Radiobiology and treatment plan progress of FLASH radiotherapy

Fig. 1. (a) Cell survival curves after irradiation at different dose rates; (b) cell survival curves after irradiation at ultra-high dose rates with different oxygen concentrations^［9-10］

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Fig. 2. Time scale of ultra-high dose rate irradiation induced events^{［14，24-25］}

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Table 1. Chemical reaction of oxygen depletion
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Table 1. Chemical reaction of oxygen depletion
化学反应
Chemical reaction
反应速率k / （10¹⁰ mol·L^-1·s^-1）
Reaction rate k
e $_{a q}^{-}$ + O₂ → O₂·^- 1.9
H·+ O₂ → HO₂·₂ 2.0

Table 2. Proton FLASH radiotherapy treatment plan research

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Table 2. Proton FLASH radiotherapy treatment plan research

作者

Authors

剂量率算法

Dose rate algorithm

治疗计划

Treatment planning

部位

Area

结果

Outcomes

van de Water^[56]

剂量平均剂量率

Dose-averaged dose rate (DADR)

1.常规临床治疗计划；2.“标准”束斑减少计划；3.旋转弧形束斑减少计划；4.旋转弧形“穿透”束斑减少计划

1. The clinical treatment plan; 2. A 'standard' spot-reduced plan; 3. An 'arc' spot-reduced plan; 4. An 'arc-shoot-through' spot-reduced plan

鼻窦

Paranasal

sinuses

束斑减少计划的剂量分布等于或优于调强质子放疗计划。与其他技术相比，旋转弧形“穿透”计划中的危及器官剂量分布更好，但累积剂量较高

Dose distribution of spot-reduced plans were equal or better than those of the intensity-modulated proton therapy (IMPT) plans. Organs at risk (OARs) dose distribution in arc-shoot-through plans were sometimes better compared to the other techniques, but integral dose was high

van

Marlen^[54]

点峰值剂量率

Spot peak dose rate(SPDR)

“穿透”计划

Transmission/

shoot-through

plan

肺

Lung

FLASH治疗计划的内靶区和计划靶体积剂量与容积调强放疗治疗计划相当，危及器官的剂量更低

FLASH plans had internal target volume (ITV) and planning target volume (PTV) doses comparable withvolumetric modulated arc therapy (VMAT) plans, but achieved lower doses for most OARs

van

Marlen^[58]

点峰值剂量率；剂量平均剂量率

SPDR; DADR

“穿透”计划

Transmission/shoot-through plan

头颈部

Head-and-neck

常规分割质子FLASH治疗计划的危及器官剂量与调强质子放疗计划相似，并优于容积调强放疗

Conventionally-fractionated proton FLASH plans achieved comparable OARs-sparing to IMPT and better than VMAT

Wei^[59]

平均剂量率

Averaged dose rate(ADR)

“穿透”计划

Transmission/shoot-through plan

肝

Liver

与常规调强质子放疗计划相比，“穿透”计划的剂量学较差

The transmission plans generally yielded inferior dosimetry quality to the conventional IMPT plans

Wei^[60]

剂量平均剂量率；剂量阈值剂量率；平均剂量率

DADR; dose threshold dose rate; ADR

布拉格峰计划；“穿透”计划

Bragg peak plans; transmission/shoot-through plan

肺

Lung

相比“穿透”计划，布拉格峰计划能进一步降低危及器官剂量

Compared with the transmission plans, the Bragg peak plans further reduced doses to OARs

Gao^[61]

剂量平均剂量率

DADR

布拉格峰计划；“穿透”计划

Bragg peak plans; transmission/shoot-through plan

前列腺、肺、头颈部、脑

Prostate, lung, head-and-neck, brain

“穿透”计划的正常组织保护作用不如布拉格峰计划

Shoot-through plan is generally suboptimal to Bragg peak plans for normal tissue sparing

van

Marlen^[62]

剂量平均剂量率

DADR

“穿透”计划

Transmission/shoot-through plan

肺

Lung

FLASH“穿透”计划的剂量分布与VMAT相似，但不如IMPT

FLASH shoot-through plan dosimetry was similar to that of VMAT, but inferior to that of IMPT

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Xun WU, Ruifeng LIU, Qiuning ZHANG, Xiaohu WANG. Radiobiology and treatment plan progress of FLASH radiotherapy[J]. Journal of Radiation Research and Radiation Processing, 2023, 41(2): 020101

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