{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:27:36Z","timestamp":1790612856297,"version":"4.1.0"},"reference-count":90,"publisher":"The Ewha Medical Journal, Ewha Womans University College of Medicine","issue":"4","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2023R1A2C1002539"],"award-info":[{"award-number":["2023R1A2C1002539"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.e-emj.org"],"crossmark-restriction":true},"short-container-title":["Ewha Med J"],"abstract":"<jats:p>\n                FLASH radiotherapy (FLASH-RT) is an innovative approach that delivers ultra-high\n                    dose rates exceeding 40 Gy in less than a second, aiming to widen the\n                    therapeutic window by minimizing damage to normal tissue while maintaining tumor\n                    control. This review explores the advancements, mechanisms, and clinical\n                    applications of FLASH-RT across various radiation sources. Electrons have been\n                    predominantly used due to technical feasibility, but their limited penetration\n                    depth restricts clinical application. Protons, offering deeper tissue\n                    penetration, are considered promising for treating deep-seated tumors despite\n                    challenges in beam delivery. Preclinical studies demonstrate that FLASH-RT\n                    reduces normal tissue toxicity in the lung, brain, skin, intestine, and heart\n                    without compromising antitumor efficacy. The mechanisms underlying the FLASH\n                    effect may involve oxygen depletion leading to transient hypoxia, reduced DNA\n                    damage in normal tissues, and modulation of immune and inflammatory responses.\n                    However, these mechanisms are incompletely understood, and inconsistent results\n                    across studies highlight the need for further research. Initial clinical\n                    studies, including treatment of cutaneous lymphoma and bone metastases, indicate\n                    the feasibility and potential benefits of FLASH-RT in patients. Challenges for\n                    clinical implementation include technical issues in dosimetry accuracy at\n                    ultra-high dose rates, adaptations in treatment planning systems, beam delivery\n                    methods, and economic considerations due to specialized equipment requirements.\n                    Future directions will involve comprehensive preclinical studies to optimize\n                    irradiation parameters, large-scale clinical trials to establish standardized\n                    protocols, and technological advancements to overcome limitations. FLASH-RT\n                    holds the potential to revolutionize radiotherapy by reducing normal tissue\n                    toxicity and improving therapeutic outcomes, but significant research is\n                    required for real-world clinical applications.\n            <\/jats:p>","DOI":"10.12771\/emj.2024.e54","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T01:08:29Z","timestamp":1728954509000},"update-policy":"https:\/\/doi.org\/10.12771\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["FLASH radiotherapy: bridging revolutionary mechanisms and clinical\n                    frontiers in cancer treatment \u2013 a narrative review"],"prefix":"10.12771","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0039-8667","authenticated-orcid":false,"given":"Jae Sik","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-2263","authenticated-orcid":false,"given":"Hak Jae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4998","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"issue":"4","key":"key2.0241212065459e+13_B1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3857\/roj.2022.00500","article-title":"Clinical utilization of radiation therapy in Korea between 2017\n                        and 2019","volume":"40","author":"Kim","year":"2022","journal-title":"Radiat Oncol J"},{"key":"key2.0241212065459e+13_B2","doi-asserted-by":"crossref","first-page":"718636","DOI":"10.3389\/fonc.2021.718636","article-title":"Biological adaptations of tumor cells to radiation\n                        therapy","volume":"11","author":"Carlos-Reyes","year":"2021","journal-title":"Front Oncol"},{"issue":"13","key":"key2.0241212065459e+13_B3","doi-asserted-by":"crossref","first-page":"3173","DOI":"10.3390\/cancers13133173","article-title":"Re-irradiation for head and neck cancer: cumulative dose to\n                        organs at risk and late side effects","volume":"13","author":"Embring","year":"2021","journal-title":"Cancers"},{"issue":"1","key":"key2.0241212065459e+13_B4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3857\/roj.2022.00353","article-title":"Safety