Yadav Usha, Sapra Balvinder Kaur
Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India.
Homi Bhabha National Institute, Mumbai, India.
Clin Transl Sci. 2025 Feb;18(2):e70137. doi: 10.1111/cts.70137.
COVID-19 caused a worldwide pandemic resulting in break of demand-supply chain in all aspects of healthcare, high mortality rates, and a constant quest for effective treatment modalities. Based on historical and recent evidences of anti-inflammatory effects of low dose of ionizing radiation, several healthcare professionals proposed low-dose radiation therapy (LDRT) along with ongoing pharmacological treatment for COVID-19 pneumonia. A positive response in a few initial studies led to systematic trials by increasing the number of patients in the range of 0.5-1.5 Gy. However, the concerns of radiation-induced risks were also raised in parallel. In the present article, we have highlighted the basis of LDRT for COVID-19 therapy. We have reviewed the available literature, specifically for outcomes on various clinical trials carried out with LDRT. Meta-analysis was performed to identify if any survival benefits are offered by addition of LDRT over pharmacological treatment alone among COVID-19 pneumonia patients. Other clinical recovery parameters such as intubation rates, oxygenation status, anti-inflammatory response have also been compared. Overall data trends favored LDRT with standard pharmacological treatment against control cohort which received standard treatment alone at all the endpoints in majority studies. LDRT addition resulted in significantly higher odds of survival than control cohort. Among critical and/or mechanically ventilated patients, LDRT did not show any promising outcomes over the control group. In conclusion, LDRT may serve as a promising complementary treatment modality with a potential of better prognosis, provided the patient selection criteria are critically identified and implemented.
新冠病毒病引发了一场全球大流行，导致医疗保健各个方面的供需链中断、高死亡率，以及对有效治疗方式的不断探索。基于低剂量电离辐射抗炎作用的历史和近期证据，一些医疗保健专业人员提出将低剂量放射治疗（LDRT）与正在进行的新冠病毒肺炎药物治疗相结合。一些初步研究中的阳性反应促使开展了系统试验，将患者数量增加到0.5-1.5戈瑞范围。然而，与此同时也有人提出了对辐射诱发风险的担忧。在本文中，我们强调了将LDRT用于新冠病毒病治疗的依据。我们回顾了现有文献，特别是关于采用LDRT进行的各种临床试验的结果。进行了荟萃分析，以确定在新冠病毒肺炎患者中，添加LDRT是否比单纯药物治疗具有任何生存益处。还比较了其他临床恢复参数，如插管率、氧合状态、抗炎反应。总体数据趋势表明，在大多数研究的所有终点，与仅接受标准治疗的对照组相比，LDRT联合标准药物治疗更具优势。添加LDRT后的生存几率显著高于对照组。在重症和/或机械通气患者中，LDRT与对照组相比未显示出任何有前景的结果。总之，如果能严格确定并实施患者选择标准，LDRT可能成为一种有前景的辅助治疗方式，具有改善预后的潜力。
