Harshamitra Super-Specialty Cancer Centre and Research Institute, Trichy, India.
Harshamitra Super-Specialty Cancer Centre and Research Institute, Trichy, India.
Radiother Oncol. 2022 Feb;167:133-142. doi: 10.1016/j.radonc.2021.12.024. Epub 2021 Dec 25.
The ability of low dose radiotherapy (LDRT) to control the unprecedented cytokine release associated with COVID-19 pathogenesis has been an area of widespread research since the COVID pandemic. It has not been studied adequately whether the anti-inflammatory effect of LDRT provides additional benefit when used concurrently with steroids amongst other standard pharmacologic therapy.
51 RT-PCR positive COVID-19 patients were recruited between November 2020 and July 2021. 34 patients were allotted to receive 0.5 Gy single session LDRT along with standard pharmacologic therapy while 17 patients received standard pharmacologic therapy alone. All had SpO <94% on room air, respiratory frequency >24/min and SpO/FiO (SF) ratio between >89 but <357. All patients underwent a baseline CT scan. They were followed up for 28 days during when serial SF ratio, blood biomarkers (CRP, Serum ferritin, IL-6), Absolute lymphocyte count (ALC), repeat CT scan were performed at pre-defined time points.
LDRT showed a statistically significant early improvement in oxygenation, an early time to clinical recovery, early hospital discharge and better radiological resolution compared to control group. There was no statistically significant difference between the two groups with respect to ALC or blood biomarkers at any of the measured time points. The 28-day mortality rate did not show statistically significant difference between the two groups.
LDRT can be considered for selected oxygen-dependent moderate to severe COVID-19 patients for rapid relief of respiratory distress. It can be safely combined with standard pharmacologic treatment in such patients for added clinical benefit.
自 COVID-19 大流行以来，低剂量放射疗法（LDRT）控制 COVID-19 发病机制相关的前所未有的细胞因子释放的能力一直是广泛研究的领域。尚未充分研究 LDRT 的抗炎作用在与其他标准药物治疗同时使用类固醇时是否提供额外益处。
2020 年 11 月至 2021 年 7 月期间，共招募了 51 名 RT-PCR 阳性 COVID-19 患者。将 34 名患者分配接受 0.5 Gy 单次 LDRT 联合标准药物治疗，而 17 名患者仅接受标准药物治疗。所有患者在室温空气中 SpO <94%，呼吸频率 >24/min 且 SpO/FiO（SF）比值 >89 但 <357。所有患者均进行基线 CT 扫描。在 28 天的随访期间，在预定的时间点进行了连续 SF 比值、血液生物标志物（CRP、血清铁蛋白、IL-6）、绝对淋巴细胞计数（ALC）、重复 CT 扫描。
与对照组相比，LDRT 在氧合方面表现出统计学上的显著早期改善，临床恢复时间更早，更早出院，放射学改善更好。在任何测量时间点，两组之间的 ALC 或血液生物标志物均无统计学显著差异。两组 28 天死亡率无统计学显著差异。
对于依赖氧气的中度至重度 COVID-19 患者，LDRT 可考虑用于快速缓解呼吸窘迫。它可以与标准药物治疗安全地联合用于此类患者，以获得额外的临床益处。
