Which 'dose rate' definition describes the FLASH sparing effect for scanned proton beams? A meta-analysis of skin murine data.

Colizzi, Isabella; Poulsen, Per Rugaard; Sørensen, Brita; Meer, David; Lomax, Antony John; Psoroulas, Serena · Radiother Oncol · 2025

meta_analysis · Level V

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Abstract

We compiled preclinical proton PBS skin toxicity data to assess how various dose rate definitions (field, average, and dose average) explain the FLASH sparing effect. Only average dose rate (ADR), accounting for 'effective irradiation time,' reliably describes it. We identified high-dose and ADR regions where the effect was consistently observed.

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