and efficacy of salvage conventional re-irradiation\n                        following stereotactic radiosurgery for spine metastases","volume":"41","author":"Florez","year":"2023","journal-title":"Radiat Oncol J"},{"issue":"2","key":"key2.0241212065459e+13_B5","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3857\/roj.2023.00346","article-title":"Research progress and treatment of radiation enteritis and gut\n                        microbiota","volume":"41","author":"Ren","year":"2023","journal-title":"Radiat Oncol J"},{"issue":"37","key":"key2.0241212065459e+13_B6","doi-asserted-by":"crossref","first-page":"62742","DOI":"10.18632\/oncotarget.18409","article-title":"Improving radiotherapy in cancer treatment: promises and\n                        challenges","volume":"8","author":"Chen","year":"2017","journal-title":"Oncotarget"},{"issue":"4","key":"key2.0241212065459e+13_B7","doi-asserted-by":"crossref","first-page":"242","DOI":"10.3857\/roj.2022.00332","article-title":"Dosimetric evaluation of magnetic resonance imaging-guided\n                        adaptive radiation therapy in pancreatic cancer by extent of re-contouring\n                        of organs-at-risk","volume":"40","author":"Song","year":"2022","journal-title":"Radiat Oncol J"},{"issue":"1","key":"key2.0241212065459e+13_B8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3857\/roj.2021.00542","article-title":"Limited field adaptive radiotherapy for glioblastoma: changes in\n                        target volume and organ at risk doses","volume":"40","author":"\u015eenkesen","year":"2022","journal-title":"Radiat Oncol J"},{"issue":"4","key":"key2.0241212065459e+13_B9","doi-asserted-by":"crossref","first-page":"232","DOI":"10.3857\/roj.2022.00136","article-title":"Stereotactic radiosurgery for limited brain metastasis using\n                        three different techniques: helical tomotherapy, volumetric modulated arc\n                        therapy, and cone-based LINAC radiosurgery","volume":"40","author":"Jia-Mahasap","year":"2022","journal-title":"Radiat Oncol J"},{"issue":"4","key":"key2.0241212065459e+13_B10","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3857\/roj.2023.00563","article-title":"CyberKnife-based stereotactic radiosurgery or fractionated\n                        stereotactic radiotherapy in older patients with brain metastases from\n                        non-small cell lung cancer","volume":"41","author":"Lee","year":"2023","journal-title":"Radiat Oncol J"},{"issue":"3","key":"key2.0241212065459e+13_B11","doi-asserted-by":"crossref","first-page":"186","DOI":"10.3857\/roj.2023.00444","article-title":"Feasibility of artificial intelligence-driven interfractional\n                        monitoring of organ changes by mega-voltage computed tomography in\n                        intensity-modulated radiotherapy of prostate cancer","volume":"41","author":"Lee","year":"2023","journal-title":"Radiat Oncol J"},{"key":"key2.0241212065459e+13_B12","doi-asserted-by":"crossref","first-page":"644400","DOI":"10.3389\/fonc.2021.644400","article-title":"FLASH radiotherapy: history and future","volume":"11","author":"Lin","year":"2021","journal-title":"Front 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Oncol"},{"issue":"7","key":"key2.0241212065459e+13_B16","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.clon.2019.04.001","article-title":"Biological benefits of ultra-high dose rate FLASH radiotherapy:\n                        sleeping beauty awoken","volume":"31","author":"Vozenin","year":"2019","journal-title":"Clin Oncol"},{"issue":"10","key":"key2.0241212065459e+13_B17","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.3390\/biom12101376","article-title":"Radiobiological aspects of FLASH radiotherapy","volume":"12","author":"Hageman","year":"2022","journal-title":"Biomolecules"},{"issue":"12","key":"key2.0241212065459e+13_B18","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1038\/s41571-022-00697-z","article-title":"Towards clinical translation of FLASH\n                        radiotherapy","volume":"19","author":"Vozenin","year":"2022","journal-title":"Nat Rev Clin Oncol"},{"key":"key2.0241212065459e+13_B19","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.radonc.2021.09.011","article-title":"FLASH radiotherapy: considerations for multibeam and\n                        hypofractionation dose delivery","volume":"164","author":"MacKay","year":"2021","journal-title":"Radiother Oncol"},{"issue":"3","key":"key2.0241212065459e+13_B20","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1002\/mp.15442","article-title":"Ultra-high dose rate electron beams and the FLASH effect: from\n                        preclinical evidence to a new radiotherapy