The potential and challenges of proton FLASH in head and neck cancer reirradiation Review


Authors: Cheng, C.; Xu, L.; Jing, H.; Selvaraj, B.; Lin, H.; Pennock, M.; Chhabra, A. M.; Hasan, S.; Zhai, H.; Zhang, Y.; Nie, K.; Bakst, R. L.; Kabarriti, R.; Choi, J. I.; Lee, N. Y.; Simone, C. B. 2nd; Kang, M.; Wu, H.
Review Title: The potential and challenges of proton FLASH in head and neck cancer reirradiation
Abstract: Ultrahigh-dose-rate therapy, also known as FLASH radiotherapy (RT), is an emerging technique that is garnering significant interest in cancer treatment due to its potential to revolutionize therapy. This method can achieve comparable tumor control to conventional-dose-rate RT while offering the enhanced protection of normal tissue through the FLASH-sparing effect. This innovative technique has demonstrated promising results in preclinical studies involving animals and cell lines. Particularly noteworthy is its potential application in treating head and neck (HN) cancers, especially in patients with challenging recurrent tumors and reirradiation cases, where the toxicity rates with conventional radiotherapy are high. Such applications aim to enhance tumor control while minimizing side effects and preserving patients’ quality of life. In comparison to electron or photon FLASH modalities, proton therapy has demonstrated superior dosimetric and delivery characteristics and is a safe and effective FLASH treatment for human malignancies. Compared to the transmission proton FLASH, single-energy Bragg peak FLASH is a novel delivery method that allows highly conformal doses to targets and minimal radiation doses to crucial OARs. Proton Bragg peak FLASH for HN cancer has still not been well studied. This review highlights the significance of proton FLASH in enhancing cancer therapy by examining the advantages and challenges of using it for HN cancer reirradiation. © 2024 by the authors.
Keywords: review; radiation dose; radiotherapy; flushing; head and neck cancer; neck; cancer control; stereotactic body radiation therapy; photon; proton; reirradiation; proton therapy; conventional radiotherapy; re-irradiation; head and neck cancers; human; female; flash radiotherapy
Journal Title: Cancers
Volume: 16
Issue: 19
ISSN: 2072-6694
Publisher: MDPI  
Date Published: 2024-10-01
Start Page: 3249
Language: English
DOI: 10.3390/cancers16193249
PROVIDER: scopus
PMCID: PMC11482542
PUBMED: 39409872
DOI/URL:
Notes: Review -- Source: Scopus
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  1. Nancy Y. Lee
    870 Lee
  2. Charles Brian Simone
    190 Simone
  3. Jehee Isabelle Choi
    69 Choi