Research: Time is of essence when saving skin during FLASH radiotherapy

A published study by researchers at the University of Cincinnati Cancer Center and Cincinnati Children's Hospital Medical Center shows that multiple beams and intervals in delivery during FLASH proton therapy treatment reduced skin-saving effects in preclinical models.

The study was published in the International Journal of Radiation Oncology, Biology, Physics.

FLASH is an experimental mode of delivering radiation therapy for cancer that can be delivered to a patient in less than one second and which can be over 100 times faster than conventional radiation therapy.

Research in the laboratory suggests that FLASH may be safer than standard forms of radiation and, in many cases, causes fewer side effects, including irritation or burning of the skin.

Sertorio says that the single beam delivery showed a maximum benefit to skin, but when it was interrupted for two minutes and then readministered in the same area, it reduced the FLASH skin-saving effect. After two interruptions, the skin tissue-sparing effect was further eliminated.

"Our results indicate that the FLASH skin-sparing effect in areas of beam overlap were diminished by multiple beams as opposed to single beams," he says. "This study suggests the number of beams and the spatial arrangement of those beams are important parameters for FLASH studies. Furthermore, the effect of multibeam delivery is likely different for different organs of interest."

"This study is important because it informs the clinical translation of FLASH radiotherapy, with respect to beam delivery modalities, treatment planning and radiation prescriptions," says co-author Anthony Mascia, PhD, of Cincinnati Children's. "We need to identify where FLASH works and where FLASH doesn't work to move forward."

This research was funded by Varian, a Siemens Healthineers company. Sertorio, as well as co-investigators Mascia and John Perentesis, MD, from Cincinnati Children's report research grants from Varian.

Featured photo of radiation therapist situating someone in one of the gantries at the Proton Therapy Center. Photo/Cincinnati Children's.

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