Physical mechanism of normal-tissue sparing at ultra-high dose rate

In plain words

Healthy tissue survives better when the dose arrives in a flash rather than slowly. The task is to find the physical or chemical process responsible.

Precise statement

Identify the mechanism by which mean dose rates above roughly $4000\ \mathrm{rad}/\mathrm{s}$ ($1\ \mathrm{rad} = 100\ \mathrm{erg}/\mathrm{g}$), delivered in under $200\ \mathrm{ms}$, raise normal-tissue tolerance at fixed total dose (typically $1000\ \text{to}\ 3000\ \mathrm{rad}$ single fraction) without a matching rise in tumour tolerance. Candidate classes: transient radiolytic oxygen depletion, inter-track radical-radical recombination altering peroxidation yields, differential iron and labile metal pools, immune and vascular responses. An answer is a quantitative model reproducing the measured sparing as a function of dose, dose rate, pulse structure and tissue oxygen tension.

What would settle it

A model whose parameters are fixed by independent chemical and physiological measurements and that predicts, without refitting, the sparing measured across electron, proton and photon FLASH experiments in several tissues.

Status in the literature

Unverified note: it names recent work and was partly written without a live literature search; it awaits a check by an editor.

As of 2025 oxygen depletion alone is widely judged insufficient and no consensus mechanism exists.

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