论文标题

用于闪光疗法的变革性技术:雪地2021白皮书

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

论文作者

Boucher, Salime, Esarey, Eric, Geddes, Cameron, Johnstone, Carol, Kutsaev, Sergey, Loo Jr, 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., van Tilborg, Jeroen

论文摘要

常规的癌症疗法包括手术,放射治疗,化学疗法以及最近的免疫疗法。这些方式通常是合并的,以改善治疗指数。放射疗法的一般概念是通过在肿瘤和正常组织之间通过精确剂量靶向,图像引导和高辐射梁在肿瘤和正常组织之间产生物理剂量差来增加治疗指数,从而提供具有高保险性的辐射剂量,例如质子和离子。但是,治疗和治愈仍然受到正常组织辐射毒性的限制,许多患者患有急性和长期副作用。然而,最近,出现了一种从根本上不同的,用于增加放射治疗的治疗指数,并得到临床前研究的支持,并基于闪光辐射效应。 Flash辐射疗法(Flash-RT)是在一秒钟内的治疗辐射剂量的超高剂量率递送。实验研究表明,正常组织似乎在这些高剂量速率下普遍幸免,而肿瘤则没有。剂量输送条件尚未完全表征。尽管如此,目前据估计,在200 ms或更少的情况下,大剂量的10 Gy或更多剂量会产生正常的组织保留效应,但有效地杀死了肿瘤细胞。加速器社区有一个很大的机会,但也有许多技术挑战,可以通过新颖和紧凑的加速器创建所需的剂量率,以确保安全交付闪光灯光束。

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.

扫码加入交流群

加入微信交流群

微信交流群二维码

扫码加入学术交流群,获取更多资源