{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:37:56Z","timestamp":1790710676886,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pre\u2010clinical ultra\u2010high dose rate (UHDR) electron irradiations on time scales of 100\u00a0ms have demonstrated a remarkable sparing of brain and lung tissues while retaining tumor efficacy when compared to conventional dose rate irradiations. While clinically\u2010used gantries and intensity modulation techniques are too slow to match such time scales, novel very\u2010high energy electron (VHEE, 50\u2013250\u00a0MeV) radiotherapy (RT) devices using 3D\u2010conformed broad VHEE beams are designed to deliver UHDR treatments that fulfill these timing requirements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess the dosimetric plan quality obtained using VHEE\u2010based 3D\u2010conformal RT (3D\u2010CRT) for treatments of glioblastoma and lung cancer patients and compare the resulting treatment plans to those delivered by standard\u2010of\u2010care intensity modulated photon RT (IMRT) techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seven glioblastoma patients and seven lung cancer patients were planned with VHEE\u2010based 3D\u2010CRT using 3 to 16 coplanar beams with equidistant angular spacing and energies of 100 and 200\u00a0MeV using a forward planning approach. Dose distributions, dose\u2010volume histograms, coverage (V<jats:sub>95%<\/jats:sub>) and homogeneity (HI<jats:sub>98%<\/jats:sub>) for the planning target volume (PTV), as well as near\u2010maximum doses (D<jats:sub>2%<\/jats:sub>) and mean doses (D<jats:sub>mean<\/jats:sub>) for organs\u2010at\u2010risk (OAR) were evaluated and compared to clinical IMRT plans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean differences of V<jats:sub>95%<\/jats:sub> and HI<jats:sub>98%<\/jats:sub> of all VHEE plans were within 2% or better of the IMRT reference plans. Glioblastoma plan dose metrics obtained with VHEE configurations of 200\u00a0MeV and 3\u201316 beams were either not significantly different or were significantly improved compared to the clinical IMRT reference plans. All OAR plan dose metrics evaluated for VHEE plans created using 5 beams of 100\u00a0MeV were either not significantly different or within 3% on average, except for D<jats:sub>mean<\/jats:sub> for the body, D<jats:sub>mean<\/jats:sub> for the brain, D<jats:sub>2%<\/jats:sub> for the brain stem, and D<jats:sub>2%<\/jats:sub> for the chiasm, which were significantly increased by 1, 2, 6, and 8\u00a0Gy, respectively (however below clinical constraints). Similarly, the dose metrics for lung cancer patients were also either not significantly different or were significantly improved compared to the reference plans for VHEE configurations with 200\u00a0MeV and 5 to 16 beams with the exception of D<jats:sub>2%<\/jats:sub> and D<jats:sub>mean<\/jats:sub> to the spinal canal (however below clinical constraints). For the lung cancer cases, the VHEE configurations using 100\u00a0MeV or only 3 beams resulted in significantly worse dose metrics for some OAR. Differences in dose metrics were, however, strongly patient\u2010specific and similar for some patient cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>VHEE\u2010based 3D\u2010CRT may deliver conformal treatments to simple, mostly convex target shapes in the brain and the thorax with a limited number of critical adjacent OAR using a limited number of beams (as low as 3 to 7). Using such treatment techniques, a dosimetric plan quality comparable to that of standard\u2010of\u2010care IMRT can be achieved. Hence, from a treatment planning perspective, 3D\u2010conformal UHDR VHEE treatments delivered on time scales of 100\u00a0ms represent a promising candidate technique for the clinical transfer of the FLASH effect.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16586","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T10:28:56Z","timestamp":1688984936000},"page":"5745-5756","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["3D\u2010conformal very\u2010high energy electron therapy as candidate modality for FLASH\u2010RT: A treatment planning study for glioblastoma and lung cancer"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7408-0187","authenticated-orcid":false,"given":"Till Tobias","family":"B\u00f6hlen","sequence":"first","affiliation":[{"name":"Institute of Radiation Physics Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Germond","sequence":"additional","affiliation":[{"name":"Institute of Radiation Physics Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Traneus","sequence":"additional","affiliation":[{"name":"RaySearch Laboratories Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Vallet","sequence":"additional","affiliation":[{"name":"Institute of Radiation Physics Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Desorgher","sequence":"additional","affiliation":[{"name":"Institute of Radiation Physics Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esat Mahmut","family":"Ozsahin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Bochud","sequence":"additional","affiliation":[{"name":"Institute of Radiation Physics Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Bourhis","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5885-934X","authenticated-orcid":false,"given":"Rapha\u00ebl","family":"Moeckli","sequence":"additional","affiliation":[{"name":"Institute of Radiation Physics Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3008973"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00697-z"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2019.04.001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.05.045"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.05.038"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.06.019"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2021.12.045"},{"key":"e_1_2_9_9_1","unstructured":"BourhisJ FLASH Radiotherapy for Skin Cancer (LANCE).[Internet].National Library of Medicine;2023Accessed May 14 2022.https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05724875"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.5843"},{"key":"e_1_2_9_11_1","unstructured":"BrenemanJ.FLASH radiotherapy for the treatment of symptomatic bone metastases in the thorax (FAST\u201002) NCT05524064[Internet].National Library of Medicine;2022Accessed December 23 2022.https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05524064?term=FLASH+FAST02&draw=2&rank=1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abcbd0"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abe55a"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2019.1627416"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14456"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abd22d"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2020.08.005"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15135"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zemedi.2020.06.008"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aa81f4"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.05.005"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1667\/RADE-20-00069.1"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12233"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.01.017"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4918923"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14891"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13194942"},{"key":"e_1_2_9_28_1","unstructured":"CHUV press release. CHUV CERN and THERYQ join forces for a world first in cancer radiotherapy.CHUV press release;2022. [Internet] Accessed December 21 2022.https:\/\/www.chuv.ch\/fr\/chuv\u2010home\/espace\u2010pro\/journalistes\/communiques\u2010de\u2010presse\/detail\/chuv\u2010cern\u2010and\u2010theryq\u2010join\u2010forces\u2010for\u2010a\u2010world\u2010first\u2010in\u2010cancer\u2010radiotherapy"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15184"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.08.009"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.11.018"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2022.10.018"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/47\/13\/305"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/47\/8\/305"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/54\/11\/003"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaa106"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.08.1994"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.04.008"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2010.08.018"},{"key":"e_1_2_9_40_1","doi-asserted-by":"crossref","unstructured":"KlingA Bar\u00e3oF NakagawaM T\u00e1voraandL VazP Advanced Monte Carlo for Radiation Physics Particle Transport Simulation and Applications \u2010 Proceedings of the Monte Carlo 2000 Conference. 23\u201326 October 2000.Springer;2014.","DOI":"10.1007\/978-3-642-18211-2"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-59758-9_46"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/45\/7\/306"},{"key":"e_1_2_9_43_1","volume-title":"The Python Language Reference","author":"Van Rossum G","year":"2010"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ac4b37"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.7785\/tcrt.2012.500341"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(03)00743-0"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2795842"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v16i5.5768"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nimb.2020.09.008"},{"key":"e_1_2_9_50_1","unstructured":"LagzdaA JonesRM Angal\u2010KalininD et\u00a0al.Relative insensitivity to inhomogeneities on very high energy electron dose distributions. In:Proceedings of IPAC2017.2017:4791\u20104794."}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.16586","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T23:31:09Z","timestamp":1694302269000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.16586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,10]]},"references-count":49,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/mp.16586"],"URL":"https:\/\/doi.org\/10.1002\/mp.16586","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,10]]},"assertion":[{"value":"2023-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}