https://doi.org/10.1140/epjp/s13360-025-06532-5
Regular Article
Bridging research and clinical practice in ultra-high dose rate proton therapy
1
Radiation Oncology Department, University of Washington, Seattle, Washington, USA
2
Radiation Oncology Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
Received:
3
March
2025
Accepted:
6
June
2025
Published online:
9
July
2025
This paper discusses the integration of ultra-high dose rate (UHDR) proton therapy into clinical practice, emphasizing its potential to enhance the therapeutic window in radiation oncology by leveraging the FLASH effect. UHDR proton therapy delivers radiation at dose rates at least two orders of magnitude higher than traditional approaches, and this has been shown in preclinical studies to reduce normal tissue toxicity while maintaining effective tumor control. Translating these promising results into clinical settings presents several challenges, primarily due to the limited understanding of the FLASH mechanism and the complexities involved in beam production and delivery systems, which require significant modifications of the treatment planning and delivery approaches. We describe recent advancements in proton therapy technology necessary to achieve UHDR and treatment planning strategies that fulfill the constraints imposed by UHDR and still ensure an adequate level of dose conformity. Finally, we consider the broader implications of UHDR proton therapy and propose different ways to implement UHDR, in order to explore its full potential.
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© The Author(s), under exclusive licence to Società Italiana di Fisica and Springer-Verlag GmbH Germany, part of Springer Nature 2025
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
