FLASH: New intersection of physics, chemistry, biology, and cancer medicine
Marie‐Catherine Vozenin, Billy W. Loo, Sami Tantawi, Peter G. Maxim, Douglas R. Spitz, Claude Bailat, Charles L. Limoli
Abstract
. These observations define the FLASH effect. The FLASH effect has been reported to occur when using single or hypofractionated dose regimens in several experimental animal models (mice, rat, zebrafish, pig, and cats) and in multiple organs (lung, skin, gut, and brain) by numerous groups worldwide. Note that the FLASH effect has been demonstrated with electron, photon, and hadron (proton and heavier ion) beams. The current status and future technological development are reviewed, with an emphasis on critical beam parameters, future beam modalities, and prerequisites for safe clinical translation in terms of dosimetry, radioprotection, and treatment planning systems. Mechanistic investigations at the physicochemical and biological levels are presented, as are strategies to support and initiate clinical translation. This comprehensive review provides multidisciplinary radiation scientists with a road map of the technological, physical, chemical, biological, and clinical considerations that have made FLASH topical. These considerations are presented with a realistic and practical backdrop of the limitations and challenges that lie ahead.