Ultrahigh-dose-rate therapy, also known as FLASH radiotherapy (RT), is an emerging technique that is garnering significant interest in cancer treatment due to its potential to revolutionize therapy. This method can achieve comparable tumor control to conventional-dose-rate RT while offering the enhanced protection of normal tissue through the FLASH-sparing effect. This innovative technique has demonstrated promising results in preclinical studies involving animals and cell lines. Particularly noteworthy is its potential application in treating head and neck (HN) cancers, especially in patients with challenging recurrent tumors and reirradiation cases, where the toxicity rates with conventional radiotherapy are high. Such applications aim to enhance tumor control while minimizing side effects and preserving patients’ quality of life. In comparison to electron or photon FLASH modalities, proton therapy has demonstrated superior dosimetric and delivery characteristics and is a safe and effective FLASH treatment for human malignancies. Compared to the transmission proton FLASH, single-energy Bragg peak FLASH is a novel delivery method that allows highly conformal doses to targets and minimal radiation doses to crucial OARs. Proton Bragg peak FLASH for HN cancer has still not been well studied. This review highlights the significance of proton FLASH in enhancing cancer therapy by examining the advantages and challenges of using it for HN cancer reirradiation.
超高剂量率疗法，又称FLASH放射治疗，是一种新兴技术，因其可能彻底改变癌症治疗方式而备受关注。该方法在实现与传统剂量率放疗相当的肿瘤控制效果的同时，通过FLASH保护效应增强了对正常组织的保护作用。这一创新技术在动物和细胞系的临床前研究中已展现出良好前景。尤其值得注意的是其在头颈部癌症治疗中的潜在应用价值，特别是针对常规放疗毒性反应较高的复杂复发性肿瘤及再程放疗病例。此类应用旨在提升肿瘤控制效果的同时，最大限度减少副作用并维护患者生活质量。相较于电子或光子FLASH模式，质子治疗展现出更优越的剂量学特性和递送特性，已成为人类恶性肿瘤安全有效的FLASH治疗手段。相比透射质子FLASH，单能布拉格峰FLASH作为一种新型递送方式，能够实现高度适形的靶区剂量分布，同时对重要危及器官的辐射剂量降至最低。目前针对头颈部癌症的质子布拉格峰FLASH研究尚不充分。本综述通过探讨质子FLASH在头颈部癌症再程放疗中的应用优势与挑战，重点阐述了该技术在提升癌症治疗效果方面的重要意义。
The Potential and Challenges of Proton FLASH in Head and Neck Cancer Reirradiation
肿瘤(癌症)患者之家