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Low-Dose Whole Lung Irradiation for Treatment of COVID-19 Pneumonia: A Systematic Review and Meta-Analysis.
Kolahdouzan, Kasra; Chavoshi, Mohammadreza; Bayani, Reyhaneh; Darzikolaee, Nima Mousavi.
  • Kolahdouzan K; Department of Radiation Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
  • Chavoshi M; Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Bayani R; Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiation Oncology, Hamadan University of Medical Sciences, Hamadan, Iran.
  • Darzikolaee NM; Department of Radiation Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran. Electronic
Int J Radiat Oncol Biol Phys ; 113(5): 946-959, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1821289
ABSTRACT

PURPOSE:

Studies dating back to a century ago have reported using low-dose radiation therapy for the treatment of viral and bacterial pneumonia. In the modern era, since the COVID-19 pandemic began, several groups worldwide have researched the applicability of whole lung irradiation (WLI) for the treatment of COVID-19. We aimed to bring together the results of these experimental studies. METHODS AND MATERIALS We performed a systematic review and meta-analysis searching PubMed and Scopus databases for clinical trials incorporating WLI for the treatment of patients with COVID-19. Required data were extracted from each study. Using the random-effects model, the overall pooled day 28 survival rate, survival hazard ratio, and intubation-free days within 15 days after WLI were calculated, and forest plots were produced.

RESULTS:

Ten studies were identified, and eventually, 5 were included for meta-analysis. The overall survival hazard ratio was calculated to be 0.85 (0.46-1.57). The pooled mean difference of intubation-free days within 15 days after WLI was 1.87, favoring the WLI group (95% confidence interval, -0.02 to 3.76). The overall day 28 survival rate of patients receiving WLI for the 9 studies with adequate follow-up data was 74% (95% confidence interval, 61-87). Except for 2 studies, the other 8 studies were assessed to have moderate to high risk of bias, and there were many differences among the designs of the studies, included patients, primary endpoints, outcome measurement methods, and reporting of the results.

CONCLUSIONS:

Despite a mild improvement in intubation-free days, WLI had no significant effect on patients' overall survival. Currently, we cannot recommend routine use of WLI for the treatment of patients with moderate-to-severe COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Lung Neoplasms Type of study: Cohort study / Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Int J Radiat Oncol Biol Phys Year: 2022 Document Type: Article Affiliation country: J.ijrobp.2022.04.043

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Lung Neoplasms Type of study: Cohort study / Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Int J Radiat Oncol Biol Phys Year: 2022 Document Type: Article Affiliation country: J.ijrobp.2022.04.043