FLASH radiotherapy (FLASH RT) is an innovative modality in cancer treatment that delivers ultrahigh dose rates (UHDRs), distinguishing it from conventional radiotherapy (CRT). FLASH RT has demonstrated the potential to enhance the therapeutic window by reducing radiation-induced damage to normal tissues while maintaining tumor control, a phenomenon termed the FLASH effect. Despite promising outcomes, the precise mechanisms underlying the FLASH effect remain elusive and are a focal point of current research. This review explores the metabolic and cellular responses to FLASH RT compared to CRT, with particular focus on the differential impacts on normal and tumor tissues. Key findings suggest that FLASH RT may mitigate damage in healthy tissues via altered reactive oxygen species (ROS) dynamics, which attenuate downstream oxidative damage. Studies indicate the FLASH RT influences iron metabolism and lipid peroxidation pathways differently than CRT. Additionally, various studies indicate that FLASH RT promotes the preservation of mitochondrial integrity and function, which helps maintain apoptotic pathways in normal tissues, attenuating damage. Current knowledge of the metabolic influences following FLASH RT highlights its potential to minimize toxicity in normal tissues, while also emphasizing the need for further studies in biologically relevant, complex systems to better understand its clinical potential. By targeting distinct metabolic pathways, FLASH RT could represent a transformative advance in RT, ultimately improving the therapeutic window for cancer treatment.
FLASH放射治疗（FLASH RT）是一种创新的癌症治疗模式，其通过提供超高剂量率（UHDRs）区别于常规放射治疗（CRT）。FLASH RT已显示出通过减少对正常组织的辐射损伤同时维持肿瘤控制来扩大治疗窗口的潜力，这一现象被称为FLASH效应。尽管结果令人鼓舞，但FLASH效应的确切机制仍不明确，是当前研究的焦点。本综述探讨了FLASH RT与CRT相比引发的代谢和细胞反应，特别关注其对正常组织和肿瘤组织的差异影响。关键发现表明，FLASH RT可能通过改变活性氧（ROS）动力学来减轻健康组织的损伤，从而减弱下游的氧化损伤。研究表明，FLASH RT对铁代谢和脂质过氧化途径的影响与CRT不同。此外，多项研究指出，FLASH RT有助于保持线粒体的完整性和功能，从而在正常组织中维持凋亡通路，减轻损伤。目前关于FLASH RT后代谢影响的认识，突显了其最小化正常组织毒性的潜力，同时也强调需要在生物学相关的复杂系统中进行进一步研究，以更好地理解其临床潜力。通过靶向不同的代谢途径，FLASH RT可能代表放射治疗领域的一次变革性进步，最终改善癌症治疗的治疗窗口。
肿瘤(癌症)患者之家