Robotic FLASH radiotherapy: A technical, biological, clinical and societal evaluation

FLASH radiotherapy (RT) is an emerging technique that delivers radiation at ultra-high dose rates (UHDR, > 40 Gy/s), and has shown promising results in preclinical studies. Research has shown that with UHDR, tumor control can be maintained while sparing healthy tissues and reducing toxicities. Currently, FLASH-RT is predominantly available in pre-clinical settings, with clinical trials conducted using preclinical and intraoperative devices, limiting their clinical applications. The goal of this project is to pioneer FLASH-RT using a clinical linear accelerator (LINAC) modified to deliver UHDR external-beam RT, and ultimately make this cutting-edge technology avaible to a significantly broader patient population.

This project involves the implementation of a FLASH electron infrastructure for FLASH electron radiotherapy, utilising THERYQ’s FLASHKNiFE linac machine.

In the first phase of the project, identification and quantification of various types of scattered particles will be performed to optimise monitoring using a customised detector.

Comprehensive beam characterisation will be performed by analysing dose distribution, dose rate, treatment delivery time, pulse length, structure, etc. Spatio-temporal dose distribution is crucial to capture the rapid changes that occur during the UHDR delivery. These measurements will be coupled with Monte Carlo simulations to validate the experimental results further. The Timepix family of chips offers remarkable time resolution, operating at the nanosecond level and facilitating precise measurement of the time of irradiation. They can capture single pulse structures and record the number of pulses and treatment plan irradiation times.

Figure 1: Monitoring of electron beam of linac FLASHKNiFE

 

Figure 2: 2D visualization of per-pixel deposited energy
Grant provider
Technology Agency of the Czech Republic
Programme
FWO
Project ID
I014024N
Duration
01/2025 — 12/2028
Principal investigator
Cristina Oancea