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. 2023 Dec 15;3:183. doi: 10.1038/s43856-023-00411-9

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — a Irradiation geometry. All groups received unilateral transmission irradiations using the plateau area of a mono energy 226 MeV proton beam. The original scanned beam was modified into a 12 × 12 mm² collimated scanned beam at the irradiation point using a brass collimator (and 7 cm airgap), with a flatness of §5% at maximum dose level. In all cases, the dose prescription was 25 Gy at 1 cm depth in the brain or in the tumor. b Average lesion score after pFLASH irradiation as a function of oxygen level (n = 6 in each group). c Average lesion score after CPT, as function of oxygen level (n = 6 in each group). d Duration of injuries among the irradiated groups (n = 6 in each group). e Representative images of radiation dermatitis among the groups. Images in the groups receiving 25 Gy (n = 6 in each group) at 22 days post-irradiation (maximal severity), correspond to the mean grade observed on this day (grade 3 for pFLASH with O₂, grade 2.5 for pFLASH without O₂, grade 3 for CPT with O₂, grade 3 for CPT without O₂). The rats receiving 15 Gy in CPT or pFLASH did not develop radiation-induced injuries. The data are presented as the mean ± standard deviation (SD).