The First FLASH Clinical Trial—The Journey of a Thousand Miles Begins With 1 Step
Mené aux Etats-Unis entre 2020 et 2022 sur 10 patients présentant des métastases osseuses aux extrémités (âge médian : 63 ans ; durée médiane de suivi : 4,8 mois), cet essai évalue la faisabilité et la toxicité d'un traitement par radiothérapie Flash
It took the field of radiation oncology 40 years (1969) to appreciate and reinvestigate the phenomenon we now call the FLASH effect, which is normal tissue sparing from ultra-high-dose-rate (UHDR) delivery. Less than a decade ago (2014), the normal tissue sparing by UHDR delivery was confirmed in animal studies. Now, in this issue of JAMA Oncology, Mascia et al report their phase 1 trial of proton FLASH radiotherapy in humans. As a first-in-human trial, the primary objectives were simply feasibility and safety of UHDR treatment. The trial was small—10 patients—and the dose delivered was modest—8 Gy. The authors achieved their stated objectives by demonstrating feasibility with acceptable time to deliver the treatment, and toxic effects were mild, mostly consisting of grade 1 skin reactions.
JAMA Oncology , éditorial, 2021