ArticleCancers2021
Quantitative Assessment of 3D Dose Rate for Proton Pencil Beam Scanning FLASH Radiotherapy and Its Application for Lung Hypofractionation Treatment Planning.
Article in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.
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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
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- American Radium Society Appropriate Use Criteria Systematic Review and Guidelines on Reirradiation for Non-Small Cell Lung Cancer Executive Summary.International journal of radiation oncology, biology, physics · 2025Guideline
- Impact assessment of current knowledge gaps and mitigation strategies in clinical FLASH proton therapy through a systematic review.Frontiers in oncology · 2025Pooled it
- The evolution of FLASH radiotherapy: a bibliometric analysis.Frontiers in oncology · 2025Pooled it
- Towards FLASH Radiotherapy in Lung Cancer: A Review on Preclinical Evidence and Technical Feasibility.Cancers · 2026Review
- Conditional sparing in FLASH radiotherapy: Conformal dosimetry and ALARA remain essential.Journal of applied clinical medical physics · 2026Review
- Proton Bragg peak flash stereotactic radiosurgery for recurrent glioblastoma reirradiation.Physics and imaging in radiation oncology · 2026Article
- Review
- FLASH Radiotherapy in Lung Cancer: Translational Mechanisms, Preclinical Evidence, and Barriers.Cureus · 2026Review
- Novel Bragg peak FLASH radiotherapy: treatment of base-of-skull tumors within existing clinical guidelines.Frontiers in oncology · 2026Article
- Comparison of protons and very high-energy electrons transmission pencil-beam-scanning for FLASH radiotherapy.Physics and imaging in radiation oncology · 2025Article
- Implementation of a novel pencil beam scanning Bragg peak FLASH technique to a commercial treatment planning system.Medical physics · 2025Article
- Design and characterization of a novel scintillator array for UHDR PBS proton therapy surface dosimetry.Medical physics · 2025Article
- FLASH Stereotactic Body Radiation Therapy for Spine Tumors Using a Single-Energy Proton Pristine Bragg Peak Delivery Technique.Advances in radiation oncology · 2025Article
- FLASH Radiotherapy: Benefits, Mechanisms, and Obstacles to Its Clinical Application.International journal of molecular sciences · 2024Review
- Optimizing focused very-high-energy electron beams for radiation therapy based on Monte Carlo simulation.Scientific reports · 2024Article
- Optimal minimum MU for intensity-modulated proton therapy with pencil-beam scanning proton beams.Journal of applied clinical medical physics · 2024Article
- CERN-based experiments and Monte-Carlo studies on focused dose delivery with very high energy electron (VHEE) beams for radiotherapy applications.Scientific reports · 2024Article
- Development and benchmarking of a dose rate engine for raster-scanned FLASH helium ions.Medical physics · 2024Article
- Pencil Beam Scanning Proton Bragg Peak Conformal FLASH in Prostate Cancer Stereotactic Body Radiotherapy.Cancers · 2024Article
- Diamond detectors for dose and instantaneous dose-rate measurements for ultra-high dose-rate scanned helium ion beams.Medical physics · 2024Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To quantitatively assess target and organs-at-risk (OAR) dose rate based on three proposed proton PBS dose rate metrics and study FLASH intensity-modulated proton therapy (IMPT) treatment planning using transmission beams. An in-house FLASH planning platform was developed to optimize transmission (shoot-through) plans for nine consecutive lung cancer patients previously planned with proton SBRT. Dose and dose rate calculation codes were developed to quantify three types of dose rate calculation methods (dose-averaged dose rate (DADR), average dose rate (ADR), and dose-threshold dose rate (DTDR)) based on both phantom and patient treatment plans. Two different minimum MU/spot settings were used to optimize two different dose regimes, 34-Gy in one fraction and 45-Gy in three fractions. The OAR sparing and target coverage can be optimized with good uniformity (hotspot < 110% of prescription dose). ADR, accounting for the spot dwelling and scanning time, gives the lowest dose rate; DTDR, not considering this time but a dose-threshold, gives an intermediate dose rate, whereas DADR gives the highest dose rate without considering any time or dose-threshold. All three dose rates attenuate along the beam direction, and the highest dose rate regions often occur on the field edge for ADR and DTDR, whereas DADR has a better dose rate uniformity. The differences in dose rate metrics have led a large variation for OARs dose rate assessment, posing challenges to FLASH clinical implementation. This is the first attempt to study the impact of the dose rate models, and more investigations and evidence for the details of proton PBS FLASH parameters are needed to explore the correlation between FLASH efficacy and the dose rate metrics.
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Registered trials
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