Transformative Technology for FLASH Radiation Therapy: A Snowmass 2021 White Paper

Conventional cancer therapies include surgery, radiation therapy, chemotherapy, and, more recently, immunotherapy. These modalities are often combined to improve the therapeutic index. The general concept of radiation therapy is to increase the therapeutic index by creating a physical dose different...

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Bibliographic Details
Published in:arXiv.org 2022-03
Main Authors: Boucher, Salime, Esarey, Eric, Geddes, Cameron, Johnstone, Carol, Kutsaev, Sergey, Loo, Billy W, Méot, Francois, Mustapha, Brahim, Nakamura, Kei, Nanni, Emilio, Obst-Huebl, Lieselotte, Sampayan, Stephen E, Schroeder, Carl, Schulte, Reinhard, Sheng, Ke, Snijders, Antoine, Snively, Emma, Tantawi, Sami G, Jeroen van Tilborg
Format: Article
Language:English
Subjects:
Radiation dosage
Radiation therapy
Side effects
Toxicity
Tumors
Online Access:Get full text
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Summary:Conventional cancer therapies include surgery, radiation therapy, chemotherapy, and, more recently, immunotherapy. These modalities are often combined to improve the therapeutic index. The general concept of radiation therapy is to increase the therapeutic index by creating a physical dose differential between tumors and normal tissues through precision dose targeting, image guidance, and high radiation beams that deliver radiation dose with high conformality, e.g., protons and ions. However, treatment and cure are still limited by normal tissue radiation toxicity, with many patients experiencing acute and long-term side effects. Recently, however, a fundamentally different paradigm for increasing the therapeutic index of radiation therapy has emerged, supported by preclinical research, and based on the FLASH radiation effect. FLASH radiation therapy (FLASH-RT) is an ultra-high dose-rate delivery of a therapeutic radiation dose within a fraction of a second. Experimental studies have shown that normal tissues seem to be universally spared at these high dose rates, whereas tumors are not. The dose delivery conditions are not yet fully characterized. Still, it is currently estimated that large doses of 10 Gy or more delivered in 200 ms or less produce normal tissue sparing effects yet effectively kill tumor cells. There is a great opportunity, but also many technical challenges, for the accelerator community to create the required dose rates with novel and compact accelerators to ensure the safe delivery of FLASH radiation beams.
ISSN:2331-8422