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Thu, 01.01.1970
Exploring Space and Time in Radiation Therapy: Spatially Fractionated Radiation Therapy As an Alternative to FLASH
Abstract
Abstract Body
There are ever increasing shreds of evidence that the dose delivery method can play a major role in the biological response to radiation. One prominent illustration is FLASH therapy (1), which uses unconventional temporal dose delivery. Another example, based this time on a distinct spatial dose modulation of the dose, is Spatially Fractionated Radiation Therapy (SFRT) (2,3). Both approaches based on two non-conventional microstructures in time and space have already demonstrated a remarkable increase of normal tissue dose tolerances while providing an equivalent (and even superior, occasionally) tumor control than standard radiotherapy. In this presentation, a general overview of SFRT will be provided. SFRT uses a strong spatial modulation of the dose to create alternating regions of high and low dose in order to increase the tolerance of normal tissue. Despite the first treatments dating back to the early 20th century, SFRT remains rarely employed compared to conventional RT which is based on laterally homogeneous irradiation fields. However, decades of clinical and preclinical data have shown that SFRT has huge potential to become an extremely high therapeutic index treatment. Nowadays, there is a renewed interest in SFRT worldwide, with several additional clinical trials being anticipated in the near future. In this presentation the fundamental concepts of spatial dose fractionation will be described and the different forms of SFRT (GRID, Lattice, micro and minibeam RT) will be presented. The distinct radiobiological and dosimetric aspects will be also discussed. The recent exploration of the synergies between the advantages of SFRT and the benefits of charged particles for therapy and the main results presented (3,4,5). Finally, a comparative evaluation of SFRT versus FLASH therapy, focussing in the potential complementarities will be discussed.
(1) V. Fauvadon et al. Sci. Trasl. Med. 2014
(2) W. Yan et al, CTRO 2020.
(3) A. Mazal et al, BRJ 2020.
(4) Y. Prezado, Scie Reports 2018.
(5) Y. Prezado, Cancers 2021.