Abstract
The use of particle accelerators in radiotherapy has significantly changed the therapeutic outcomes for many types of solid tumours. In particular, protons are well known for sparing normal tissues and increasing the overall therapeutic index. Recent studies show that normal tissue sparing can be further enhanced through proton delivery at 100 Gy/s and above, in the so-called FLASH regime. This has generated very significant interest in assessing the biological effects of proton pulses delivered at very high dose rates. Laser-accelerated proton beams have unique temporal emission properties, which can be exploited to deliver Gy level doses in single or multiple pulses at dose rates exceeding by many orders of magnitude those currently used in FLASH approaches. An extensive investigation of the radiobiology of laser-driven protons is therefore not only necessary for future clinical application, but also offers the opportunity of accessing yet untested regimes of radiobiology. This paper provides an updated review of the recent progress achieved in ultra-high dose rate radiobiology experiments employing laser-driven protons, including a brief discussion of the relevant methodology and dosimetry approaches.
Highlights
Radiotherapy is delivered to over 50% of cancer patients with curative intent for solid localized tumours [1]
Modalities such as Intensity Modulated Radiotherapy (IMRT), Stereotactic Body Radiotherapy (SBRT) or Volumetric Modulated Arc Therapy (VMAT) can conform doses to tumours more precisely than possible a few decades ago sparing the normal tissue to a larger extent
Laser-driven proton-induced DNA Double Strand Break (DSB) damage in mammalian cells were first detected by using the γ-H2AX foci formation assay by Yogo et al [81] in A549 lung adenocarcinoma cells monolayers irradiated with 2.4 MeV protons delivered in multiple 15 nanosecond pulses
Summary
Radiotherapy is delivered to over 50% of cancer patients with curative intent for solid localized tumours [1]. Extending the use of ionization chambers as absolute dosimeters for laser-driven protons at dose-rates near 109 Gy/s and at therapeutic doses (1–10 Gy) delivered per pulse, as typical in single-shot radiobiology experiments, is a significant challenge, as it requires a large correction factor for the ion collection efficiency, which may affect the reliability of the dose measurement, as pointed out by McManus et al [59].
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