Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients : The SEOR-GICOR IPACOVID comparative cohort trial.
Strahlenther Onkol
; 2023 Mar 31.
Article
in English
| MEDLINE | ID: covidwho-2250140
ABSTRACT
PURPOSE:
To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia. MATERIALS ANDMETHODS:
Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5â¯Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia not candidates for admission to the intensive care unit (ICU) for mechanical ventilation.RESULTS:
Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group could not be found at 48â¯h after LD-RT, which was the primary endpoint of the study. However, PAFI values significantly improved after 1 month (473 vs. 302â¯mmâ¯Hg; pâ¯< 0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than in control patients at 1 week (405 vs. 334â¯mmâ¯Hg; pâ¯= 0.0157) and 1 month after LD-RT (462 vs. 326â¯mmâ¯Hg; pâ¯< 0.0001). All other timepoint measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; pâ¯= 0.047). Fifteen and 26 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; pâ¯= 0.1). LD-RT was associated with a decreased odds ratio (OR) for 1month COVID-19 mortality (ORâ¯= 0.302 [0.106-0.859]; pâ¯= 0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared to the control group (log-rank pâ¯= 0.027). No adverse events related to radiation treatment were observed.CONCLUSION:
Treatment of frail patients with COVID-19 pneumonia with SoC plus single-dose LD-RT of 0.5â¯Gy improved respiratory parameters, reduced the period of hospitalization, decreased the rate of 1month mortality, and prolonged actuarial overall survival compared to SoC alone.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Vaccines
Language:
English
Journal subject:
Neoplasms
/
Radiotherapy
Year:
2023
Document Type:
Article
Affiliation country:
S00066-023-02067-9
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