Treatment planning of intracranial lesions with VHEE: comparing conventional and FLASH irradiation potential with state-of-the-art photon and proton radiotherapy

• DOI: 10.3389/fphy.2023.1185598
• Publication Date: 2023-07-06T09:41:30Z
• Authors: A. Muscato; L. Arsini; G. Battistoni; L. Campana; D. Carlotti; F. De Felice; A. De Gregorio; M. De Simoni; C. Di Felice; Y. Dong; G. Franciosini; M. Marafini; I. Mattei; R. Mirabelli; S. Muraro; M. Pacilio; L. Palumbo; V. Patera; A. Schiavi; A. Sciubba; M. Schwarz; S. Sorbino; V. Tombolini; M. Toppi; G. Traini; A. Trigilio; A. Sarti
• Keywords: very high-energy electrons; Physics; QC1-999; external beam radiotherapy; intracranial lesions; FLASH effect; very high-energy electrons; deep-seated tumours; FLASH effect; external beam radiotherapy; intracranial lesions; deep-seated tumours

The treatment of deep-seated tumours with electrons very high energies (VHEE, 70–150 MeV) has already been explored in the past, suggesting that a dosimetric coverage comparable state-of-the-art proton (PT) or photon radiotherapy (RT) could be achieved large ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="m1"><mml:mo>&gt;</mml:mo></mml:math> 10) number fields and electron energy. technical economical challenges posed by deployment such beams centres, together expected small therapeutic gain, prevented development technique. This scenario radically change light recent developments occurred compact, high-gradient, acceleration technology and, additionally, experimental evidence sparing organs at risk ultra-high dose rate irradiation, also referred to as FLASH. Electrons energy required treat intracranial lesions provided, rates compatible what is needed trigger FLASH effect, accelerators are few metres long, organ exploited significantly simplify irradiation geometry, decreasing patient. In this paper, case two patients affected chordoma meningioma, respectively, treated protons Trento (IT) presented. plans have compared VHEE X-ray intensity-modulated (IMRT) plans. were first evaluated terms physical distribution then assuming regimen can achieved. demonstrated their potential obtaining tumour when benchmarked against current IMRT PT. These results obtained was range between 3 7, consistent routinely performed PT conventional irradiations. regimen, all cases, showed its reducing damage placed nearby target volume, allowing, particularly where geometry more challenging, better respect treatments.