ArticleRadiation oncology (London, England)2025
Preclinical validation of a clinical prototype of intraoperative electron FLASH radiotherapy equipment: key evidence for a new radiotherapy paradigm.
Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
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13 authors.
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Abstract
background and purposeThis study aimed to evaluate whether the clinical prototype of intraoperative electron FLASH radiotherapy (CPIO-EFLASH), with a source-surface distance (SSD) of 50 cm, could achieve ultra-high dose rates, effectively control tumors, and trigger the FLASH tissue-sparing effect in preclinical models. MATERIALS AND
methodsSubcutaneous tumor-bearing mice (4T1 breast cancer, U87-MG glioma, PAN02 pancreatic cancer) and healthy C57BL/6 female mice (whole-brain, thorax, abdomen and single-leg irradiation) were subjected with ultra-high dose rate radiotherapy (UHDR-RT, ≥ 40 Gy/s), conventional doserate radiotherapy (CONV-RT,0.07 Gy/s), or sham radiotherapy (Control). We evaluated survival status, tumor growth suppression, apoptosis, proliferation, and DNA damage in tumor tissues, along with radiation-induced injuries to the brain, lung, intestine, and skin tissues.
resultsThe actual dose rates of UHDR-RT ranged from 192 to 473 Gy/s. No significant difference in tumor growth suppression was observed between the UHDR-RT and CONV-RT. Two months post whole-brain irradiation, UHDR-RT demonstrated better spatial learning and memory abilities compared to CONV-RT. At 120 days post whole-thorax irradiation and 90 days post whole-abdomen irradiation, the survival rates of UHDR-RT were also significantly higher. Histological analyses revealed more severe injury to lung and intestinal tissues in the CONV-RT group. Additionally, UHDR-RT exhibited milder radiation-induced skin injury from 2 to 8 weeks post-irradiation.
conclusionThe CPIO-EFLASH can achieve ultra-high dose rates (≥ 40 Gy/s at an SSD of 50 cm) and trigger significant normal tissue-sparing effects. Integrating electronic FLASH technology into intraoperative radiotherapy may bring potential clinical benefits by effectively treating tumors, while minimizing radiation-induced injury to normal tissues. Our findings highlight the necessity for further clinical trials of CPIO-EFLASH in intraoperative radiotherapy.
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