Evidence map›Paper›PMID 37839557›Full record

ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2024

Dosimetric and biologic intercomparison between electron and proton FLASH beams.

A Almeida, M Togno, P Ballesteros-Zebadua, J Franco-Perez, R Geyer, R Schaefer, B Petit, V Grilj, D Meer, S Safai and 5 more

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Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

A AlmeidaLaboratory of Radiation Oncology/Radiation Oncology Service/Department of Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
M TognoCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland.
P Ballesteros-ZebaduaLaboratory of Radiation Oncology/Radiation Oncology Service/Department of Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico.
J Franco-PerezLaboratory of Radiation Oncology/Radiation Oncology Service/Department of Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico.
R GeyerDepartment of Radiation Oncology, lnselspital, Bern University Hospital, University of Bern, Switzerland.
R SchaeferCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland.
B PetitLaboratory of Radiation Oncology/Radiation Oncology Service/Department of Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
V GriljInstitute of Radiation Physics (IRA)/CHUV, Lausanne University Hospital, Lausanne, Switzerland.
D MeerCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland.
S SafaiCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland.
T LomaxCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland.
D C WeberCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland; Department of Radiation Oncology, lnselspital, Bern University Hospital, University of Bern, Switzerland; Department of Radiation Oncology, University Hospital of Zurich, Switzerland.
C BailatInstitute of Radiation Physics (IRA)/CHUV, Lausanne University Hospital, Lausanne, Switzerland.
S PsoroulasCenter for Proton Therapy, Paul Scherrer Institute, 5323, Villigen, Switzerland.
Marie-Catherine VozeninLaboratory of Radiation Oncology/Radiation Oncology Service/Department of Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Radiotherapy and Radiobiology sector, Radiation Therapy service, University hospital of Geneva, Geneva, Switzerland. Electronic address: marie-catherine.vozenin@chuv.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe FLASH effect has been validated in different preclinical experiments with electrons (eFLASH) and protons (pFLASH) operating at an average dose rate above 40 Gy/s. However, no systematic intercomparison of the FLASH effect produced by eFLASHvs. pFLASH has yet been performed and constitutes the aim of the present study. MATERIALS AND

methodsThe electron eRT6/Oriatron/CHUV/5.5 MeV and proton Gantry1/PSI/170 MeV were used to deliver conventional (0.1 Gy/s eCONV and pCONV) and FLASH (≥110 Gy/s eFLASH and pFLASH) dose rates. Protons were delivered in transmission. Dosimetric and biologic intercomparisons were performed using previously validated dosimetric approaches and experimental murine models.

resultsThe difference between the average absorbed dose measured at Gantry 1 with PSI reference dosimeters and with CHUV/IRA dosimeters was -1.9 % (0.1 Gy/s) and + 2.5 % (110 Gy/s). The neurocognitive capacity of eFLASH and pFLASH irradiated mice was indistinguishable from the control, while both eCONV and pCONV irradiated cohorts showed cognitive decrements. Complete tumor response was obtained after an ablative dose of 20 Gy delivered with the two beams at CONV and FLASH dose rates. Tumor rejection upon rechallenge indicates that anti-tumor immunity was activated independently of the beam-type and the dose-rate.

conclusionDespite major differences in the temporal microstructure of proton and electron beams, this study shows that dosimetric standards can be established. Normal brain protection and tumor control were produced by the two beams. More specifically, normal brain protection was achieved when a single dose of 10 Gy was delivered in 90 ms or less, suggesting that the most important physical parameter driving the FLASH sparing effect might be the mean dose rate. In addition, a systemic anti-tumor immunological memory response was observed in mice exposed to high ablative dose of electron and proton delivered at CONV and FLASH dose rate.

Indexed as

Biological ProductsNeoplasmsProton TherapyAnimalsElectronsHumansMiceProtonsRadiometryRadiotherapy DosageBiological ProductsProtonsDosimetryFLASHIntercomparisonNeurocognitionTumor response

Identifiers

PMID37839557

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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.