Department of Clinical Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Radiat Oncol Biol Phys. 2020 Dec 1;108(5):1134-1139. doi: 10.1016/j.ijrobp.2020.07.026. Epub 2020 Jul 21.
The COVID-19 outbreak is affecting people worldwide. Many infected patients have respiratory involvement that may progress to acute respiratory distress syndrome. This pilot study aimed to evaluate the clinical efficacy of low-dose whole-lung radiation therapy in patients with COVID-19 pneumonia.
In this clinical trial, conducted in Iran, we enrolled patients with COVID-19 who were older than 60 years and hospitalized to receive supplementary oxygen for their documented pneumonia. Participants were treated with whole-lung irradiation in a single fraction of 0.5 Gy plus the national protocol for the management of COVID-19. Vital signs (including blood oxygenation and body temperature) and laboratory findings (interleukin-6 and C-reactive peptide) were recorded before and after irradiation.
Between May 21, 2020 and June 24, 2020, 5 patients received whole-lung irradiation. They were followed for 5 to 7 days to evaluate the response to treatment and toxicities. The clinical and paraclinical findings of 4 of the 5 patients (patient 4 worsened and died on day 3) improved on the first day of irradiation. Patient 3 opted out of the trial on the third day after irradiation. The mean time to discharge was 6 days for the other 3 patients. No acute radiation-induced toxicity was recorded.
With a response rate of 80%, whole-lung irradiation in a single fraction of 0.5 Gy had encouraging results in oxygen-dependent patients with COVID-19 pneumonia.
COVID-19 疫情正在影响全球人民。许多受感染的患者存在呼吸道受累，可能进展为急性呼吸窘迫综合征。本研究旨在评估低剂量全肺照射治疗 COVID-19 肺炎患者的临床疗效。
本临床试验在伊朗进行，纳入了年龄大于 60 岁且因确诊肺炎而需要补充氧气的 COVID-19 住院患者。参与者接受全肺照射，单次剂量为 0.5Gy，并按照 COVID-19 国家管理方案进行治疗。照射前后记录生命体征（包括血氧饱和度和体温）和实验室检查结果（白细胞介素-6 和 C 反应蛋白）。
2020 年 5 月 21 日至 6 月 24 日，5 名患者接受了全肺照射。对他们进行了 5 至 7 天的随访，以评估治疗反应和毒性。5 名患者中的 4 名（患者 4 在第 3 天恶化并死亡）的临床和实验室检查结果在照射的第一天就有所改善。患者 3 在照射后的第 3 天退出了试验。其余 3 名患者的平均出院时间为 6 天。未记录到急性放射性毒性。
单次 0.5Gy 全肺照射的应答率为 80%，对依赖氧气的 COVID-19 肺炎患者有令人鼓舞的效果。
