Articles producció científica> Medicina i Cirurgia

Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients: The SEOR-GICOR IPACOVID comparative cohort trial

  • Identification data

    Identifier: imarina:9295571
    Handle: https://hdl.handle.net/20.500.11797/imarina9295571
    Authors:
    Arenas MPiqué BTorres-Royo LAcosta JCRodríguez-Tomàs EDe Febrer GVasco CAraguas PGómez JAMalave BÁrquez MAlgara MMontero AMontero MSimó JMGabaldó XParada DRiu FSabater SCamps JJoven J
    Abstract:
    Purpose: To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia. Materials and methods: Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5 Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia not candidates for admission to the intensive care unit (ICU) for mechanical ventilation. Results: Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group could not be found at 48 h after LD-RT, which was the primary endpoint of the study. However, PAFI values significantly improved after 1 month (473 vs. 302 mm Hg; p < 0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than in control patients at 1 week (405 vs. 334 mm Hg; p = 0.0157) and 1 month after LD-RT (462 vs. 326 mm Hg; p < 0.0001). All other timepoint measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; p = 0.047). Fifteen and 26 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; p = 0.1). LD-RT was associated with a decreased odds ratio (OR) for 1‑month COVID-19 mortality (OR = 0.302 [0.106–0.859]; p = 0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared to the control

  • Others:

    Author, as appears in the article.: Arenas M; Piqué B; Torres-Royo L; Acosta JC; Rodríguez-Tomàs E; De Febrer G; Vasco C; Araguas P; Gómez JA; Malave B; Árquez M; Algara M; Montero A; Montero M; Simó JM; Gabaldó X; Parada D; Riu F; Sabater S; Camps J; Joven J
    Department: Medicina i Cirurgia Ciències Mèdiques Bàsiques
    URV's Author/s: Arenas Prat, Meritxell / Arquez Pianetta, Miguel / Camps Andreu, Jorge / Gomez Ramos, Junior Anderson / Joven Maried, Jorge / Rodriguez Tomas, Elisabet
    Keywords: Whole-lung irradiation Standard of care Low-dose radiation therapy Frai patients Covid-19 pneumonia Anti-inflammatory effects standard of care low-dose radiation therapy frai patients anti-inflammatory effects
    Abstract: Purpose: To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia. Materials and methods: Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5 Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia not candidates for admission to the intensive care unit (ICU) for mechanical ventilation. Results: Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group could not be found at 48 h after LD-RT, which was the primary endpoint of the study. However, PAFI values significantly improved after 1 month (473 vs. 302 mm Hg; p < 0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than in control patients at 1 week (405 vs. 334 mm Hg; p = 0.0157) and 1 month after LD-RT (462 vs. 326 mm Hg; p < 0.0001). All other timepoint measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; p = 0.047). Fifteen and 26 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; p = 0.1). LD-RT was associated with a decreased odds ratio (OR) for 1‑month COVID-19 mortality (OR = 0.302 [0.106–0.859]; p = 0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared to the control group (log-rank p = 0.027). No adverse events related to radiation treatment were observed. Conclusion: Treatment of frail patients with COVID-19 pneumonia with SoC plus single-dose LD-RT of 0.5 Gy improved respiratory parameters, reduced the period of hospitalization, decreased the rate of 1‑month mortality, and prolonged actuarial overall survival compared to SoC alone.
    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: miguel.arquez@urv.cat jorge.camps@urv.cat junioranderson.gomez@estudiants.urv.cat miguel.arquez@urv.cat elisabet.rodriguezt@estudiants.urv.cat elisabet.rodriguezt@estudiants.urv.cat meritxell.arenas@urv.cat jorge.joven@urv.cat
    Author identifier: 0000-0002-3165-3640 0000-0003-0815-2570 0000-0003-2749-4541
    Record's date: 2024-08-03
    Papper version: info:eu-repo/semantics/publishedVersion
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Strahlentherapie Und Onkologie. 199 (9): 847-856
    APA: Arenas M; Piqué B; Torres-Royo L; Acosta JC; Rodríguez-Tomàs E; De Febrer G; Vasco C; Araguas P; Gómez JA; Malave B; Árquez M; Algara M; Montero A; Mo (2023). Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients: The SEOR-GICOR IPACOVID comparative cohort trial. Strahlentherapie Und Onkologie, 199(9), 847-856. DOI: 10.1007/s00066-023-02067-9
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2023
    Publication Type: Journal Publications

  • Keywords:

    Oncology,Radiology, Nuclear Medicine & Medical Imaging,Radiology, Nuclear Medicine and Imaging
    Whole-lung irradiation
    Standard of care
    Low-dose radiation therapy
    Frai patients
    Covid-19 pneumonia
    Anti-inflammatory effects
    standard of care
    low-dose radiation therapy
    frai patients
    anti-inflammatory effects
    Radiology, nuclear medicine and imaging
    Radiology, nuclear medicine & medical imaging
    Oncology
    General medicine

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