{"entity":{"id":"idea-moon-compact-flash-proton","kind":"idea","name":"Compact FLASH and proton systems at the price of a conventional linac","aka":[],"tldr":"Ultra-fast FLASH radiotherapy and proton beams may spare healthy tissue dramatically, but the machines cost tens of millions. Engineer versions that any hospital can afford.","summary":"FLASH radiotherapy (dose delivered in under a second) reduces normal tissue toxicity in animal models with preserved tumour control and has entered early human trials; proton therapy spares normal tissue by physics but costs an order of magnitude more than photon systems. Compact accelerator concepts (very-high-energy electrons, laser-driven and superconducting compact proton sources) could lower cost. The proposal is a focused engineering programme, with milestone funding, to deliver a compact system capable of FLASH-rate delivery at a capital cost comparable to a conventional linac, paired with the clinical trials needed to establish the FLASH effect in humans.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Surgery and radiotherapy cure most, get least): Sullivan et al., Global cancer surgery (Lancet Oncology Commission 2015)","url":"https://doi.org/10.1016/S1470-2045(15)00223-5"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["flash-rt","proton-therapy"],"targets":[],"drugs":[],"companies":["iba","mevion","varian"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-surgery-radiation-innovation","b-toxicity-qol"],"keyPapers":["paper-sullivan-lancet-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A compact system delivers FLASH-rate treatment at conventional linac cost within eight years, and randomised trials confirm reduced late toxicity at equal tumour control in at least one indication.","rationale":"Toxicity from radiotherapy limits dose and quality of life; if the FLASH effect holds in humans, cost is the only barrier to universal benefit, and accelerator physics is advancing quickly.","test":"Prototype within four years with dosimetric validation; first randomised FLASH versus conventional trial in a toxicity-limited indication such as head and neck or paediatric tumours.","maturity":"preclinical-evidence","actor":"industry","cost":"large","horizonYears":8},"route":"/ideas/idea-moon-compact-flash-proton/","neighbours":{"technology":[{"id":"flash-rt","kind":"technology","name":"FLASH radiotherapy","route":"/technologies/flash-rt/"},{"id":"proton-therapy","kind":"technology","name":"Proton therapy","route":"/technologies/proton-therapy/"}],"company":[{"id":"iba","kind":"company","name":"IBA (Ion Beam Applications)","route":"/companies/iba/"},{"id":"mevion","kind":"company","name":"Mevion Medical Systems","route":"/companies/mevion/"},{"id":"varian","kind":"company","name":"Varian (Siemens Healthineers)","route":"/companies/varian/"}],"bottleneck":[{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-sullivan-lancet-oncol","kind":"paper","name":"Global cancer surgery: delivering safe, affordable, and timely cancer surgery","route":"/key-papers/paper-sullivan-lancet-oncol/"}]}}