ArticleCommunications medicine2023
Oxygen supplementation in anesthesia can block FLASH effect and anti-tumor immunity in conventional proton therapy.
Article in Communications medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 26 citations in OpenAlex.
- Harnessing the sparing effect of FLASH-RT: From phenomenon observation, radiophysical determinants to molecular mechanisms and synergistic strategies.Materials today. Bio · 2026Review
- Sustained AMPAR expression in CA3 neurons may mediate neuroprotection following FLASH-RT.Cell reports · 2026Article
- Article
- Six-month evaluation of normal mouse brain side effects: Comparing FLASH and conventional proton partial brain irradiation.Clinical and translational radiation oncology · 2026Article
- Neuroprotection following FLASH-RT may be mediated by sustained glutamate receptor AMPAR activation in CA3 neurons.bioRxiv : the preprint server for biology · 2026Article
- Systematic tissue oxygen variation shows the modulation of murine skin radiation toxicity at ultra-high dose rates.Physics in medicine and biology · 2026Article
- Systematic analysis of biological endpoint variability and implications for quantitative modeling of the FLASH sparing effect.Physics and imaging in radiation oncology · 2026Review
- FLASH radiotherapy as an emerging paradigm in radioimmunotherapy: biological rationale, preclinical evidence, and translational roadmap.Frontiers in immunology · 2026Review
- The Implications of Radiotherapy-Induced Cellular Senescence for Cancer Treatment and Tumor Microenvironment Modulation.International journal of biological sciences · 2026Review
- The potential and risks of FLASH radiotherapy in pediatric patients.Neuro-oncology pediatrics · 2026Review
- Factors Influencing the Biological Effects of FLASH Irradiation.Antioxidants (Basel, Switzerland) · 2025Review
- Intermediate tissue oxygen level is required to observe murine FLASH skin sparing.bioRxiv : the preprint server for biology · 2025Article
- Fixation method influences FLASH skin sparing in an in vivo leg model.Acta oncologica (Stockholm, Sweden) · 2025Article
- New Approaches in Radiotherapy.Cancers · 2025Review
- Medical physics dataset article: A database of FLASH murine in vivo studies.Medical physics · 2025Article
- Mini-GRID therapy delivers optimised spatially fractionated radiation therapy using a flattening free filter accelerator.Communications medicine · 2025Article
- Anesthesia is a potent determinant of ultra-high dose rate sparing in the murine total abdominal irradiation model.Frontiers in oncology · 2025Article
- The oxygen puzzle in FLASH radiotherapy: A comprehensive review and experimental outlook.Clinical and translational radiation oncology · 2024Review
- 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
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundRadiation-induced neurocognitive dysfunction is a major adverse effect of brain radiation therapy and has specific relevance in pediatric oncology, where serious cognitive deficits have been reported in survivors of pediatric brain tumors. Moreover, many pediatric patients receive proton therapy under general anesthesia or sedation to guarantee precise ballistics with a high oxygen content for safety. The present study addresses the relevant question of the potential effect of supplemental oxygen administered during anesthesia on normal tissue toxicity and investigates the anti-tumor immune response generated following conventional and FLASH proton therapy.
methodsRats (Fischer 344) were cranially irradiated with a single high dose of proton therapy (15 Gy or 25 Gy) using FLASH dose rate proton irradiation (257 ± 2 Gy/s) or conventional dose rate proton irradiation (4 ± 0.02 Gy/s), and the toxicities in the normal tissue were examined by histological, cytometric and behavioral analysis. Glioblastoma-bearing rats were irradiated in the same manner and tumor-infiltrating leukocytes were quantified by flow cytometry.
resultsOur findings indicate that supplemental oxygen has an adverse impact on both functional and anatomical evaluations of normal brain following conventional and FLASH proton therapy. In addition, oxygen supplementation in anesthesia is particularly detrimental for anti-tumor immune response by preventing a strong immune cell infiltration into tumoral tissues following conventional proton therapy.
conclusionsThese results demonstrate the need to further optimize anesthesia protocols used in radiotherapy with the goal of preserving normal tissues and achieving tumor control, specifically in combination with immunotherapy agents.
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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.