Potential pof laser-driven VHEEs towards FLASH radiotherapy: Monte Carlo dosimetric study of single-field pencil beam scanning of a brain tumor

TL;DR

This study uses simulations to evaluate the dosimetric properties of laser-driven VHEE pencil beams for brain tumor radiotherapy, considering the FLASH effect and technological feasibility.

Contribution

It provides a comprehensive simulation-based assessment of laser-driven VHEE beams' dosimetric features and potential for clinical translation in FLASH radiotherapy.

Findings

Dose volume histograms indicate effective tumor coverage.

Energy spread and tessellation impact dose distribution.

FLASH effect modeling suggests healthy tissue sparing.

Abstract

Radiotherapy with Very High Energy Electron (VHEE) beams is being extensively investigated for the treatment of deep-seated tumours, even in view of novel protocols based on the so-called FLASH effect. Laser WakeField Acceleration (LWFA) provides a compact and affordable accelerator technology for VHEE electron beams, featuring ultra-high instantaneous dose rates and holding the promise to provide Ultra-High (average) Dose Rates (UHDRs) needed to activate the FLASH effect, with major efforts ongoing worldwide to fulfill this promise. Therapeutic doses are already at reach, using pencil beams produced via LWFA. These beams typically exhibit significant energy spread, and small transverse size. These features are rather different from those of other beams considered so far in radiotherapy studies. In view of a rapid clinical translation of LWFA-VHEE beams it is therefore of paramount importance to assess the role of these properties in the dose delivery to the patient. Here we present a study carried out via start-to-end (PIC and Monte Carlo) simulations, of the main dosimetric features of a realistic laser-driven VHEE pencil beam targeted on a brain tumor. The entire tumor coverage is achieved by a scanning procedure; the dose pattern resulting from tessellation, i.e. the overlapping of adjacent beamlets, and the role of energy spread are thoroughly discussed. Dose Volume Histograms are presented, and their quality is discussed. The impact of the FLASH effect is also considered, introducing a degree of healthy tissue sparing in the modelling. Finally, the foreseen technological path toward the achievement of FLASH dose rates with LWFA-VHEE beams is briefly outlined.