{"doi":"10.3389/fonc.2021.687593","title":"Letter in Response to Doyen et al., “Early Toxicities After High Dose Rate Proton Therapy in Cancer Treatments”","abstract":"Ultra-high dose rate \"FLASH\" radiation therapy (FLASH-RT) has attracted considerable attention if not excitement in the radiation oncology field. This enthusiasm has been based on the growing evidence showing that FLASH-RT prevents the development of the majority of normal tissue complications associated with radiotherapy while maintaining isoefficient tumor control, an effect defined in vivo and termed the \"FLASH effect\". In their recent retrospective study, Doyen et al. (1) investigated the normal tissue toxicities developed by 127 cancer patients treated by \"high dose rate\" proton therapy. They reported that proton therapy delivered at a mean dose rate of 10 Gy/s triggered significant acute and subacute toxicities on different organs including the skin, eye, GI and brain. While the authors express their surprise and concerns about this absence of normal tissue protection, a careful examination of the published literature would have revealed that these results were in fact not unexpected since the reported studies did not implement dose rates remotely close to those required to achieve a FLASH effect.","journal":"Frontiers in Oncology","year":2021,"id":224280,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9607,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":232801,"name":"Marie‐Catherine Vozenin","orcid":"0000-0002-2109-8073","position":1,"is_corresponding":false},{"id":232800,"name":"Charles L. Limoli","orcid":"0000-0002-1321-4142","position":2,"is_corresponding":false},{"id":232789,"name":"Pierre Montay‐Gruel","orcid":"0000-0003-0623-1355","position":0,"is_corresponding":true}],"reference_count":13,"raw_metadata":null,"created_at":"2026-07-18T23:54:18.470602Z","pmid":"34055651","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}