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This study compared the tumor microenvironment effects of FLASH-RT and conventional RT. After a single-fraction of 15 Gy FLASH, there was increased ROS production, fewer gamma-H2AX foci, and increased immune infiltrate in the tumor microenvironment compared to conventional RT. In contrast to FLASH, conventional RT resulted in activation of myosin light chain (MLC, molecule involved in cell contraction) in tumor cells and endothelial cells, which led to transient vascular collapse. They then inhibited MLC activation and found microenvironment changes from conventional RT that were similar to FLASH. | Kim, Int J Radiat Oncol Biol Phys 2020
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