Scientists have explored how a new high-powered laboratory accelerator could one day be used to treat cancer, offering new insights into an emerging form of radiotherapy known as FLASH.
Led by a team of researchers at The Institute of Cancer Research, London, The Royal Marsden NHS Foundation Trust and Deutsches Elektronen-Synchrotron (DESY) in Germany, the study uses computational modelling to investigate how powerful controlled electron beams generated by the accelerator could be precisely delivered to tumours.
The research also contributes to growing efforts to better understand FLASH radiotherapy – an experimental technique investigated by The Institute of Cancer Research (ICR) that delivers radiation at ultra-high dose rates in fractions of a second and has shown promise in reducing damage to healthy tissue.
The findings, published in the journal Physics in Medicine and Biology, provide an early look at how this technology might be adapted for cancer treatment in the future. The work was funded by National Institute for Health Research (NIHR) Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and the ICR.
A new direction for radiotherapy
Radiotherapy is a cornerstone of cancer treatment, used in around half of all patients. It works by administering high-energy beams to damage the DNA of cancer cells and to alter their chemical environment, preventing them from growing and dividing. However, it can also affect nearby healthy tissue adjacent to tumours, leading to side effects such as fatigue, skin irritation and the malfunction of adjacent organs.
FLASH is an emerging radiation delivery technology that aims to address this challenge by delivering radiation in extremely short precise bursts at very high dose rates for just a fraction of a second.
Early studies suggest that FLASH may help spare healthy tissue while still effectively targeting tumours. However, researchers are still working to understand exactly how and why this effect occurs, as well as how to safely and precisely deliver these ultra-fast radiation doses in clinical settings.
Modelling a new type of accelerator
In this study, the researchers explored how modern particle accelerator technology generating high-intensity, precisely-controlled electron beams – a physics research tool originally designed for basic research – could potentially be adapted for medical use.
Using computational modelling, the team investigated how scanned electron beams could be delivered at the ultra-high dose rates required for FLASH radiotherapy. These beams can be rapidly steered across a target area, allowing radiation to be distributed with high precision.
This work builds on existing technology developed at DESY, a leading accelerator research centre, where much of the underlying system design has been established. Specifically, the particle source and accelerator research and development facility PITZ, located at DESY’s campus in Zeuthen near Berlin, houses the FLASHlab@PITZ R&D programme that collaborated with the ICR and NIHR for this paper.
The modelling allowed the research team to simulate how such a system might perform in a clinical setting, including how effectively it could deliver radiation to tumour sites while limiting exposure to surrounding healthy tissue.
Understanding the potential of FLASH
As part of the study, the team focused on brain metastases – which are tumours that have spread to the brain from cancers elsewhere in the body. These are a common and challenging complication, affecting an estimated 10–30 per cent of cancer patients.
The researchers specifically modelled the treatment of superficial brain metastases, which are located close to the surface and therefore more accessible to electron beams. Their findings suggest that the beams could potentially deliver the dose rates needed for FLASH radiotherapy while maintaining precise targeting.
Although early experimental studies have suggested that FLASH could reduce damage to healthy tissue, the magnitude of this effect, and the conditions under which it occurs, are still being investigated.
By modelling how different beam configurations behave, the study could help guide future research on identifying the most promising approaches to test. However, the work is an early-stage planning and feasibility study, so further research is required to confirm whether these approaches can be translated into real-world applications.
Future steps
Before FLASH can be implemented in patient care, researchers must gain a deeper understanding of its biological effects, particularly how much protection it offers to healthy tissue and how consistent this effect is across at different dose rates and in different tumour and normal tissue types.
In parallel, the accelerator technology itself needs to be developed into a clinical system. This will involve adapting large-scale research equipment suitable for hospital settings and ensuring it meets strict safety and regulatory requirements.
The researchers also highlight the need for future studies to explore how high-intensity electron beams could be used in a wider range of clinical scenarios, beyond the superficial tumours examined in this work. For instance, they may have potential in combination with spatially fractionated radiation therapy – a related technique that delivers radiation in a grid-like pattern of high-dose regions.
Senior author Professor Uwe Oelfke, Deputy Head of Radiotherapy and Imaging and Group Leader of the Radiotherapy Physics Modelling Image Group at the ICR, said: “In the long term, approaches like this could contribute to the development of more precise and potentially less harmful forms of radiotherapy. For now, our research provides an important foundation – helping researchers and clinicians better understand how emerging techniques like FLASH might be realised and guiding the next generation of experimental studies.”
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