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Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients

Børresen, Betina ; Arendt, Maja L. ; Konradsson, Elise LU ; Bastholm Jensen, Kristine ; Bäck, Sven LU ; Munck Af Rosenschöld, Per LU orcid ; Ceberg, Crister LU orcid and Petersson, Kristoffer LU (2023) In Frontiers in Oncology 13. p.1-10
Abstract
Background: FLASH radiotherapy (RT) is a novel method for delivering ionizing
radiation, which has been shown in preclinical studies to have a normal tissue
sparing effect and to maintain anticancer efficacy as compared to conventional
RT. Treatment of head and neck tumors with conventional RT is commonly
associated with severe toxicity, hence the normal tissue sparing effect of FLASH
RT potentially makes it especially advantageous for treating oral tumors. In this
work, the objective was to study the adverse effects of dogs with spontaneous
oral tumors treated with FLASH RT.
Methods: Privately-owned dogs with macroscopic malignant tumors of the oral
cavity were treated with a single fraction of ≥30Gy... (More)
Background: FLASH radiotherapy (RT) is a novel method for delivering ionizing
radiation, which has been shown in preclinical studies to have a normal tissue
sparing effect and to maintain anticancer efficacy as compared to conventional
RT. Treatment of head and neck tumors with conventional RT is commonly
associated with severe toxicity, hence the normal tissue sparing effect of FLASH
RT potentially makes it especially advantageous for treating oral tumors. In this
work, the objective was to study the adverse effects of dogs with spontaneous
oral tumors treated with FLASH RT.
Methods: Privately-owned dogs with macroscopic malignant tumors of the oral
cavity were treated with a single fraction of ≥30Gy electron FLASH RT and
subsequently followed for 12 months. A modified conventional linear accelerator
was used to deliver the FLASH RT.
Results: Eleven dogs were enrolled in this prospective study. High grade adverse
effects were common, especially if bone was included in the treatment field. Four
out of six dogs, who had bone in their treatment field and lived at least 5 months
after RT, developed osteoradionecrosis at 3-12 months post treatment. The
treatment was overall effective with 8/11 complete clinical responses and 3/11
partial responses.
Conclusion: This study shows that single-fraction high dose FLASH RT was
generally effective in this mixed group of malignant oral tumors, but the risk of
osteoradionecrosis is a serious clinical concern. It is possible that the risk of
osteonecrosis can be mitigated through fractionation and improved dose
conformity, which needs to be addressed before moving forward with clinical
trials in human cancer patients. (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Frontiers in Oncology
volume
13
article number
1256760
pages
1 - 10
publisher
Frontiers Media S. A.
external identifiers
  • scopus:85170663184
  • pmid:37766866
ISSN
2234-943X
DOI
10.3389/fonc.2023.1256760
language
English
LU publication?
yes
id
f176d600-30bb-4a30-93a0-692d22be57a6
date added to LUP
2023-09-11 12:21:42
date last changed
2023-12-12 03:00:23
@article{f176d600-30bb-4a30-93a0-692d22be57a6,
  abstract     = {{Background: FLASH radiotherapy (RT) is a novel method for delivering ionizing<br/>radiation, which has been shown in preclinical studies to have a normal tissue<br/>sparing effect and to maintain anticancer efficacy as compared to conventional<br/>RT. Treatment of head and neck tumors with conventional RT is commonly<br/>associated with severe toxicity, hence the normal tissue sparing effect of FLASH<br/>RT potentially makes it especially advantageous for treating oral tumors. In this<br/>work, the objective was to study the adverse effects of dogs with spontaneous<br/>oral tumors treated with FLASH RT.<br/>Methods: Privately-owned dogs with macroscopic malignant tumors of the oral<br/>cavity were treated with a single fraction of ≥30Gy electron FLASH RT and<br/>subsequently followed for 12 months. A modified conventional linear accelerator<br/>was used to deliver the FLASH RT.<br/>Results: Eleven dogs were enrolled in this prospective study. High grade adverse<br/>effects were common, especially if bone was included in the treatment field. Four<br/>out of six dogs, who had bone in their treatment field and lived at least 5 months<br/>after RT, developed osteoradionecrosis at 3-12 months post treatment. The<br/>treatment was overall effective with 8/11 complete clinical responses and 3/11<br/>partial responses.<br/>Conclusion: This study shows that single-fraction high dose FLASH RT was<br/>generally effective in this mixed group of malignant oral tumors, but the risk of<br/>osteoradionecrosis is a serious clinical concern. It is possible that the risk of<br/>osteonecrosis can be mitigated through fractionation and improved dose<br/>conformity, which needs to be addressed before moving forward with clinical<br/>trials in human cancer patients.}},
  author       = {{Børresen, Betina and Arendt, Maja L. and Konradsson, Elise and Bastholm Jensen, Kristine and Bäck, Sven and Munck Af Rosenschöld, Per and Ceberg, Crister and Petersson, Kristoffer}},
  issn         = {{2234-943X}},
  language     = {{eng}},
  month        = {{09}},
  pages        = {{1--10}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Oncology}},
  title        = {{Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients}},
  url          = {{http://dx.doi.org/10.3389/fonc.2023.1256760}},
  doi          = {{10.3389/fonc.2023.1256760}},
  volume       = {{13}},
  year         = {{2023}},
}