Potential Molecular Mechanisms behind the Ultra-High Dose Rate “FLASH” Effect

Round 1

Reviewer 1 Report

This paper describes the molecular mechanism of FLASH and is very interesting.

The proton beam is currently the only clinically viable device for FLASH. However, in the future, electron beams may lead to the development of clinically viable devices.

Proton beams and electron beams have different treatment mechanisms, and proton beam FLASH and electron beam FLASH should also have different mechanisms.

Since the paper cites FLASH literature on proton beams, electron beams, and carbon beams, it is desirable to add a discussion on how differences in beam types affect the mechanism.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

the paper is a review of the biological effects behind the FLASH method which is a relatively new concept in the radiotherapy field. The authors provide a good overview of the mechanisms involved in FlASH and other studies done in this field. I recommend this paper for publication in the present form at the IJMS.

some comments for improving the paper:

1. in Table 1: the outcome of study 37 is not mentioned. please complete this part in the table.

2. adding some figures for section 2.2 and other sections helps clarify the concept to the readers.

3. in the conclusion, please add your point of view on FLASH in cancer treatment

 

 

 

 

 

Author Response

Please see the attachment.

Author Response File: Author Response.docx