paradigm","volume":"49","author":"Sch\u00fcler","year":"2022","journal-title":"Med Phys"},{"issue":"S1","key":"key2.0241212065459e+13_B21","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/mp.16271","article-title":"Ultra-high dose rate FLASH radiation therapy for\n                        cancer","volume":"50","author":"Kim","year":"2023","journal-title":"Med Phys"},{"issue":"2","key":"key2.0241212065459e+13_B22","doi-asserted-by":"crossref","first-page":"343","DOI":"10.5603\/RPOR.a2022.0038","article-title":"FLASH radiotherapy: an emerging approach in radiation\n                        therapy","volume":"27","author":"Matuszak","year":"2022","journal-title":"Rep Pract Oncol Radiother"},{"key":"key2.0241212065459e+13_B23","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.nimb.2020.09.008","article-title":"Influence of heterogeneous media on very high energy electron\n                        (VHEE) dose penetration and a Monte Carlo-based comparison with existing\n                        radiotherapy modalities","volume":"482","author":"Lagzda","year":"2020","journal-title":"Nucl Instrum Methods Phys Res Sect B Beam Interact Mater Atoms"},{"issue":"1","key":"key2.0241212065459e+13_B24","doi-asserted-by":"crossref","first-page":"14013","DOI":"10.1038\/s41598-021-93276-8","article-title":"Focused VHEE (very high energy electron) beams and dose delivery\n                        for radiotherapy applications","volume":"11","author":"Whitmore","year":"2021","journal-title":"Sci Rep"},{"issue":"3","key":"key2.0241212065459e+13_B25","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.radonc.2018.08.016","article-title":"X-rays can trigger the FLASH effect: ultra-high dose-rate\n                        synchrotron light source prevents normal brain injury after whole brain\n                        irradiation in mice","volume":"129","author":"Montay-Gruel","year":"2018","journal-title":"Radiother Oncol"},{"issue":"9","key":"key2.0241212065459e+13_B26","doi-asserted-by":"crossref","first-page":"095006","DOI":"10.1088\/1361-6560\/abf2fa","article-title":"Ultrahigh dose-rate (FLASH) X-ray irradiator for pre-clinical\n                        laboratory research","volume":"66","author":"Rezaee","year":"2021","journal-title":"Phys Med Biol"},{"issue":"2","key":"key2.0241212065459e+13_B27","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3857\/roj.2023.00073","article-title":"Proton therapy for reducing heart and cardiac substructure doses\n                        in Indian breast cancer patients","volume":"41","author":"Nangia","year":"2023","journal-title":"Radiat Oncol J"},{"issue":"4","key":"key2.0241212065459e+13_B28","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3857\/roj.2023.00500","article-title":"Synchronous radiation-induced enterovesical and enterocervical\n                        fistulas in carcinoma of the uterine cervix","volume":"41","author":"Mandava","year":"2023","journal-title":"Radiat Oncol J"},{"issue":"4","key":"key2.0241212065459e+13_B29","doi-asserted-by":"crossref","first-page":"274","DOI":"10.3857\/roj.2023.00773","article-title":"Pulmonary function and toxicities of proton versus photon for\n                        limited-stage small cell lung cancer","volume":"41","author":"Seo","year":"2023","journal-title":"Radiat Oncol J"},{"issue":"2","key":"key2.0241212065459e+13_B30","doi-asserted-by":"crossref","first-page":"89","DOI":"10.3857\/roj.2021.00766","article-title":"An overview of radiation-induced heart disease","volume":"40","author":"Ellahham","year":"2022","journal-title":"Radiat Oncol J"},{"issue":"10","key":"key2.0241212065459e+13_B31","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1080\/09553002.2023.2194403","article-title":"Fractionated FLASH radiation in xenografted lung tumors induced\n                        FLASH effect at a split dose of 2 Gy","volume":"99","author":"Dai","year":"2023","journal-title":"Int J Radiat Biol"},{"key":"key2.0241212065459e+13_B32","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.radonc.2021.11.004","article-title":"First demonstration of the FLASH effect with ultrahigh dose rate\n                        high-energy X-rays","volume":"166","author":"Gao","year":"2022","journal-title":"Radiother Oncol"},{"issue":"6","key":"key2.0241212065459e+13_B33","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1158\/1078-0432.CCR-19-1440","article-title":"FLASH irradiation spares lung progenitor cells and limits the\n                        incidence of radio-induced senescence","volume":"26","author":"Fouillade","year":"2020","journal-title":"Clin Cancer Res"},{"issue":"3","key":"key2.0241212065459e+13_B34","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.radonc.2017.05.003","article-title":"Irradiation in a flash: unique sparing of memory