley dose-driven translational framework.Radiation oncology (London, England) · 2026Article
- Musculoskeletal and Marrow Sparing With Proton FLASH Radiation Therapy in Juvenile Mice.International journal of radiation oncology, biology, physics · 2026Article
- FLASH radiotherapy enables dose escalation resulting in improved survival in an orthotopic muscle-invasive bladder cancer mouse model.The British journal of radiology · 2026Article
- A beam model and Boltzmann solver for radiotherapy treatment planning of superficial brain metastases using a scanned electron beam at ultra-high (FLASH) dose rate.Physics in medicine and biology · 2026Article
179 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
22 authors at 1 institution in 1 country.
Funding
Abstract
purposeRecent studies suggest that ultrahigh-dose-rate, "FLASH," electron radiation therapy (RT) decreases normal tissue damage while maintaining tumor response compared with conventional dose rate RT. Here, we describe a novel RT apparatus that delivers FLASH proton RT (PRT) using double scattered protons with computed tomography guidance and provide the first report of proton FLASH RT-mediated normal tissue radioprotection. METHODS AND MATERIALS: Absolute dose was measured at multiple depths in solid water and validated against an absolute integral charge measurement using a Faraday cup. Real-time dose rate was obtained using a NaI detector to measure prompt gamma rays. The effect of FLASH versus standard dose rate PRT on tumors and normal tissues was measured using pancreatic flank tumors (MH641905) derived from the KPC autochthonous PanCa model in syngeneic C57BL/6J mice with analysis of fibrosis and stem cell repopulation in small intestine after abdominal irradiation.
resultsThe double scattering and collimation apparatus was dosimetrically validated with dose rates of 78 ± 9 Gy per second and 0.9 ± 0.08 Gy per second for the FLASH and standard PRT. Whole abdominal FLASH PRT at 15 Gy significantly reduced the loss of proliferating cells in intestinal crypts compared with standard PRT. Studies with local intestinal irradiation at 18 Gy revealed a reduction to near baseline levels of intestinal fibrosis for FLASH-PRT compared with standard PRT. Despite this difference, FLASH-PRT did not demonstrate tumor radioprotection in MH641905 pancreatic cancer flank tumors after 12 or 18 Gy irradiation.
conclusionsWe have designed and dosimetrically validated a FLASH-PRT system with accurate control of beam flux on a millisecond time scale and online monitoring of the integral and dose delivery time structure. Using this system, we found that FLASH-PRT decreases acute cell loss and late fibrosis after whole-abdomen and focal intestinal RT, whereas tumor growth inhibition is preserved between the 2 modalities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.