Evidence map›Paper›PMID 38655137›Full record

SynthesisFrontiers in oncology2024

Electron FLASH radiotherapy in vivo studies. A systematic review.

Noemi Giannini, Giovanni Gadducci, Taiusha Fuentes, Alessandra Gonnelli, Fabio Di Martino, Paola Puccini, Monica Naso, Francesco Pasqualetti, Simone Capaccioli, Fabiola Paiar

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
8.8field-weighted citation impact, top 2% of its field
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

15 citing papers in PubMed, 21 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Chronic radiation-induced dermatitis: what is new in 2024? A narrative review.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026
    Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Mechanisms of the FLASH effect: current insights and advances.Frontiers in cell and developmental biology · 2025
    Review
  15. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Noemi GianniniDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy.
Giovanni GadducciDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy.
Taiusha FuentesDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy.
Alessandra GonnelliDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy.
Fabio Di MartinoCentro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy.
Paola PucciniDepartment of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy.
Monica NasoDepartment of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy.
Francesco PasqualettiDepartment of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy.
Simone CapaccioliCentro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy.
Fabiola PaiarDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy.
University of Pisa · ITAzienda Ospedaliera Universitaria Pisana · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

FLASH-radiotherapy delivers a radiation beam a thousand times faster compared to conventional radiotherapy, reducing radiation damage in healthy tissues with an equivalent tumor response. Although not completely understood, this radiobiological phenomenon has been proved in several animal models with a spectrum of all kinds of particles currently used in contemporary radiotherapy, especially electrons. However, all the research teams have performed FLASH preclinical studies using industrial linear accelerator or LINAC commonly employed in conventional radiotherapy and modified for the delivery of ultra-high-dose-rate (UHDRs). Unfortunately, the delivering and measuring of UHDR beams have been proved not to be completely reliable with such devices. Concerns arise regarding the accuracy of beam monitoring and dosimetry systems. Additionally, this LINAC totally lacks an integrated and dedicated Treatment Planning System (TPS) able to evaluate the internal dose distribution in the case of in vivo experiments. Finally, these devices cannot modify dose-time parameters of the beam relevant to the flash effect, such as average dose rate; dose per pulse; and instantaneous dose rate. This aspect also precludes the exploration of the quantitative relationship with biological phenomena. The dependence on these parameters need to be further investigated. A promising advancement is represented by a new generation of electron LINAC that has successfully overcome some of these technological challenges. In this review, we aim to provide a comprehensive summary of the existing literature on in vivo experiments using electron FLASH radiotherapy and explore the promising clinical perspectives associated with this technology.

Indexed as

beam parametersclinical translationdosimetryelectron FLASHhealthy tissue sparingin vivo studiesUHDRVHEE

Identifiers

PMID38655137
PMCPMC11035725
OpenAlexW4394615887

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.