ArticleMedical physics2022
The minimal FLASH sparing effect needed to compensate the increase of radiobiological damage due to hypofractionation for late-reacting tissues.
Article in Medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact assessment of current knowledge gaps and mitigation strategies in clinical FLASH proton therapy through a systematic review.Frontiers in oncology · 2025Pooled it
- Towards FLASH Radiotherapy in Lung Cancer: A Review on Preclinical Evidence and Technical Feasibility.Cancers · 2026Review
- Systematic analysis of biological endpoint variability and implications for quantitative modeling of the FLASH sparing effect.Physics and imaging in radiation oncology · 2026Review
- Mechanisms, challenges and opportunities for FLASH radiotherapy in cancer.Nature reviews. Cancer · 2026Review
- Equilibrium state dynamics-based modeling of temporal dose delivery dependencies of FLASH skin sparing.Medical physics · 2025Article
- FLASH effect is diminished by daily fractionation of electron RT in mouse skin.Physics in medicine and biology · 2025Article
- Embracing the Future of Clinical Trials in Radiation Therapy: An NRG Oncology CIRO Technology Retreat Whitepaper on Pioneering Technologies and AI-Driven Solutions.International journal of radiation oncology, biology, physics · 2025Review
- Mathematical modeling in radiotherapy for cancer: a comprehensive narrative review.Radiation oncology (London, England) · 2025Review
- Review
- Major contributors to FLASH sparing efficacy emerge from murine skin studies: dose rate, total dose per fraction, anesthesia and oxygenation.Frontiers in oncology · 2024Review
- Navigating the straits: realizing the potential of proton FLASH through physics advances and further pre-clinical characterization.Frontiers in oncology · 2024Review
- Independent Reproduction of the FLASH Effect on the Gastrointestinal Tract: A Multi-Institutional Comparative Study.Cancers · 2023Article
- Do We Preserve Tumor Control Probability (TCP) in FLASH Radiotherapy? A Model-Based Analysis.International journal of molecular sciences · 2023Article
- The minimal FLASH sparing effect needed to compensate the increase of radiobiological damage due to hypofractionation for late-reacting tissues.Medical physics · 2022Article
- To FLASH or to Fractionate? That is the question.Zeitschrift fur medizinische Physik · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
purposeNormal tissue (NT) sparing by ultra-high dose rate (UHDR) irradiations compared to conventional dose rate (CONV) irradiations while being isotoxic to the tumor has been termed "FLASH effect" and has been observed when large doses per fraction (d ≳ 5 Gy) have been delivered. Since hypofractionated treatment schedules are known to increase toxicities of late-reacting tissues compared to normofractionated schedules for many clinical scenarios at CONV dose rates, we developed a formalism based on the biologically effective dose (BED) to assess the minimum magnitude of the FLASH effect needed to compensate the loss of late-reacting NT sparing when reducing the number of fractions compared to a normofractionated CONV treatment schedule while remaining isoeffective to the tumor.
methodsBy requiring the same BED for the tumor, we derived the "break-even NT sparing weighting factor" W
resultsFor many clinically relevant scenarios, W
conclusionsWe developed a formalism that quantifies the minimal NT sparing by the FLASH effect needed to compensate for hypofractionation, based on the LQ and LQ-L models. For a given hypofractionated UHDR treatment scenario and magnitude of the FLASH effect, the formalism predicts if a net NT sparing benefit is expected compared to a respective normofractionated CONV treatment.
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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.