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FLASH Therapy - Current Status and the Way to the Clinic

M Mendonca1*, T Karan2*, J Schuemann3*, E Diffenderfer4*, P Montay-gruel5*, (1) Indiana University, Indianapolis, IN, (2) BCCA Vancouver Centre, Vancouver, BC, CA, (3) Massachusetts General Hospital, Boston, MA, (4) University of Pennsylvania, Philadelphia, PA, (5) UC Irvine Health, Irvine, CA


(Sunday, 7/12/2020) 10:30 AM - 12:30 PM [Eastern Time (GMT-4)]

Room: Track 3

Radiation therapy is a key treatment for many solid tumors, using precisely targeted radiation exposures to kill tumor cells while sparing normal tissues. However, healthy tissues are also inevitably exposed to radiation, potentially leading to significant side-effects. Improving tumor control while reducing side-effects and enhancing the therapeutic ratio is one of the main challenges in radiotherapy. Recent studies have shown that delivering ionizing radiation with ultra- high dose rates (= 40 Gy/s), termed Flash radiotherapy (Flash-RT), may dramatically reduce side-effects while maintaining tumor control. Initial studies were performed using electron irradiations. Since then, the Flash effect has also been demonstrated with photon and proton irradiations, increasing the potential for clinical translation of Flash-RT.

The Flash normal tissue sparing effect is thought to be an in vivo phenomenon, with first data suggesting instantaneous oxygen depletion and a resulting reduction in oxygen-mediated toxicities as the underlying mechanism. Extensive animal experiments have shown the benefits of Flash-RT in mice, cats and minipigs. To date, one human patient has been treated with an experimental protocol for surface lesions using electron Flash-RT.

This symposium will discuss the current state of Flash-RT, results from different irradiation modalities, gaps in our knowledge that need to be addressed before wide-spread routine Flash-RT can become reality, the path to clinical translation, and ideal treatment sites, methods and potential limitations of future Flash-RT.

Learning Objectives:
1. Learn about the current understanding of underlying mechanisms of FLASH-RT.
2. Learn about the current status and major obstacles on the way to clinical translation.
3. Learn which modalities, new or old apparatus will enable FLASH-RT in the clinic.

Funding Support, Disclosures, and Conflict of Interest: Funding by NCI/NIH Damon Runyon Foundation Brain Tumour Charity



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