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• FLASH-RT a paradigm-shifting method of delivering doses within an extremely short irradiation time. • FLASH-RT is a promising new tool to enhance the differential effect between tumors and normal tissues. • The consistency of the preclinical data clinical justifies transfer of FLASH-RT. • The most relevant parameters for FLASH are the combination of dose, dose-rate within the pulse, and overall time of irradiation. • A first proof of concept could be done with low-energy electrons and further tested with VHEE, protons and X-rays. Over the past decades, technological advances have transformed radiation therapy (RT) into a precise and powerful treatment for cancer patients. Nevertheless, the treatment of radiation-resistant tumors is still restricted by the dose-limiting normal tissue complications. In this context, FLASH-RT is emerging in the field. Consisting of delivering doses within an extremely short irradiation time, FLASH-RT has been identified as a promising new tool to enhance the differential effect between tumors and normal tissues. Indeed, preclinical studies on various animal models and a veterinarian clinical trial have recently shown that compared to conventional dose-rate RT, FLASH-RT could control tumors while minimizing normal tissue toxicity. In the present review, we summarize the main data supporting the clinical translation of FLASH-RT and explore its feasibility, the key irradiation parameters and the potential technologies needed for a successful clinical translation. [ABSTRACT FROM AUTHOR]

A patient with a cutaneous lymphoma was treated on the same day for 2 distinct tumors using a 15 Gy single electron dose given in a dose rate of 0.08 Gy/second versus 166 Gy/second. Comparing the two treatments, there was no difference for acute reactions, late effects at 2 years and tumor control. [ABSTRACT FROM AUTHOR]