RT Journal Article
T1 Low-Dose Radiation Therapy in the Management of Coronavirus Disease 2019 (COVID-19) Pneumonia (LOWRAD-Cov19): Preliminary Report
A1 Noelia Sanmamed, 
A1 Alcántara Carrió, María Del Pino
A1 Elena Cerezo, 
A1 Gaztañaga Boronat, Miren
A1 Cabello Clotet, Noemí
A1 Sara Gómez, 
A1 Bustos García De Castro, Ana María
A1 Mercedes Duffort, 
A1 Anxela Doval, 
A1 Corona Sánchez, Juan Antonio
A1 Gabriel Rodriguez, 
A1 Ortuño Andériz, Francisco
A1 Castro Fernández, Javier De
A1 Manuel Enrique Fuentes, 
A1 Alvaro Sanz, 
A1 Amanda López, 
A1 Pérez Vázquez, José Manuel
AB Purpose: 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.
PB Elsevier
SN 0360-3016
YR 2021
FD 2021-03-15
LK https://hdl.handle.net/20.500.14352/100480
UL https://hdl.handle.net/20.500.14352/100480
LA eng
NO Sanmamed N, Alcantara P, Cerezo E, Gaztañaga M, Cabello N, Gómez S, Bustos A, Doval A, Corona J, Rodriguez G, Duffort M, Ortuño F, de Castro J, Fuentes ME, Sanz A, López A, Vazquez M. Low-Dose Radiation Therapy in the Management of Coronavirus Disease 2019 (COVID-19) Pneumonia (LOWRAD-Cov19): Preliminary Report. Int J Radiat Oncol Biol Phys. 2021 Mar 15;109(4):880-885. doi: 10.1016/j.ijrobp.2020.11.049. Epub 2020 Nov 26. PMID: 33249142; PMCID: PMC7690272.
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DS Docta Complutense
RD 7 sept 2024