FLASH Irradiation Spares Lung Progenitor Cells and Limits the Incidence of Radio-induced Senescence

Charles Fouillade*, Sandra Curras-Alonso, Lorena Giuranno, Eddy Quelennec, Sophie Heinrich, Sarah Bonnet-Boissinot, Arnaud Beddok, Sophie Leboucher, Hamza Umut Karakurt, Mylène Bohec, Sylvain Baulande, Marc Vooijs, Pierre Verrelle, Marie Dutreix, Arturo Londoño-Vallejo, Vincent Favaudon*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

109 Citations (Web of Science)


PURPOSE: One of the main limitations to anticancer radiotherapy lies in irreversible damage to healthy tissues located within the radiation field. "FLASH" irradiation at very high dose-rate is a new treatment modality that has been reported to specifically spare normal tissue from late radiation-induced toxicity in animal models and therefore could be a promising strategy to reduce treatment toxicity.

EXPERIMENTAL DESIGN: Lung responses to FLASH irradiation were investigated by qPCR, single-cell RNA sequencing (sc-RNA-Seq), and histologic methods during the acute wound healing phase as well as at late stages using C57BL/6J wild-type and Terc-/- mice exposed to bilateral thorax irradiation as well as human lung cells grown in vitro.

RESULTS: In vitro studies gave evidence of a reduced level of DNA damage and induced lethality at the advantage of FLASH. In mouse lung, sc-RNA-seq and the monitoring of proliferating cells revealed that FLASH minimized the induction of proinflammatory genes and reduced the proliferation of progenitor cells after injury. At late stages, FLASH-irradiated lungs presented less persistent DNA damage and senescent cells than after CONV exposure, suggesting a higher potential for lung regeneration with FLASH. Consistent with this hypothesis, the beneficial effect of FLASH was lost in Terc-/- mice harboring critically short telomeres and lack of telomerase activity.

CONCLUSIONS: The results suggest that, compared with conventional radiotherapy, FLASH minimizes DNA damage in normal cells, spares lung progenitor cells from excessive damage, and reduces the risk of replicative senescence.

Original languageEnglish
Pages (from-to)1497-1506
Number of pages10
JournalClinical Cancer Research
Issue number6
Publication statusPublished - 15 Mar 2020


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