From the Physics Community of Baghdad to the Frontiers of Cancer Research – FLASH radiotherapy (FLASH-RT) is redefining radiation delivery timescales by administering therapeutic doses at ultra-high dose rates, commonly at or above 40 Gy/s, within milliseconds to fractions of a second. In selected preclinical studies, this approach has reduced radiation-induced injury to healthy tissues while maintaining comparable tumour control, a phenomenon known as the “FLASH effect”. However, this protective response depends on several irradiation and biological parameters and is not guaranteed by dose rate alone. Early clinical studies, including FAST-01 and FAST-02, have demonstrated the feasibility and encouraging safety profile of proton FLASH in small groups of adults with painful bone metastases, including sites near sensitive thoracic structures. Its potential applications in deep-seated cancers and paediatric oncology remain important research priorities rather than established clinical benefits. Advances in precision dosimetry, beam monitoring, treatment planning and long-term comparative trials are essential to bridge the gap “from bench to bedside”, opening new possibilities for safer cancer treatment while preserving scientific rigour.
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