in mice after\n                        whole brain irradiation with dose rates above 100Gy\/s","volume":"124","author":"Montay-Gruel","year":"2017","journal-title":"Radiother Oncol"},{"issue":"6","key":"key2.0241212065459e+13_B35","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1667\/RADE-20-00067.1","article-title":"Ultra-high-dose-rate FLASH irradiation limits reactive gliosis in\n                        the brain","volume":"194","author":"Montay-Gruel","year":"2020","journal-title":"Radiat Res"},{"issue":"22","key":"key2.0241212065459e+13_B36","doi-asserted-by":"crossref","first-page":"10943","DOI":"10.1073\/pnas.1901777116","article-title":"Long-term neurocognitive benefits of FLASH radiotherapy driven by\n                        reduced reactive oxygen species","volume":"116","author":"Montay-Gruel","year":"2019","journal-title":"Proc Natl Acad Sci USA"},{"issue":"3","key":"key2.0241212065459e+13_B37","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.ijrobp.2022.02.020","article-title":"Neuroprotective effects of ultra-high dose rate FLASH Bragg peak\n                        proton irradiation","volume":"113","author":"Dokic","year":"2022","journal-title":"Int J Radiat Oncol"},{"issue":"6","key":"key2.0241212065459e+13_B38","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.3390\/cancers12061671","article-title":"Neuroprotection of radiosensitive juvenile mice by ultra-high\n                        dose rate FLASH irradiation","volume":"12","author":"Alaghband","year":"2020","journal-title":"Cancers"},{"issue":"5","key":"key2.0241212065459e+13_B39","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/neuonc\/noac248","article-title":"Elucidating the neurological mechanism of the FLASH effect in\n                        juvenile mice exposed to hypofractionated radiotherapy","volume":"25","author":"Allen","year":"2023","journal-title":"Neuro-Oncology"},{"issue":"3","key":"key2.0241212065459e+13_B40","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1158\/1078-0432.CCR-20-0894","article-title":"Hypofractionated FLASH-RT as an effective treatment against\n                        glioblastoma that reduces neurocognitive side effects in\n                        mice","volume":"27","author":"Montay-Gruel","year":"2021","journal-title":"Clin Cancer Res"},{"key":"key2.0241212065459e+13_B41","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.radonc.2019.06.006","article-title":"Reduced cognitive deficits after FLASH irradiation of whole mouse\n                        brain are associated with less hippocampal dendritic spine loss and\n                        neuroinflammation","volume":"139","author":"Simmons","year":"2019","journal-title":"Radiother Oncol"},{"key":"key2.0241212065459e+13_B42","doi-asserted-by":"crossref","first-page":"109767","DOI":"10.1016\/j.radonc.2023.109767","article-title":"The sparing effect of FLASH-RT on synaptic plasticity is\n                        maintained in mice with standard fractionation","volume":"186","author":"Limoli","year":"2023","journal-title":"Radiother Oncol"},{"issue":"3","key":"key2.0241212065459e+13_B43","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.ijrobp.2022.12.018","article-title":"Proton FLASH radiation therapy and immune infiltration:\n                        evaluation in an orthotopic glioma rat model","volume":"116","author":"Iturri","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"6","key":"key2.0241212065459e+13_B44","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1667\/RADE-20-00060.1","article-title":"Maintenance of tight junction integrity in the absence of\n                        vascular dilation in the brain of mice exposed to ultra-high-dose-rate FLASH\n                        irradiation","volume":"194","author":"Allen","year":"2020","journal-title":"Radiat Res"},{"issue":"6","key":"key2.0241212065459e+13_B45","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1667\/RADE-20-00090","article-title":"FLASH irradiation results in reduced severe skin toxicity\n                        compared to conventional-dose-rate irradiation","volume":"194","author":"Soto","year":"2020","journal-title":"Radiat Res"},{"issue":"18","key":"key2.0241212065459e+13_B46","doi-asserted-by":"crossref","first-page":"4808","DOI":"10.1158\/0008-5472.CAN-21-1500","article-title":"FLASH proton radiotherapy spares normal epithelial and\n                        mesenchymal tissues while preserving sarcoma response","volume":"81","author":"Velalopoulou","year":"2021","journal-title":"Cancer Res"},{"issue":"5","key":"key2.0241212065459e+13_B47","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.3390\/cancers13051012","article-title":"FLASH proton pencil beam scanning irradiation minimizes\n                        radiation-induced leg contracture