Person: Corona Sánchez, Juan Antonio
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First Name
Juan Antonio
Last Name
Corona Sánchez
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Radiología, Rehabilitación y Fisioterapia
Area
Radiología y Medicina Física
Identifiers
3 results
Search Results
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Item Low-dose Radiation Therapy in the Management of COVID-19 Pneumonia (LOWRAD-Cov19). Final results of a prospective phase I–II trial(Radiotherapy and Oncology, 2022) Sanmamed, Noelia; Alcántara Carrió, María Del Pino; Bustos García De Castro, Ana María; Corona Sánchez, Juan Antonio; Gaztañaga Boronat, Miren; Cabello Clotet, Noemí; Ortuño Andériz, Francisco; Castro Fernández, Javier De; Fuentes Ramos, Manuel; Vazquez, Manuel; Michael Baumann, MDBackground and purpose: To evaluate the results of low-dose radiation therapy (LD-RT) to lungs in the management of patients with COVID-19 pneumonia. Material and methods: We conducted a prospective phase I-II trial enrolling COVID-19 patients ≥50 years-old, with bilateral lung involvement at imaging study and oxygen requirement (oxygen saturation ≤93% on room air). Patients received 1 Gy to whole lungs in a single fraction. Primary outcome was a radiological response assessed as severity and extension scores at days +3 and +7. Secondary outcomes were toxicity (CTCAE v5.0), days of hospitalization, changes in inflammatory blood parameters (ferritin, lymphocytes, C-reactive protein, d-dimer and LDH) and SatO2/FiO2 index (SAFI), at day +3 and +7. Descriptive analyses were summarized as means with standard deviation (SD) and/or medians with interquartile ranges (IQR). A Wilcoxon sign rank test for paired data was used to assess the CT scores and Chi Square was used to assess for comparison of categorical variables. Results: Forty-one patients were included. Median age was 71 (IQR 60-84). Eighteen patients (44%) previously received an anti-COVID treatment (tocilizumab, lopinavir/ritonavir, remdesivir) and thirty-two patients (84%) received steroids during LD-RT. The extension score improved significantly (p = 0.02) on day +7. Mean baseline extension score was 13.7 (SD ± 4.9) with a score of 12.2 (±5.2) at day 3, and 12.4 ± 4.7 at day 7. No differences were found in the severity score. SAFI improved significantly on day +3 and +7 (p < 0.01). Median SAFI on day 0 was 147 (IQR 118-264), 230 (IQR 120-343) on day +3 and 293 (IQR 121-353) on day +7. Significant decrease was found in C-reactive protein on day +7 (p = 0.02) and in lymphocytes counts on day +3 and +7 (p = 0.02). The median number of days in hospital after RT was 11 (range 4-78). With a median follow-up of 60 days after LD-RT, 26 (63%) patients were discharged, 11 (27%) died because of COVID respiratory failure and 4 (10%) died of other causes. Conclusions: LD-RT is a feasible and well-tolerated treatment that could lead to rapid clinical improvement. Large randomized trials would be required to establish the efficacy of LD-RT to treat COVID-19 pneumonia.- Project number: 240
Item Aprendizaje activo basado en la resolución de casos clínico-radiológicos de patología del aparato locomotor en enseñanza virtual(2021) Crespo Rodríguez, Ana María; Archanco Olcese, Miguel; Cabrera Martín, Mª Nieves; Carreras Delgado, José Luis; Casado Herráez, Antonio; Corona Sánchez, Juan Antonio; Cuenca González, Concepción; Fernández Gutiérrez, Benjamín; Francés Borrego, Alberto; García Merino, Mikel; Gómez Peña, Sara; Lópiz Morales, María Yaiza; Marco Martínez, Fernando; Marquina Ospina, Gloria; Muñoz Hernando, Miriam; Nava Muñoz, ÁngelLas estrategias de enseñanza on-line basadas en Tecnologías de la Información y la Comunicación (TIC) se han utilizado con éxito para acercar la práctica clínica de Radiología a los estudiantes de Grado de Medicina durante el curso académico 2020-21. Los alumnos trabajaron por equipos con el método de Aprendizaje Basado en la Resolución de Problemas (ABRP). De esta manera, se aseguró la consecución de los objetivos formativos y se dio a conocer la forma de trabajo del médico radiólogo, el proceso de razonamiento diagnóstico, los sistemas de información de los hospitales y en particular del Picture Archiving and Communication System (PACS). Item Low-Dose Radiation Therapy in the Management of Coronavirus Disease 2019 (COVID-19) Pneumonia (LOWRAD-Cov19): Preliminary Report(International journal of radiation oncology, biology, physics, 2021) Noelia Sanmamed; Alcántara Carrió, María Del Pino; Elena Cerezo; Gaztañaga Boronat, Miren; Cabello Clotet, Noemí; Sara Gómez; Bustos García De Castro, Ana María; Mercedes Duffort; Anxela Doval; Corona Sánchez, Juan Antonio; Gabriel Rodriguez; Ortuño Andériz, Francisco; Castro Fernández, Javier De; Manuel Enrique Fuentes; Alvaro Sanz; Amanda López; Pérez Vázquez, José ManuelPurpose: Low-dose radiation therapy (LD-RT) has been shown to have an anti-inflammatory effect, and preliminary results suggest it is feasible to treat patients with coronavirus disease 2019 (COVID-19) pneumonia. Materials and methods: We conducted a prospective, single-arm, phase 1/2 clinical trial enrolling patients aged ≥50 years, who were coronavirus disease 2019 (COVID-19) positive, at phase 2 or 3 with lung involvement at imaging study and oxygen requirement. Patients received 100 cGy to total lungs in a single fraction. Primary outcome was radiologic response using severity and extension score on baseline computed tomography (CT), at days 3 and 7 after LD-RT. Secondary outcomes were toxicity using Common Terminology Criteria for Adverse Events v.5.0, duration of hospitalization, blood work evolution, and oxygen requirements using SatO2/FiO2 index (SAFI), at days 3 and 7 after LD-RT. Results: Nine patients were included. Median age was 66 (interquartile range, 57-77). Severity score was stable or decreased in the third CT but was not statistically significant (P = .28); however, there were statistically significant changes in the extension score (P = .03). SAFI index significantly improved 72 hours and 1 week after LD-RT (P = .01). Inflammatory blood parameters decreased 1 week after RT compared with baseline; only lactate dehydrogenase decreased significantly (P = .04). Two patients presented grade 2 lymphopenia after RT and another (with baseline grade 3) worsened to grade 4. Overall, the median number of days of hospitalization was 59 (range, 26-151). After RT the median number of days in the hospital was 13 (range, 4-77). With a median follow-up after RT of 112 days (range, 105-150), 7 patients were discharged and 2 patients died, 1 due to sepsis and the other with severe baseline chronic obstructive pulmonary disease from COVID-19 pneumonia. Conclusions: Our preliminary results show that LD-RT was a feasible and well-tolerated treatment, with potential clinical improvement. Randomized trials are needed to establish whether LD-RT improves severe pneumonia.