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. 2019 Jan 1;25(1):35-42.
doi: 10.1158/1078-0432.CCR-17-3375. Epub 2018 Jun 6.

The Advantage of FLASH Radiotherapy Confirmed in Mini-pig and Cat-cancer Patients

Marie-Catherine Vozenin #  1 , Pauline De Fornel #  2 , Kristoffer Petersson #  3   4 , Vincent Favaudon  5 , Maud Jaccard  3   4 , Jean-François Germond  4 , Benoit Petit  3 , Marco Burki  6 , Gisèle Ferrand  7 , David Patin  4 , Hanan Bouchaab  3 , Mahmut Ozsahin  3   7 , François Bochud  4 , Claude Bailat  4 , Patrick Devauchelle #  2 , Jean Bourhis #  3   7
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Free article

The Advantage of FLASH Radiotherapy Confirmed in Mini-pig and Cat-cancer Patients

Marie-Catherine Vozenin et al. Clin Cancer Res. .
Free article

Abstract

Purpose: Previous studies using FLASH radiotherapy (RT) in mice showed a marked increase of the differential effect between normal tissue and tumors. To stimulate clinical transfer, we evaluated whether this effect could also occur in higher mammals.

Experimental design: Pig skin was used to investigate a potential difference in toxicity between irradiation delivered at an ultrahigh dose rate called "FLASH-RT" and irradiation delivered at a conventional dose rate called "Conv-RT." A clinical, phase I, single-dose escalation trial (25-41 Gy) was performed in 6 cat patients with locally advanced T2/T3N0M0 squamous cell carcinoma of the nasal planum to determine the maximal tolerated dose and progression-free survival (PFS) of single-dose FLASH-RT.

Results: Using, respectively, depilation and fibronecrosis as acute and late endpoints, a protective effect of FLASH-RT was observed (≥20% dose-equivalent difference vs. Conv-RT). Three cats experienced no acute toxicity, whereas 3 exhibited moderate/mild transient mucositis, and all cats had depilation. With a median follow-up of 13.5 months, the PFS at 16 months was 84%.

Conclusions: Our results confirmed the potential advantage of FLASH-RT and provide a strong rationale for further evaluating FLASH-RT in human patients.See related commentary by Harrington, p. 3.

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