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Outside more radical radiation techniques such as FLASH, most people largely ignore the therapeutic implications of varying the rate of standard radiation dose deliveries. Here’s an interesting review of preclinical and clinical data on the radiobiologic implications of dose rates spanning low-dose rate brachy up to flattening filter-free external beam radiation. It turns out, for the same total dose delivered, as dose rate increases between 0.01 to 20 Gy/min, sublethal DNA damage becomes increasingly unrepaired leading to increasing tumor and healthy cell death, with the havoc increasing even further when delivered in pulses. | Beddock, Int J Radiat Oncol Biol Phys 2022