Establishment and Initial Experience of Clinical FLASH Radiotherapy in Canine Cancer Patients
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Establishment and Initial Experience of Clinical FLASH Radiotherapy in Canine Cancer Patients. / Konradsson, Elise; Arendt, Maja L.; Bastholm Jensen, Kristine; Børresen, Betina; Hansen, Anders E.; Bäck, Sven; Kristensen, Annemarie T.; Munck af Rosenschöld, Per; Ceberg, Crister; Petersson, Kristoffer.
In: Frontiers in Oncology, Vol. 11, 658004, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Establishment and Initial Experience of Clinical FLASH Radiotherapy in Canine Cancer Patients
AU - Konradsson, Elise
AU - Arendt, Maja L.
AU - Bastholm Jensen, Kristine
AU - Børresen, Betina
AU - Hansen, Anders E.
AU - Bäck, Sven
AU - Kristensen, Annemarie T.
AU - Munck af Rosenschöld, Per
AU - Ceberg, Crister
AU - Petersson, Kristoffer
N1 - Publisher Copyright: © Copyright © 2021 Konradsson, Arendt, Bastholm Jensen, Børresen, Hansen, Bäck, Kristensen, Munck af Rosenschöld, Ceberg and Petersson.
PY - 2021
Y1 - 2021
N2 - FLASH radiotherapy has emerged as a treatment technique with great potential to increase the differential effect between normal tissue toxicity and tumor response compared to conventional radiotherapy. To evaluate the feasibility of FLASH radiotherapy in a relevant clinical setting, we have commenced a feasibility and safety study of FLASH radiotherapy in canine cancer patients with spontaneous superficial solid tumors or microscopic residual disease, using the electron beam of our modified clinical linear accelerator. The setup for FLASH radiotherapy was established using a short electron applicator with a nominal source-to-surface distance of 70 cm and custom-made Cerrobend blocks for collimation. The beam was characterized by measuring dose profiles and depth dose curves for various field sizes. Ten canine cancer patients were included in this initial study; seven patients with nine solid superficial tumors and three patients with microscopic disease. The administered dose ranged from 15 to 35 Gy. To ensure correct delivery of the prescribed dose, film measurements were performed prior to and during treatment, and a Farmer-type ion-chamber was used for monitoring. Treatments were found to be feasible, with partial response, complete response or stable disease recorded in 11/13 irradiated tumors. Adverse events observed at follow-up ranging from 3-6 months were mild and consisted of local alopecia, leukotricia, dry desquamation, mild erythema or swelling. One patient receiving a 35 Gy dose to the nasal planum, had a grade 3 skin adverse event. Dosimetric procedures, safety and an efficient clincal workflow for FLASH radiotherapy was established. The experience from this initial study will be used as a basis for a veterinary phase I/II clinical trial with more specific patient inclusion selection, and subsequently for human trials.
AB - FLASH radiotherapy has emerged as a treatment technique with great potential to increase the differential effect between normal tissue toxicity and tumor response compared to conventional radiotherapy. To evaluate the feasibility of FLASH radiotherapy in a relevant clinical setting, we have commenced a feasibility and safety study of FLASH radiotherapy in canine cancer patients with spontaneous superficial solid tumors or microscopic residual disease, using the electron beam of our modified clinical linear accelerator. The setup for FLASH radiotherapy was established using a short electron applicator with a nominal source-to-surface distance of 70 cm and custom-made Cerrobend blocks for collimation. The beam was characterized by measuring dose profiles and depth dose curves for various field sizes. Ten canine cancer patients were included in this initial study; seven patients with nine solid superficial tumors and three patients with microscopic disease. The administered dose ranged from 15 to 35 Gy. To ensure correct delivery of the prescribed dose, film measurements were performed prior to and during treatment, and a Farmer-type ion-chamber was used for monitoring. Treatments were found to be feasible, with partial response, complete response or stable disease recorded in 11/13 irradiated tumors. Adverse events observed at follow-up ranging from 3-6 months were mild and consisted of local alopecia, leukotricia, dry desquamation, mild erythema or swelling. One patient receiving a 35 Gy dose to the nasal planum, had a grade 3 skin adverse event. Dosimetric procedures, safety and an efficient clincal workflow for FLASH radiotherapy was established. The experience from this initial study will be used as a basis for a veterinary phase I/II clinical trial with more specific patient inclusion selection, and subsequently for human trials.
KW - canine cancer patients
KW - dosimetry
KW - flash
KW - normal tissue
KW - radiation oncology
KW - radiotherapy
KW - ultra-high dose rate
U2 - 10.3389/fonc.2021.658004
DO - 10.3389/fonc.2021.658004
M3 - Journal article
C2 - 34055624
AN - SCOPUS:85107130902
VL - 11
JO - Frontiers in Oncology
JF - Frontiers in Oncology
SN - 2234-943X
M1 - 658004
ER -
ID: 272068908