Evidence map›Paper›PMID 41080989›Full record

ArticleClinical and translational radiation oncology2026

First-in-human e-Flash radiotherapy using a modified conventional C-arm linear accelerator.

Jens von der Grün, Riccardo Dal Bello, Serena Psoroulas, Jerome Krayenbuehl, Debra Fesslmeier, Egle Ramelyte, Joanna Mangana, Wendy Smith, Marta Vilalta, Lena Tirpak and 4 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06549439 (A Phase I Clinical Study on Feasibility and Toxicity of LINAC-based Flash Radiotherapy for Palliative Treatment of Skin Lesions of Malignant Melanomas), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT06549439 nacompletednot on this map

A Phase I Clinical Study on Feasibility and Toxicity of LINAC-based Flash Radiotherapy for Palliative Treatment of Skin Lesions of Malignant Melanomas

TypeinterventionalSponsorUniversity of ZurichRan2024 to 2026Enrolled7ConditionsMetastatic MelanomaArmsElectron FLASH radiotherapy
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Article
  3. Development and application ofPhysics and imaging in radiation oncology · 2026
    Article
  4. Microenvironmental remodeling in FLASH radiotherapy.Frontiers in cell and developmental biology · 2026
    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

14 authors.

Jens von der GrünDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Riccardo Dal BelloDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Serena PsoroulasDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Jerome KrayenbuehlDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Debra FesslmeierDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Egle RamelyteDepartment of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Joanna ManganaDepartment of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Wendy SmithVarian Medical Systems, Inc., Palo Alto, California, United States.
Marta VilaltaVarian Medical Systems, Inc., Palo Alto, California, United States.
Lena TirpakVarian Medical Systems, Inc., Palo Alto, California, United States.
Ricky A SharmaVarian Medical Systems, Inc., Palo Alto, California, United States.
Matthias GuckenbergerDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Stephanie Tanadini-LangDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Panagiotis BalermpasDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The FLASH effect is considered being the widening of the therapeutic window at (ultra-)high dose rates due to sparing of normal tissues while preserving tumor response. Our goal was to provide first data on the safety in treating a patient using a conventional linear accelerator converted to deliver 9 MeV UHDR electron beams in the research setting. Material & methods: A conventional Varian TrueBeam linac was converted in the research setting to become capable of delivering 9 MeV UHDR electron beams. A phase I trial protocol was approved by the local authorities (NCT06549439). One patient with ≥ 1 melanoma (sub)-cutaneous lesion(s) was treated with 3x 9 Gy. The first two fractions were applied via e-Flash and the third via conventional electrons. Results: Here we present the experience of the first patient treated with e-Flash in a modified conventional linac. The e-Flash fractions were successfully delivered according to the protocol. The film in-vivo dosimetry confirmed correctness of the delivered dose. A good tumor response without severe or unexpected toxicity was observed up to six weeks after treatment. Conclusion: We demonstrate first-in-human application of e-Flash delivered by a modified conventional linear accelerator. Conversion of conventional linacs into e-Flash systems will accelerate testing Flash radiotherapy in clinical trials.

Indexed as

Clinical translationDosimetryElectronsFlash-RTMalignant melanomaUHDR

Identifiers

PMID41080989
PMCPMC12509727

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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.