Current views on mechanisms of the FLASH effect in cancer radiotherapy  

作　　者：Yuqi Ma Wenkang Zhang Ziming Zhao Jianfeng Lv Junyi Chen Xueqin Yan XiaoJi Lin Junlong Zhang Bingwu Wang Song Gao Jie Xiao Gen Yang 

机构地区：[1]State Key Laboratory of Nuclear Physics and Technology,School of Physics,Peking University,Beijing 100871,China [2]Oncology Discipline Group,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325003,China [3]Beijing National Laboratory of Molecular Science,College of Chemistry and Molecular Engineering,Peking University,Beijing 100871,China [4]Guangdong Basic Research Center of Excellence for Functional Molecular Engineering,School of Chemistry,Sun Yat-sen University,Guangzhou 510275,China [5]KIRI Precision Particle Therapy Flash Technologies Research Center,Guangzhou 510700,China

出　　处：《National Science Review》2024年第10期380-395,共16页国家科学评论（英文版）

基　　金：partially supported by the National Natural Science Foundation of China(12375334);the National Key Research and Development Program of China(2023YFC2413200/2023YFC2413201 and 2019YFF01014402).

摘　　要：FLASH radiotherapy(FLASH-RT)is a new modality of radiotherapy that delivers doses with ultra-high dose rates.The FLASH effect was defined as the ability of FLASH-RT to suppress tumor growth while sparing normal tissues.Although the FLASH effect has been proven to be valid in various models by different modalities of irradiation and clinical trials of FLASH-RT have achieved promising initial success,the exact underlying mechanism is still unclear.This article summarizes mainstream hypotheses of the FLASH effect at physicochemical and biological levels,including oxygen depletion and free radical reactions,nuclear and mitochondria damage,as well as immune response.These hypotheses contribute reasonable explanations to the FLASH effect and are interconnected according to the chronological order of the organism’s response to ionizing radiation.By collating the existing consensus,evidence and hypotheses,this article provides a comprehensive overview of potential mechanisms of the FLASH effect and practical guidance for future investigation in the field of FLASH-RT.

关 键 词：ultra-high dose-rate irradiation FLASH effect RADIOTHERAPY mechanism 

分 类 号：R730.55[医药卫生—肿瘤]