Treatment of a first patient with FLASH-radiotherapy.

Details

Serval ID
serval:BIB_83AB60DD8B00
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treatment of a first patient with FLASH-radiotherapy.
Journal
Radiotherapy and oncology
Author(s)
Bourhis J., Sozzi W.J., Jorge P.G., Gaide O., Bailat C., Duclos F., Patin D., Ozsahin M., Bochud F., Germond J.F., Moeckli R., Vozenin M.C.
ISSN
1879-0887 (Electronic)
ISSN-L
0167-8140
Publication state
Published
Issued date
10/2019
Peer-reviewed
Oui
Volume
139
Pages
18-22
Language
english
Notes
Publication types: Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
When compared to conventional radiotherapy (RT) in pre-clinical studies, FLASH-RT was shown to reproducibly spare normal tissues, while preserving the anti-tumor activity. This marked increase of the differential effect between normal tissues and tumors prompted its clinical translation. In this context, we present here the treatment of a first patient with FLASH-RT.
A 75-year-old patient presented with a multiresistant CD30+ T-cell cutaneous lymphoma disseminated throughout the whole skin surface. Localized skin RT has been previously used over 110 times for various ulcerative and/or painful cutaneous lesions progressing despite systemic treatments. However, the tolerance of these RT was generally poor, and it was hypothesized that FLASH-RT could offer an equivalent tumor control probability, while being less toxic for the skin. This treatment was given to a 3.5-cm diameter skin tumor with a 5.6-MeV linac specifically designed for FLASH-RT. The prescribed dose to the PTV was 15 Gy, in 90 ms. Redundant dosimetric measurements were performed with GafChromic films and alanine, to check the consistency between the prescribed and the delivered doses.
At 3 weeks, i.e. at the peak of the reactions, a grade 1 epithelitis (CTCAE v 5.0) along with a transient grade 1 oedema (CTCAE v5.0) in soft tissues surrounding the tumor were observed. Clinical examination was consistent with the optical coherence tomography showing no decrease of the thickness of the epidermis and no disruption at the basal membrane with limited increase of the vascularization. In parallel, the tumor response was rapid, complete, and durable with a short follow-up of 5 months. These observations, both on normal skin and on the tumor, were promising and prompt to further clinical evaluation of FLASH-RT.
This first FLASH-RT treatment was feasible and safe with a favorable outcome both on normal skin and the tumor.
Keywords
Aged, Drug Resistance, Neoplasm, Humans, Lymphoma, T-Cell, Cutaneous/radiotherapy, Male, Organ Sparing Treatments/methods, Radiotherapy/methods, Radiotherapy Dosage, Skin Neoplasms/radiotherapy, Treatment Outcome, Clinical translation, Differential effect, FLASH-RT, Normal tissue protection
Pubmed
Web of science
Create date
22/07/2019 16:41
Last modification date
27/04/2020 5:20
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