A universal range shifter and range compensator can enable proton pencil beam scanning single-energy Bragg peak FLASH-RT treatment using current commercially available proton systems.
Published in the Red Journal, this study by the group from New York Proton Center (ProBeam) demonstrated FLASH dose rate based on current machine parameters using a single-energy Bragg peak is achievable. A C-shape target in phantom and six lung cancer patients previously treated with proton SBRT were planned using the Bragg Peak method and also transmission technique. For the six lung cases delivery of 34 GyRBE in 1 fraction, this study reported that the lung V7GyRBE volume was reduced by up to 32%(p=0.001) for Bragg peak plans. Bragg peak plans could reach the FLASH-RT threshold of V40GyRBE/s using a higher minimum MU/spot (1200 MU/spot) and sophisticated dose rate optimization algorithm.