tetano
Editor, Senior Moderator
Int J Radiat Oncol Biol Phys
. 2021 Mar 4;S0360-3016(21)00239-X.
doi: 10.1016/j.ijrobp.2021.02.054. Online ahead of print.
Low dose radiation therapy for severe COVID-19 pneumonia: a randomized double-blind study
Alexandros Papachristofilou[SUP] 1 [/SUP], Tobias Finazzi[SUP] 2 [/SUP], Andrea Blum[SUP] 3 [/SUP], Tatjana Zehnder[SUP] 3 [/SUP], N?ria Zellweger[SUP] 3 [/SUP], Jens Lustenberger[SUP] 2 [/SUP], Tristan Bauer[SUP] 2 [/SUP], Christian Dott[SUP] 2 [/SUP], Yasar Avcu[SUP] 2 [/SUP], G?tz Kohler[SUP] 2 [/SUP], Frank Zimmermann[SUP] 2 [/SUP], Hans Pargger[SUP] 3 [/SUP], Martin Siegemund[SUP] 3 [/SUP]
Affiliations
Abstract
Purpose: The morbidity and mortality of patients requiring mechanical ventilation for coronavirus disease 2019 (COVID-19) pneumonia is considerable. We studied the use of whole-lung low dose radiation therapy (LDRT) in this patient cohort.
Methods and materials: Patients admitted to the intensive care unit (ICU) and requiring mechanical ventilation for COVID-19 pneumonia were included in this randomized double-blind study. Patients were randomized to 1 Gy whole-lung LDRT or sham irradiation (sham-RT). Treatment group allocation was concealed from patients and ICU clinicians, who treated patients according to the current standard of care. Patients were followed for the primary endpoint of ventilator-free days (VFDs) at day 15 post-intervention. Secondary endpoints included overall survival, as well as changes in oxygenation and inflammatory markers.
Results: Twenty-two patients were randomized to either whole-lung LDRT or sham-RT between November and December 2020. Patients were generally elderly and comorbid, with a median age of 75 years in both arms. No difference in 15-day VFDs was observed between groups (p = 1.00), with a median of 0 days (range, 0-9) in the LDRT arm, and 0 days (range, 0-13) in the sham-RT arm. Overall survival at 28 days was identical at 63.6% (95%CI, 40.7-99.5%) in both arms (p = 0.69). Apart from a more pronounced reduction in lymphocyte counts following LDRT (p < 0.01), analyses of secondary endpoints revealed no significant differences between the groups.
Conclusions: Whole-lung LDRT failed to improve clinical outcomes in critically ill patients requiring mechanical ventilation for COVID-19 pneumonia.
. 2021 Mar 4;S0360-3016(21)00239-X.
doi: 10.1016/j.ijrobp.2021.02.054. Online ahead of print.
Low dose radiation therapy for severe COVID-19 pneumonia: a randomized double-blind study
Alexandros Papachristofilou[SUP] 1 [/SUP], Tobias Finazzi[SUP] 2 [/SUP], Andrea Blum[SUP] 3 [/SUP], Tatjana Zehnder[SUP] 3 [/SUP], N?ria Zellweger[SUP] 3 [/SUP], Jens Lustenberger[SUP] 2 [/SUP], Tristan Bauer[SUP] 2 [/SUP], Christian Dott[SUP] 2 [/SUP], Yasar Avcu[SUP] 2 [/SUP], G?tz Kohler[SUP] 2 [/SUP], Frank Zimmermann[SUP] 2 [/SUP], Hans Pargger[SUP] 3 [/SUP], Martin Siegemund[SUP] 3 [/SUP]
Affiliations
- PMID: 33677049
- DOI: 10.1016/j.ijrobp.2021.02.054
Abstract
Purpose: The morbidity and mortality of patients requiring mechanical ventilation for coronavirus disease 2019 (COVID-19) pneumonia is considerable. We studied the use of whole-lung low dose radiation therapy (LDRT) in this patient cohort.
Methods and materials: Patients admitted to the intensive care unit (ICU) and requiring mechanical ventilation for COVID-19 pneumonia were included in this randomized double-blind study. Patients were randomized to 1 Gy whole-lung LDRT or sham irradiation (sham-RT). Treatment group allocation was concealed from patients and ICU clinicians, who treated patients according to the current standard of care. Patients were followed for the primary endpoint of ventilator-free days (VFDs) at day 15 post-intervention. Secondary endpoints included overall survival, as well as changes in oxygenation and inflammatory markers.
Results: Twenty-two patients were randomized to either whole-lung LDRT or sham-RT between November and December 2020. Patients were generally elderly and comorbid, with a median age of 75 years in both arms. No difference in 15-day VFDs was observed between groups (p = 1.00), with a median of 0 days (range, 0-9) in the LDRT arm, and 0 days (range, 0-13) in the sham-RT arm. Overall survival at 28 days was identical at 63.6% (95%CI, 40.7-99.5%) in both arms (p = 0.69). Apart from a more pronounced reduction in lymphocyte counts following LDRT (p < 0.01), analyses of secondary endpoints revealed no significant differences between the groups.
Conclusions: Whole-lung LDRT failed to improve clinical outcomes in critically ill patients requiring mechanical ventilation for COVID-19 pneumonia.