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Framework for Quality Assurance of Ultra-High Dose Rate Clinical Trials Investigating FLASH Effects and Current Technology Gaps. International journal of radiation oncology, biology, physics Zou, W., Zhang, R., Schueler, E., Taylor, P. A., Mascia, A. E., Diffenderfer, E. S., Zhao, T., Ayan, A. S., Sharma, M., Yu, S. J., Lu, W., Bosch, W. R., Tsien, C., Surucu, M., Pollard-Larkin, J. M., Schuemann, J., Moros, E. G., Bazalova-Carter, M., Gladstone, D. J., Li, H., Simone, C. B., Petersson, K., Kry, S. F., Maity, A., Loo, B. W., Dong, L., Maxim, P. G., Xiao, Y., Buchsbaum, J. C. 2023

Abstract

FLASH radiotherapy, delivered with ultra-high dose rate (UHDR), may allow patients to be treated with less normal tissue toxicity for a given tumor dose compared to currently used conventional dose rate. Clinical trials are being carried out and are needed to test whether this improved therapeutic ratio can be achieved clinically. During the clinical trials, quality assurance and credentialing of equipment and participating sites, particularly pertaining to UHDR-specific aspects, will be crucial for the validity of the outcomes of such trials. This report represents an initial framework proposed by the NRG Oncology Center for Innovation in Radiation Oncology (CIRO) FLASH working group on quality assurance of potential UHDR clinical trials, and reviews current technology gaps to overcome. An important but separate consideration is the appropriate design of trials to answer clinical and scientific questions about FLASH most effectively.

View details for DOI 10.1016/j.ijrobp.2023.04.018

View details for PubMedID 37121362