Faculty, Staff and Student Publications

Publication Date

6-1-2022

Journal

Medical Physics

DOI

10.1002/mp.15623

PMID

35366339

PMCID

PMC9321729

PubMedCentral® Posted Date

4-25-2022

PubMedCentral® Full Text Version

Post-print

Abstract

While FLASH radiation therapy is inspiring enthusiasm to transform the field, it is neither new nor well understood with respect to the radiobiological mechanisms. As FLASH clinical trials are designed, it will be important to ensure we can deliver dose consistently and safely to every patient. Much like hyperthermia and proton therapy, FLASH is a promising new technology that will be complex to implement in the clinic and similarly will require customized credentialing for multi-institutional clinical trials. There is no doubt that FLASH seems promising, but many technologies that we take for granted in conventional radiation oncology, such as rigorous dosimetry, 3D treatment planning, volumetric image guidance, or motion management, may play a major role in defining how to use, or whether to use, FLASH radiotherapy. Given the extended time frame for patients to experience late effects, we recommend moving deliberately but cautiously forward toward clinical trials. In this paper, we review the state of quality assurance and safety systems in FLASH, identify critical pre-clinical data points that need to be defined, and suggest how lessons learned from previous technological advancements will help us close the gaps and build a successful path to evidence-driven FLASH implementation.

Keywords

Clinical Trials as Topic, Credentialing, Humans, Proton Therapy, Radiation Oncology, Radiobiology, Radiotherapy Dosage, FLASH, advanced technology, clinical trials, quality assurance, radiation therapy, ultra-high dose rate

Published Open-Access

yes

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