and skin toxicity in mice","volume":"13","author":"Cunningham","year":"2021","journal-title":"Cancers"},{"issue":"5","key":"key2.0241212065459e+13_B48","doi-asserted-by":"crossref","first-page":"055010","DOI":"10.1088\/1361-6560\/acb888","article-title":"Proton FLASH effects on mouse skin at different oxygen\n                        tensions","volume":"68","author":"Zhang","year":"2023","journal-title":"Phys Med Biol"},{"key":"key2.0241212065459e+13_B49","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.radonc.2022.05.014","article-title":"Pencil beam scanning proton FLASH maintains tumor control while\n                        normal tissue damage is reduced in a mouse model","volume":"175","author":"S\u00f8rensen","year":"2022","journal-title":"Radiother Oncol"},{"issue":"1","key":"key2.0241212065459e+13_B50","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1038\/s41598-024-51951-6","article-title":"Proton-FLASH: effects of ultra-high dose rate irradiation on an\n                        in-vivo mouse ear model","volume":"14","author":"Rudigkeit","year":"2024","journal-title":"Sci Rep"},{"issue":"1","key":"key2.0241212065459e+13_B51","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1158\/1078-0432.CCR-17-3375","article-title":"The advantage of FLASH radiotherapy confirmed in mini-pig and\n                        cat-cancer patients","volume":"25","author":"Vozenin","year":"2019","journal-title":"Clin Cancer Res"},{"issue":"17","key":"key2.0241212065459e+13_B52","doi-asserted-by":"crossref","first-page":"3814","DOI":"10.1158\/1078-0432.CCR-22-0262","article-title":"Dose- and volume-limiting late toxicity of FLASH radiotherapy in\n                        cats with squamous cell carcinoma of the nasal planum and in mini\n                        pigs","volume":"28","author":"Rohrer Bley","year":"2022","journal-title":"Clin Cancer Res"},{"issue":"6","key":"key2.0241212065459e+13_B53","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/j.1600-0463.2005.apm_142.x","article-title":"Serum concentrations of GM-CSF and G-CSF correlate with the\n                        Th1\/Th2 cytokine response in cystic fibrosis patients with chronic\n                        Pseudomonas aeruginosa lung infection","volume":"113","author":"Moser","year":"2005","journal-title":"APMIS"},{"issue":"5","key":"key2.0241212065459e+13_B54","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/j.ijrobp.2021.08.004","article-title":"Irradiation at ultra-high (FLASH) dose rates reduces acute normal\n                        tissue toxicity in the mouse gastrointestinal system","volume":"111","author":"Ruan","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"key2.0241212065459e+13_B55","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.ijrobp.2019.10.049","article-title":"Design, implementation, and in vivo validation of a novel proton\n                        FLASH radiation therapy system","volume":"106","author":"Diffenderfer","year":"2020","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"16","key":"key2.0241212065459e+13_B56","doi-asserted-by":"crossref","first-page":"4244","DOI":"10.3390\/cancers13164244","article-title":"Comparison of FLASH proton entrance and the spread-out Bragg peak\n                        dose regions in the sparing of mouse intestinal crypts and in a pancreatic\n                        tumor model","volume":"13","author":"Kim","year":"2021","journal-title":"Cancers"},{"issue":"1","key":"key2.0241212065459e+13_B57","doi-asserted-by":"crossref","first-page":"21600","DOI":"10.1038\/s41598-020-78017-7","article-title":"Abdominal FLASH irradiation reduces radiation-induced\n                        gastrointestinal toxicity for the treatment of ovarian cancer in\n                        mice","volume":"10","author":"Levy","year":"2020","journal-title":"Sci Rep"},{"issue":"43","key":"key2.0241212065459e+13_B58","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2208506119","article-title":"FLASH X-ray spares intestinal crypts from pyroptosis initiated by\n                        cGAS-STING activation upon radioimmunotherapy","volume":"119","author":"Shi","year":"2022","journal-title":"Proc Natl Acad Sci USA"},{"issue":"7","key":"key2.0241212065459e+13_B59","doi-asserted-by":"crossref","first-page":"4812","DOI":"10.1002\/mp.15680","article-title":"Radioprotective effect of X-ray abdominal FLASH irradiation:\n                        adaptation to oxidative damage and inflammatory response may be benefiting\n                        factors","volume":"49","author":"Zhu","year":"2022","journal-title":"Med Phys"},{"issue":"4","key":"key2.0241212065459e+13_B60","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.ijrobp.2024.01.224","article-title":"FLASH proton 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