Oxygen depletion in FLASH ultra-high-dose-rate radiotherapy: A molecular dynamics simulation
Ramin Abolfath, David Grosshans, Radhe Mohan

TL;DR
This study uses molecular dynamics simulations to investigate how ultra-high-dose-rate radiotherapy reduces tissue damage by promoting the formation of less reactive oxygen species, explaining the FLASH effect.
Contribution
It introduces a first-principles simulation approach to elucidate oxygen depletion mechanisms and ROS dynamics in UHDR FLASH radiotherapy, providing molecular-level insights.
Findings
Formation of metastable ROS complexes at UHDR
NROS chains reduce bio-molecular damage
Higher dose rates increase NROS, decreasing toxic ROS
Abstract
We present a first-principles molecular dynamics (MD) simulation and expound upon a mechanism of oxygen depletion hypothesis to explain the mitigation of normal tissue injury observed in ultra-high-dose-rate (UHDR) FLASH radiotherapy. We simulated damage to a segment of DNA (also representing other bio-molecules such as RNA and proteins) in a simulation box filled with HO and O molecules. Attoseconds physical interactions (ionizations, electronic and vibrational excitations) were simulated by using the Monte Carlo track structure code Geant4-DNA. Immediately after ionization, {\it ab initio} Car-Parrinello molecular dynamics (CPMD) simulation was used to identify which HO and O molecules surrounding the DNA-molecule were converted into reactive oxygen species (ROS). Subsequently, the femto- to nano-second reactions of ROS were simulated by using MD with Reactive Force…
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