Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial)
Arenas, Manuel (Institut d'Investigació Sanitària Pere Virgili)
Algara, Manuel (Universitat Autònoma de Barcelona. Departament de Medicina)
De Febrer, Gabriel (Hospital Universitari Sant Joan de Reus (Tarragona))
Rubio, C. (HM Hospitales, Madrid)
Sanz, X. (Institut Hospital del Mar d'Investigacions Mèdiques)
de la Casa, M. A. (HM Hospitales, Madrid)
Vasco, C. (Hospital Universitari Sant Joan de Reus (Tarragona))
Marín, J. (Institut Hospital del Mar d'Investigacions Mèdiques)
Fernández-Letón, P.. (HM Hospitales, Madrid)
Villar, J. (Institut Hospital del Mar d'Investigacions Mèdiques)
Torres-Royo, L. (Institut d'Investigació Sanitària Pere Virgili)
Villares, P. (HM Hospitales, Madrid)
Membrive, I. (Hospital del Mar (Barcelona, Catalunya))
Acosta, Johana C (Institut d'Investigació Sanitària Pere Virgili)
López-Cano, Manuel (HM Hospitales, Madrid)
Araguas, Pablo (Institut d'Investigació Sanitària Pere Virgili)
Quera, J. (Institut Hospital del Mar d'Investigacions Mèdiques)
Rodríguez-Tomás, F. (Institut d'Investigació Sanitària Pere Virgili)
Montero, A. (HM Hospitales, Madrid)

Data:	2021
Resum:	Purpose: To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). Materials and methods: Inclusion criteria comprised patients with COVID-19-related moderate-severe pneumonia warranting hospitalization with supplemental O and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0. 5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO) or the pulse oximetry saturation (SpO) to fractional inspired oxygen (FiO) ratio of at least 20% at 24 h with respect to the preirradiation value. Results: Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X‑ray. All patients received dexamethasone treatment. Mean SpO pretreatment value was 94. 28% and the SpO/FiO ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. Conclusions: LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 pneumonia ; Low-dose radiation therapy ; Treatment outcome ; Anti-inflammatory effects ; Lung irradiation
Publicat a:	Strahlentherapie und Onkologie, 2021 , ISSN 1439-099X

DOI: 10.1007/s00066-021-01803-3
PMID: 34230996

11 p, 743.5 KB

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