ArticleAdvances in radiation oncology2024
Anesthetic Oxygen Use and Sex Are Critical Factors in the FLASH Sparing Effect.
Article in Advances in radiation oncology, 2024. 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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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.
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Who cites it
22 citing papers in PubMed.
- Article
- Article
- Systematic tissue oxygen variation shows the modulation of murine skin radiation toxicity at ultra-high dose rates.Physics in medicine and biology · 2026Article
- Article
- Timescale of FLASH Sparing Effect Determined by Varying Temporal Split of Dose Delivery in Mice.International journal of radiation oncology, biology, physics · 2026Article
- FLASH radiotherapy preserves systemic and tissue homeostasis while maintaining antitumor efficacy.BMC medicine · 2026Article
- Investigating the oxygen dependence of FLASH-RT using electron paramagnetic resonance imaging.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026Article
- Systematic analysis of biological endpoint variability and implications for quantitative modeling of the FLASH sparing effect.Physics and imaging in radiation oncology · 2026Review
- In vitro oxygen concentration alters reactive oxygen species yields with minor plasmid DNA damage change at ultra-high-dose rate.The British journal of radiology · 2026Article
- The potential and risks of FLASH radiotherapy in pediatric patients.Neuro-oncology pediatrics · 2026Review
- FLASH effect is diminished by daily fractionation of electron RT in mouse skin.Physics in medicine and biology · 2025Article
- 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
- Emerging Technologies in Radiation Therapy: Replacing Traditional Isotope-based Modalities.Health physics · 2025Review
- Dynamic oxygen assessment techniques enable determination of anesthesia's impact on tissue.Scientific reports · 2025Article
- Medical physics dataset article: A database of FLASH murine in vivo studies.Medical physics · 2025Article
- Oxygen Consumption In Vivo by Ultra-High Dose Rate Electron Irradiation Depends Upon Baseline Tissue Oxygenation.International journal of radiation oncology, biology, physics · 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
- FLASH Radiotherapy: What Can FLASH's Ultra High Dose Rate Offer to the Treatment of Patients With Sarcoma?Seminars in radiation oncology · 2024Review
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
Purpose: Ultra High Dose-Rate (UHDR) radiation has been reported to spare normal tissue, compared with Conventional Dose-Rate (CDR) radiation. However, important work remains to be done to improve the reproducibility of the FLASH effect. A better understanding of the biologic factors that modulate the FLASH effect may shed light on the mechanism of FLASH sparing. Here, we evaluated whether sex and/or the use of 100% oxygen as a carrier gas during irradiation contribute to the variability of the FLASH effect. Methods and Materials: C57BL/6 mice (24 male, 24 female) were anesthetized using isoflurane mixed with either room air or 100% oxygen. Subsequently, the mice received 27 Gy of either 9 MeV electron UHDR or CDR to a 1.6 cm Results: Neither supplemental oxygen nor sex affected time to ulceration in CDR irradiated mice. In the UHDR group, skin damage occured earlier in male and female mice that received 100% oxygen compared room air and female mice ulcerated sooner than male mice. However, there was no significant difference in time to ulceration between male and female UHDR mice that received room air. Oxygen measurements showed that tissue oxygenation was significantly higher when using 100% oxygen as the anesthesia carrier gas than when using room air, and female mice showed higher levels of tissue oxygenation than male mice under 100% oxygen. Conclusions: The skin FLASH sparing effect is significantly reduced when using oxygen during anesthesia rather than room air. FLASH sparing was also reduced in female mice compared to male mice. Both tissue oxygenation and sex are likely sources of variability in UHDR studies. These results suggest an oxygen-based mechanism for FLASH, as well as a key role for sex in the FLASH skin sparing effect.
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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.