Is there any supportive evidence for low dose radiotherapy for COVID-19 pneumonia? (original) (raw)
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Low Dose Radiation Therapy for COVID-19 Pneumonia: A Pilot Study
ABSTRACTBackgroundThe World Health Organization (WHO) has declared coronavirus disease 2019 (COVID-19) as pandemic in March 2020. Currently there is no vaccine or specific effective treatment for COVID-19. The major cause of death in COVID-19 is severe pneumonia leading to respiratory failure. Radiation in low doses (<100 cGy) has been known for its anti-inflammatory effect and therefore, low dose radiation therapy (LDRT) to lungs can potentially mitigate the severity of pneumonia and reduce mortality. We conducted a pilot trial to study the feasibility and clinical efficacy of LDRT to lungs in the management of patients with COVID-19.MethodsFrom June to Aug 2020, we enrolled 10 patients with COVID-19 having moderate to severe risk disease [National Early Warning Score (NEWS) of ≥5]. Patients were treated as per the standard COVID-19 management guidelines along with LDRT to both lungs with a dose of 70cGy in single fraction. Response assessment was done based on the clinical para...
Low Dose Radiotherapy (LDRT) Can Be an Option For Curing COVID-19?
Indian journal of forensic medicine and toxicology, 2021
In December 2019, the epidemic of Coronavirus Disease 2019 (COVID-19) broke out in Wuhan in China. Symptoms of COVID-19 are non-definite and mild symptoms include: fever, cough. However, elderly and populations with comorbidities such as diabetes, hypertension are more likely to be at risk of severe pulmonary infection and death. Many therapies have been proposed and assed for treating (COVID-19). In April 2020, two papers appeared that suggested clinical trials of low dose radiotherapy (LDRT) for COVID-19 pneumonia. Following that, some researchers carried out some studies, and they modify the amount of doses and fractionation. Regarding the aging, some study using a sensitive age that ranged from 18 to 50 years, are more likely to have stochastic effects that cannot analyzed directly as it needs more time to experience these effects. In this review, we analysis the possibility of a low dose radiotherapy that can have in treating COVID-19 pneumonia, by using almost all accessed publications that performed on a low dose radiotherapy (LDRT) for curing bacteria or virus as well as studies that focus on using LDRT for antiinflammatory. We show that LDRT can perform the mitigation and the repair response of the immune system to provide a potential therapy of COVID-19. A single dose of low-dose radiotherapy can be effective in both cost and time and could potentially relieve symptoms of respiratory rapidly. However, such treatment would not be without obstacle and it can be difficult since it is necessary to recognize those few patients who are more benefit from radiation treatment and identifying short and long-term impacts. clinical stage of disease should be known. Additionally, it is not acceptable to report that LDRT would be superior to any type treatment that are currently under taking, until results from clinical trial will be released.
2020
Purpose: Novel coronavirus disease (COVID-19) is the current global concern. Radiotherapy (RT), commonly employed in cancer management, has been considered one of the potential treatments for COVID-19 pneumonia. Here, we present the final report of the pilot trial evaluating the efficacy and safety of low-dose whole-lung irradiation (LD-WLI) in patients with COVID-19 pneumonia. Methods and Materials: We enrolled patients with moderate COVID-19 pneumonia who were older than 60 years. Participants were treated with LD-WLI in a single fraction of 0.5 or 1.0Gy along with the national protocol of COVID-19. The primary endpoints were improvement of SpO2, the number of hospital/ICU stay days, and the number of intubations after RT and the secondary endpoints were alterations of the c-reactive peptide, interleukin-6, ferritin, procalcitonin, and D-dimer. The response rate (RR) was defined as a rise in SpO2 upon RT with rising or constant trend in the next two days, and clinical recovery (CR...
Clinical and Translational Radiation Oncology, 2020
The COVID-19 pandemia is affecting people worldwide. Most of the patients suffered of a respiratory disease that will progress to an acute respiratory distress syndrome (ARDS). SARS-CoV-2 pneumonia severely ill patients, develop a systemic inflammatory response with a Cytokine Release Syndrome (CRS), that is characterized by a sudden increase in several pro-inflammatory cytokines, mainly IL-1, IL-6 and TNF-alfa by activated macrophages (M1 phenotype). Blocking IL-6 with tocilizumab and using respirator equipment seems to be a very important issue in this (SARS-CoV-2) pneumonia, but not all patients are referred to such treatments. Low dose radiotherapy (0,5 Gy), is an evidence-based anti-inflammatory treatment, that could modify the immune landscape in the lung affected of SARS-CoV-2 pneumonia, through macrophages polarization to alternatively activated Macrophages (M2 phenotype). Radiation-induced cancer risk could be assumed due to the very low dose used, the advanced age of the patients and the life-threatening condition of SARS-Cov2 pneumonia. LDRT is a cost-effective non-toxic treatment already available in most general hospitals. This fact allows that it would be used for the large number of patients that will suffer this disease, and that would not receive specific anti-IL-6 treatments in ICUs in low and middle income countries.
In Vivo
three patients with COVID-19-related pneumonia were treated with LDRT according to the COLOR-19 protocol. All patients were treated with a single fraction at the average prescription dose of 0.7 Gy to both lungs. Results: Three patients were enrolled (two males and one female, aged 61-81 years) and underwent LDRT. Despite LDRT being safely performed without significant side-effects, two patients died (one 81year-old male due to septic shock secondary to Escherichia coli infection and one 79-year-old male, already in poor condition, due to worsening of COVID-19). The remaining female patient (61 years old) underwent LDRT for less