Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2021 Nov;197(11):1010-1020.
doi: 10.1007/s00066-021-01803-3. Epub 2021 Jul 6.

Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial)

M Arenas  1   2   3 , M Algara  4   5   6 , G De Febrer  1   7 , C Rubio  8 , X Sanz  9   10   11 , M A de la Casa  8 , C Vasco  1   7 , J Marín  10   12 , P Fernández-Letón  13 , J Villar  10   14 , L Torres-Royo  1   2   3 , P Villares  15 , I Membrive  9   16 , J Acosta  1   2   3 , M López-Cano  15 , P Araguas  1   2   3 , J Quera  9   10   11 , F Rodríguez-Tomás  1   2   3 , A Montero  8
Affiliations
Clinical Trial

Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial)

M Arenas et al. Strahlenther Onkol. 2021 Nov.

Abstract

Purpose: To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19).

Materials and methods: Inclusion criteria comprised patients with COVID-19-related moderate-severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value.

Results: Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X‑ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported.

Conclusions: LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.

Keywords: Anti-inflammatory effects; COVID-19 pneumonia; Low-dose radiation therapy; Lung irradiation; Treatment outcome.

PubMed Disclaimer

Conflict of interest statement

M. Arenas, M. Algara, G. De Febrer, C. Rubio, X. Sanz, M.A. de la Casa, C. Vasco, J. Marín, P. Fernández-Letón, J. Villar, L. Torres-Royo, P. Villares, I. Membrive, J. Acosta, M. López-Cano, P. Araguas, J. Quera, F. Rodríguez-Tomás and A. Montero declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Evolution of respiratory parameters (SpO2/FiO2 [a] and PaO2/FiO2 [b]) in all patients with COVID-19 treated with low-dose radiation therapy classified by survivors, COVID-19 deaths and deaths from other causes
Fig. 2
Fig. 2
Selected respiratory (a) and biochemical (b) parameters comparisons between survivors, COVID-19 deaths and deaths from other causes before treatment and at 24 h after received treatment with low-dose radiation therapy (RT)
See this image and copyright information in PMC

References

    1. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, HLH Across Speciality Collaboration, UK COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033–1034. doi: 10.1016/S0140-6736(20)30628-0. - DOI - PMC - PubMed
    1. Calabrese EJ, Dhawan G, Kapoor R. Radiotherapy for pertussis: an historical assessment. Dose Response. 2017 doi: 10.1177/1559325817704760. - DOI - PMC - PubMed
    1. Calabrese EJ, Dhawan G, Kapoor R. The use of X rays in the treatment of bronchial asthma: a historical assessment. Radiat Res. 2015;184(2):180–192. doi: 10.1667/rr14080.1. - DOI - PubMed
    1. Calabrese EJ, Dhawan G. How radiotherapy was historically used to treat pneumonia: could it be useful today? Yale J Biol Med. 2013;86(4):555–570. - PMC - PubMed
    1. Arenas M, Sabater S, Hernández V, et al. Anti-inflammatory effects of low-dose radiotherapy. Indications, dose, and radiobiological mechanisms involved. Strahlenther Onkol. 2012;188(11):975–981. doi: 10.1007/s00066-012-0170-8. - DOI - PubMed

MeSH terms