![]() Three-dimensional cell cultures, such as cancer spheroids, organoids from normal and cancerous tissues, precision-cut tissue slices, engineered tissues, are also developed to simulate the diversified physiological environments found in humans. In addition to growing cells into a monolayer, we use cells grown in three-dimensions. In this way, we can decipher complicate effects using simple experiments. Cancer or normal cells are grown in plastic culture dishes under an environment similar to their physiological conditions. To understand the biology behind FLASH, we work with cell and tissue models (Figure 1). The beam spreads out as it travels towards the flask and is collimated (shaped) by the brass plate in the aluminium casing with a circular aperture, just prior to hitting the flask containing our monolayer of cells (attached to the inside surface of the flask closest to the brass collimator). The radiation beam comes out of the circular opening in the upper left corner. (2,3) Figure 1: One of the setups used for irradiating cells with FLASH irradiation, using our dedicated linear accelerator. However, we do not yet understand the biology underpinning the FLASH effect. Given both the radiobiological advantageous FLASH effect and its potential to “freeze” physiological motion, FLASH radiotherapy has the potential to be an important (r)evolutionary step in cancer treatment. Carefully implemented, this would allow for smaller volumes of normal tissue being unnecessarily irradiated. The short treatment times used in FLASH radiotherapy, often less than 0.1 s, have the added value of minimising treatment delivery uncertainties caused by patient motion during delivery, for example, a reduced risk of missing a lung tumour due to the breathing motion. (4,5) FLASH radiotherapy uses irradiators with a high radiation output that allows for the treatment to be delivered in fractions of a second, compared to several minutes for conventional treatments. The benefit of FLASH radiotherapy has been further shown in veterinarian clinical studies and in the first treatment of a human. However, the treatment effect on tumours is not reduced. Recent preclinical studies have shown that FLASH irradiation, which is radiation delivered in a fraction of a second, reduces incidence and severity of radiation side effects compared to conventional irradiation used in clinical practice. Hence, we need to further improve the level of success of radiotherapy treatment, and the most promising new radiotherapy technique to achieve this, is FLASH radiotherapy. The quality of life for cancer survivors is as important as the prolongation of life due to treatment. The success of radiotherapy treatment depends on the ability to deliver a high enough radiation dose to the tumour to eradicate it, while minimising the dose to adjacent normal healthy tissue, to reduce the damage and debilitating side effects caused by the radiation treatment. ![]() The current level of long-term (longer than 10 years) cancer survivors is 50% but this number is expected to increase if cancer diagnosis and treatment can continue to improve. (1) 30-50% of these are expected to receive radiotherapy as part of their treatment. One in two people in the UK born after 1960 will be diagnosed with some form of cancer during their lifetime. © Jcpjr Here, Kristoffer Petersson, MRC Investigator and Group Leader of FLASH Radiation, enlightens us to the benefits of this promising new radiotherapy technique
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