The effects of ultra-high dose rate FLASH irradiation (above 40 Gy/s) have recently been assessed and compared to conventional dose rate treatment in a variety of pre-clinical models demonstrating promising results in reducing normal tissue toxicity while maintaining tumor control. Proton FLASH is the fastest path to clinical implementation as minimal changes to existing clinical systems are required to achieve ultra-high dose rates on a wide variety of clinical indications.
Here we present FLASH treatment plans and discuss the implications of different methods to bridge the gap between pre-clinical studies and a safe clinical implementation of FLASH therapy. We show two FLASH treatment plans: a 3 field transmission lung FLASH plan of 20 Gy in 1 fraction and a 12 field pristine Bragg Peak brain FLASH plan of 12 Gy in 1 fraction created with Eclipse™ treatment planning system.
In conclusion, the ability to create high quality treatment plans in humans is a first step in the evaluation and potential implementation of FLASH therapy in the clinic.

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