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FLASH radiotherapy is a novel method that has the potential to improve the therapeutic gain ratio to a new level. FLASH radiotherapy technology is mainly characterized by irradiation at ultra-high dose rate, which can reduce radiation-induced injury to normal tissues during radiotherapy, while maintaining the ability of radiation damage to tumors. On the one hand, as a new radiotherapy technology, the radiobiological mechanisms of FLASH are unclear, which hinders its clinical transformation. On the other hand, there are many technical difficulties in the clinical application of ultra-high dose rate irradiation technology. This paper summarizes the research progress of radiobiological mechanisms underlying FLASH radiotherapy, as well as the challenges and possible solutions associated with FLASH radiotherapy treatment plans, to provide a reference for clinical translation of subsequent FLASH radiotherapy.

Objective To evaluate the safety and efficacy of carbon ion and proton therapies for pancreatic cancer (PaC). Methods The databases were electronically searched to collect the studies about the carbon ion and proton therapies for PaC from inception to June 2019. Two reviewers independently screened literature and extracted data. A Meta-analysis was performed by STATA 12.0 and MetaAnalyst Beta 3.13 software. Results A total of 8 studies involving 459 PaC patients were included. The incidence of grade 2, 3 and 5 gastrointestinal (GI) ulcer toxicities in PaC patients treated with carbon ion and proton therapies were 7%, 2% and 0; the incidence of grade 2, 3 and 4 anorexia toxicities were 6%, 3.2% and 0; the 1- and 2-year OS rates were 77% and 45%; the 2-year local control (LC), 1-year freedom from local progression (FFLP) and 1-year local recurrence(LR) rates were 81%, 88% and 15%. The incidence of grade 2, 3, 2-3 GI ulcer toxicities in carbon ion and proton therapies for PaC were 6.8%, 1.5%, 9.2% and 3.5%, 8.3%, 6.1% (P < 0.05); and the 1- and 2-year OS were 77.1%, 44.4% and 77.6%, 49.7% (P > 0.05). Conclusion Carbon ion and proton therapies for PaC are safe and effective; and the security and effectiveness of the two methods are similar.

Objective To evaluate the efficacy and safety of carbon ion and proton therapy for hepatocellular carcinoma (HCC) by Meta-analysis. Methods PubMed, The Cochrane Library, EMBASE, Chinese Journal Full-text, Chinese Biomedical Literature and Wanfang Database were searched to collect relevant clinical studies on carbon ion and proton therapy for HCC. Two reviewers independently screened the literature and extracted data based on inclusion and exclusion criteria. Meta-analysis was carried out by Stata 12.0. Results We included 7 carbon ion and 23 proton therapy studies. According to the combined results, both carbon ion and proton therapies for HCC obtained good local control rate and low adverse reactions, and the incidence of severe adverse reactions was low. Subgroup analysis showed that carbon ion and proton therapies improved the 5-year OS of HCC patients with either favorable or poor prognosis. Conclusion Both carbon ion and proton therapies may be the effective alternative treatment options for HCC with favorable prognosis, and also show better efficacy for HCC patients with poor prognosis.

MOF-74 (metal–organic framework) is utilized as a filler in mixed-matrix membranes (MMMs) to improve gas selectivity due to its unique one-dimensional hexagonal channels and high-density open metal sites (OMSs), which exhibit a strong affinity for CO2 molecules. Reducing the agglomeration of nanoparticles and improving the compatibility with the matrix can effectively avoid the existence of non-selective voids to improve the gas separation efficiency. We propose a novel, layer-by-layer modification strategy for MOF-74 with graphene oxide. Two-dimensional graphene oxide nanosheets as a supporting skeleton creatively improve the dispersion uniformity of MOFs in MMMs, enhance their interfacial compatibility, and thus optimize the selective gas permeability. Additionally, they extended the gas diffusion paths, thereby augmenting the dissolution selectivity. Compared with doping with a single component, the use of a GO skeleton to disperse MOF-74 into Pebax®1657 (Polyether Block Amide) achieved a significant improvement in terms of the gas separation effect. The CO2/N2 selectivity of Pebax®1657-MOF-74 (Ni)@GO membrane with a filler concentration of 10 wt% was 76.96, 197.2% higher than the pristine commercial membrane Pebax®1657. Our results highlight an effective way to improve the selective gas separation performance of MMMs by functionalizing the MOF supported by layered GO. As an efficient strategy for developing porous MOF-based gas separation membranes, this method holds particular promise for manufacturing advanced carbon dioxide separation membranes and also concentrates on improving CO2 capture with new membrane technologies, a key step in reducing greenhouse gas emissions through carbon capture and storage. [ABSTRACT FROM AUTHOR]

Objective To compare the difference of different radio-chemotherapy modes and clinical characters for more than grade 2 radiation pneumonitis (RP) incidence in patients with lung cancer. Methods We retrospectively analyzed the 136 patients with lung cancer who were treated with radio-chemotherapy in our hospital from January 2014 to January 2016. Following-up was undergone regularly after treatment. RTOG standard of acute radiation pneumonia was applied to evaluate lung injury grade. We also analyzed the effect of clinical character and treatment modes on RP. Results There were 36 cases diagnosed as ≥grade 2 RP, and the occurrence rate was 26.5%. The patients with dust exposure history(P=0.048) and NSCLC pathology type (P=0.047) had a higher RP incidence, while other characters had no statistical difference. Comparing between concomitant chemoradiation group and sequential chemoradiation group, there was statistical difference in the incidence of ≥grade 4 RP (6.7% vs. 0, P=0.05), however, no statistical difference in overall RP, grade 2 or grade 3 RP. There was no statistical difference among different chemotherapy regimens to ≥grade 2 RP. There was significantly positive correlation of RP severity with the total chemotherapy cycles or induction chemotherapy cycles(P=0.000). Conclusion Dust exposure history and pathology type are two clinical character factors to influence the incidence of RP. RP is closely related to the chemotherapy cycles, especially in total chemotherapy cycles or induction chemotherapy cycles.