Articles producció científica> Medicina i Cirurgia

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)

  • Identification data

    Identifier: imarina:9223767
    Authors:
    Arenas, M.Algara, M.De Febrer, G.Rubio, C.Sanz, X.de la Casa, M. A.Vasco, C.Marin, J.Fernandez-Leton, P.Villar, J.Torres-Royo, L.Villares, P.Membrive, IAcosta, J.Lopez-Cano, M.Araguas, P.Quera, J.Rodriguez-Tomas, F.Montero, A.
    Abstract:
    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-2 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 (PaO2) or the pulse oximetry saturation (SpO(2)) to fractional inspired oxygen (FiO(2)) 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(2) pretreatment value was 94.28% and the SpO(2)/FiO(2) 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.
  • Others:

    Author, as appears in the article.: Arenas, M.; Algara, M.; De Febrer, G.; Rubio, C.; Sanz, X.; de la Casa, M. A.; Vasco, C.; Marin, J.; Fernandez-Leton, P.; Villar, J.; Torres-Royo, L.; Villares, P.; Membrive, I; Acosta, J.; Lopez-Cano, M.; Araguas, P.; Quera, J.; Rodriguez-Tomas, F.; Montero, A.;
    Department: Medicina i Cirurgia
    URV's Author/s: Arenas Prat, Meritxell / Rodriguez Tomas, Elisabet
    Keywords: X-ray computed tomography Very elderly Treatment outcome Tomography, x-ray computed Time Severity of illness index Sars-cov-2 Radiotherapy, conformal Radiotherapy dosage Radiotherapy Radiation response Prospective study Prospective studies Procedures Partial pressure Oxygen therapy Oxygen inhalation therapy Oxygen Multimodality cancer therapy Multicenter study Mortality Male Lung irradiation Lung diseases, interstitial Lung Low-dose radiation therapy Lactate dehydrogenase L-lactate dehydrogenase Interstitial lung disease Interleukin-6 Interleukin 6 Il6 protein, human Humans Human Hospital mortality Fibrin fragment d Fibrin fibrinogen degradation products Fibrin degradation product Ferritins Ferritin Female Diagnostic imaging Dexamethasone Covid-19 pneumonia Covid-19 Conformal radiotherapy Comorbidity Combined modality therapy Clinical trial Cause of death C-reactive protein C reactive protein Blood Antiinflammatory agent Anti-inflammatory effects Anti-inflammatory agents Aged, 80 and over Aged
    Abstract: 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-2 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 (PaO2) or the pulse oximetry saturation (SpO(2)) to fractional inspired oxygen (FiO(2)) 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(2) pretreatment value was 94.28% and the SpO(2)/FiO(2) 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.
    Thematic Areas: Radiology, nuclear medicine and imaging Radiology, nuclear medicine & medical imaging Oncology General medicine
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: elisabet.rodriguezt@estudiants.urv.cat elisabet.rodriguezt@estudiants.urv.cat meritxell.arenas@urv.cat
    Author identifier: 0000-0003-0815-2570
    Record's date: 2024-07-27
    Papper version: info:eu-repo/semantics/publishedVersion
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Strahlentherapie Und Onkologie. 197 (11): 1010-1020
    APA: Arenas, M.; Algara, M.; De Febrer, G.; Rubio, C.; Sanz, X.; de la Casa, M. A.; Vasco, C.; Marin, J.; Fernandez-Leton, P.; Villar, J.; Torres-Royo, L.; (2021). 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). Strahlentherapie Und Onkologie, 197(11), 1010-1020. DOI: 10.1007/s00066-021-01803-3
    Article's DOI: 10.1007/s00066-021-01803-3
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Oncology,Radiology, Nuclear Medicine & Medical Imaging,Radiology, Nuclear Medicine and Imaging
    X-ray computed tomography
    Very elderly
    Treatment outcome
    Tomography, x-ray computed
    Time
    Severity of illness index
    Sars-cov-2
    Radiotherapy, conformal
    Radiotherapy dosage
    Radiotherapy
    Radiation response
    Prospective study
    Prospective studies
    Procedures
    Partial pressure
    Oxygen therapy
    Oxygen inhalation therapy
    Oxygen
    Multimodality cancer therapy
    Multicenter study
    Mortality
    Male
    Lung irradiation
    Lung diseases, interstitial
    Lung
    Low-dose radiation therapy
    Lactate dehydrogenase
    L-lactate dehydrogenase
    Interstitial lung disease
    Interleukin-6
    Interleukin 6
    Il6 protein, human
    Humans
    Human
    Hospital mortality
    Fibrin fragment d
    Fibrin fibrinogen degradation products
    Fibrin degradation product
    Ferritins
    Ferritin
    Female
    Diagnostic imaging
    Dexamethasone
    Covid-19 pneumonia
    Covid-19
    Conformal radiotherapy
    Comorbidity
    Combined modality therapy
    Clinical trial
    Cause of death
    C-reactive protein
    C reactive protein
    Blood
    Antiinflammatory agent
    Anti-inflammatory effects
    Anti-inflammatory agents
    Aged, 80 and over
    Aged
    Radiology, nuclear medicine and imaging
    Radiology, nuclear medicine & medical imaging
    Oncology
    General medicine
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