The University of Nebraska Medical Center Department of Radiation Oncology; Varian, a Siemens Healthineers Company; and Faith Regional Health Services’ Carson Cancer Center in Norfolk, Nebraska, are teaming to launch a research study to evaluate a potential radiation treatment.

The team is using the Varian FLEX™ Research System for Flash radiation therapy research – which uses modified standard radiation equipment with Flash technology. It’s the first time Varian installed FLEX to convert a linear accelerator for electron Flash research outside of Varian’s research facilities.

Flash is unique in that it delivers a much higher dose of radiation in a shorter amount of time, which kills cancer cells, but also reduces complications in the surrounding normal tissue, said Sumin Zhou, PhD, professor and director of physics, UNMC Department of Radiation Oncology.

The study will establish the foundation for clinical research to follow, said Charles Enke, MD, professor and Bill Bures & Jerry Pabst Chair in Radiation Oncology, UNMC Department of Radiation Oncology.

“We believe Flash radiation therapy is going to be a breakthrough not only for radiation therapy treatment, but for oncology in general,” Dr. Enke said. “Flash is one of the big things being talked about in the field of radiation oncology.”

UNMC is doing the study as part of Varian’s FlashForward™ Consortium – a worldwide consortium of 26 medical centers and scientific organizations conducting research in Flash radiation therapy. The goal is to establish preclinical study designs, develop technical solutions, and share research protocols to help advance the science and clinical translation of Flash therapy.

“What we’ve seen so far acknowledges that it may be possible to deliver radiation at speeds that were never possible in the past that can be used to kill cancer cells while witnessing much lower adverse effects on normal tissue,” Dr. Enke said.

In preclinical studies in mouse models, Flash therapy has been found to be equal or better for tumor control and produces less damage to normal tissue, Dr. Enke said.

“We are learning the physics of Flash and its biological effect on normal and tumor cells and tissues in cell cultures and mouse models and are looking to involve other UNMC researchers,” Dr. Zhou said.

The team is using breast, pancreatic and skin cancer cells, as well as mouse models, in the research, said Ying Yan, PhD, professor and cancer biologist doing radiation therapy and chemotherapy research, UNMC Department of Radiation Oncology.

She said Flash therapy may be useful for some patients who cannot benefit from the current radiation therapy modality. For example, she said, some patients with pancreatic cancer and brain cancer cannot receive sufficient doses of radiation treatment because of the severe injury caused by the radiation to the surrounding normal tissue and organs.

“Radiation therapy often causes an inflammatory response – such as cytokine storms in the lung, brain and gastrointestinal system, which damage the normal tissue, resulting in organs failing,” Dr. Yan said. “Cancer patients may discontinue treatment because radiation therapy side effects can reduce their quality of life. The early evidence we are seeing with Flash radiation is minimal damage to normal tissue.”

Using ultra-high dose rate radiation to eliminate cancer cells while better protecting normal tissue is the possible future of cancer treatment, said Mohammad Zahra, MD, a radiation oncologist at the Faith Regional Carson Cancer Center.

“We are proud to be a part of this study and are grateful to the Johnny Carson Foundation for the generous linear accelerator donations to enable us to conduct this important research on cancer tissue,” he said.

As the research advances, the team plans to apply for federal research funding.

“There’s significant work to be done to understand the mechanism of the Flash effect as it applies to tumor tissue and adjacent normal tissue,” Dr. Enke said. “It may be equally important to understand the impact of high dose rate areas, that are below the Flash dose rate, on normal tissue. This is an exciting field of research, and we are fortunate to have partners at the Faith Regional Carson Cancer Center and Varian join us in advancing the understanding of Flash radiation therapy.”