Version 1
: Received: 8 September 2020 / Approved: 10 September 2020 / Online: 10 September 2020 (08:36:57 CEST)
How to cite:
Ameri, A.; Ameri, P.; Rahnama, N.; Mokhtari, M.; Sedaghat, M.; Hadavand, F.; Bozorgmehr, R.; Haghighi, M.; Taghizadeh-Hesary, F. Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: What is the Optimal Dose? Final Results of a Pilot Study. Preprints2020, 2020090229 (doi: 10.20944/preprints202009.0229.v1).
Ameri, A.; Ameri, P.; Rahnama, N.; Mokhtari, M.; Sedaghat, M.; Hadavand, F.; Bozorgmehr, R.; Haghighi, M.; Taghizadeh-Hesary, F. Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: What is the Optimal Dose? Final Results of a Pilot Study. Preprints 2020, 2020090229 (doi: 10.20944/preprints202009.0229.v1).
Cite as:
Ameri, A.; Ameri, P.; Rahnama, N.; Mokhtari, M.; Sedaghat, M.; Hadavand, F.; Bozorgmehr, R.; Haghighi, M.; Taghizadeh-Hesary, F. Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: What is the Optimal Dose? Final Results of a Pilot Study. Preprints2020, 2020090229 (doi: 10.20944/preprints202009.0229.v1).
Ameri, A.; Ameri, P.; Rahnama, N.; Mokhtari, M.; Sedaghat, M.; Hadavand, F.; Bozorgmehr, R.; Haghighi, M.; Taghizadeh-Hesary, F. Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: What is the Optimal Dose? Final Results of a Pilot Study. Preprints 2020, 2020090229 (doi: 10.20944/preprints202009.0229.v1).
Abstract
Purpose: Novel coronavirus disease (COVID-19) is the current global concern. Radiotherapy (RT), commonly employed in cancer management, has been considered one of the potential treatments for COVID-19 pneumonia. Here, we present the final report of the pilot trial evaluating the efficacy and safety of low-dose whole-lung irradiation (LD-WLI) in patients with COVID-19 pneumonia. Methods and Materials: We enrolled patients with moderate COVID-19 pneumonia who were older than 60 years. Participants were treated with LD-WLI in a single fraction of 0.5 or 1.0Gy along with the national protocol of COVID-19. The primary endpoints were improvement of SpO2, the number of hospital/ICU stay days, and the number of intubations after RT and the secondary endpoints were alterations of the c-reactive peptide, interleukin-6, ferritin, procalcitonin, and D-dimer. The response rate (RR) was defined as a rise in SpO2 upon RT with rising or constant trend in the next two days, and clinical recovery (CR) included patients who were discharged from the hospital or acquired SpO2 ≥93% on room air. Results: Between 21 May 2020 and 2 July 2020, ten patients were enrolled. The median age was 75 years, 80% were male, and 80% had comorbidities. The first five patients received a single 0.5Gy-WLI, and others received 1.0Gy. Patients were followed for 2-14 days (median 5.5 days). Following one day, nine patients experienced an improvement in SpO2. Five patients were discharged (median 6th day, range 2nd-14th day), and four patients died (median 7th day, range 3rd-10th day). Overall, the RR and CR were 60.0% and 55.5%, respectively. The RR and CR rates of 0.5- and 1.0Gy group were 80% vs 40% and 75% vs 40%, respectively. No acute radiation-induced toxicity was recorded. Conclusions: LD-WLI with a single 0.5Gy fraction seems to be a more appropriate dose to warrant further evaluation in a large-scale, randomized trial.
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ahmad Ameri
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