American Association for Cancer Research
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Figure S1a from The Advantage of FLASH Radiotherapy Confirmed in Mini-pig and Cat-cancer Patients

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posted on 2023-03-31, 21:40 authored by Marie-Catherine Vozenin, Pauline De Fornel, Kristoffer Petersson, Vincent Favaudon, Maud Jaccard, Jean-François Germond, Benoit Petit, Marco Burki, Gisèle Ferrand, David Patin, Hanan Bouchaab, Mahmut Ozsahin, François Bochud, Claude Bailat, Patrick Devauchelle, Jean Bourhis

Figure S1: A- Serial pictures showing evolution of the mini-pig's skin over time post FLASH and Conv-RT. Three doses are shown (28-34Gy) 24h to 32 weeks post-RT.





Previous studies using FLASH radiotherapy (RT) in mice showed a marked increase of the differential effect between normal tissue and tumors. To stimulate clinical transfer, we evaluated whether this effect could also occur in higher mammals. Pig skin was used to investigate a potential difference in toxicity between irradiation delivered at an ultrahigh dose rate called “FLASH-RT” and irradiation delivered at a conventional dose rate called “Conv-RT.” A clinical, phase I, single-dose escalation trial (25–41 Gy) was performed in 6 cat patients with locally advanced T2/T3N0M0 squamous cell carcinoma of the nasal planum to determine the maximal tolerated dose and progression-free survival (PFS) of single-dose FLASH-RT. Using, respectively, depilation and fibronecrosis as acute and late endpoints, a protective effect of FLASH-RT was observed (≥20% dose-equivalent difference vs. Conv-RT). Three cats experienced no acute toxicity, whereas 3 exhibited moderate/mild transient mucositis, and all cats had depilation. With a median follow-up of 13.5 months, the PFS at 16 months was 84%. Our results confirmed the potential advantage of FLASH-RT and provide a strong rationale for further evaluating FLASH-RT in human patients.See related commentary by Harrington, p. 3

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