gxf2rc9f

Property	Value
?:abstract	PURPOSE: Phase 1 clinical trials have established low-dose, whole-lung radiation therapy (LD-RT) as safe for patients with coronavirus disease 2019 (COVID-19)-related pneumonia. By focally dampening cytokine hyperactivation, LD-RT may improve disease outcomes through immunomodulation. METHODS AND MATERIALS: Patients with COVID-19–related pneumonia were treated with 1.5 Gy whole-lung LD-RT, followed for 28 days or until hospital discharge, and compared with age- and comorbidity-matched controls meeting identical disease severity criteria. Eligible patients were hospitalized, severe acute respiratory syndrome coronavirus 2 positive, had radiographic consolidations, and required supplemental oxygen but had not rapidly declined on admission or before drug therapy or LD-RT. Efficacy endpoints were time to clinical recovery, radiographic improvement, and biomarker response. RESULTS: Ten patients received whole-lung LD-RT between April 24 and May 24, 2020 and were compared with 10 control patients blindly matched by age and comorbidity. Six controls received COVID-19 drug therapies. Median time to clinical recovery was 12 days in the control cohort compared with 3 days in the LD-RT cohort (hazard ratio 2.9, P = .05). Median time to hospital discharge (20 vs 12 days, P = .19) and intubation rates (40% vs 10%, P = .12) in the control and LD-RT cohorts were compared. Median time from admission to recovery was 10 versus 13 days (P = .13). Hospital duration average was 19 versus 22.6 days (P = .53). Average hospital days on supplemental oxygen of any duration was 13.1 versus 14.7 days (P = .69). Average days with a documented fever was 1 versus 4.3 days (P = .12). Twenty-eight–day overall survival was 90% for both cohorts. The LD-RT cohort trended toward superior rates of improved radiographs (P = .12) and delirium (P < .01). Statistically significant reductions were observed in numerous hematologic, cardiac, hepatic, and inflammatory markers. CONCLUSIONS: A prospective cohort of predominantly elderly hospitalized patients with COVID-19–related pneumonia were recovered to room air quicker than age- and comorbidity-matched controls, with trending or significant improvements in delirium, radiographs, and biomarkers, and no significant acute toxicity. Low dose whole-lung radiation for patients with COVID-19–related pneumonia appears safe and may be an effective immunomodulatory treatment. Larger prospective randomized trials are needed to define the efficacy of LD-RT for COVID-19.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/gxf2rc9f_hasAnnotation_C0011206> <https://research.tib.eu/covid-19/entity/gxf2rc9f_hasAnnotation_C0015967> <https://research.tib.eu/covid-19/entity/gxf2rc9f_hasAnnotation_C0600688> <https://research.tib.eu/covid-19/entity/gxf2rc9f_hasAnnotation_C5203676>
?:creator	<https://research.tib.eu/covid-19/entity/Hess%2C_Clayton_B.%3B_Nasti%2C_Tahseen_H.%3B_Dhere%2C_Vishal%3B_Kleber%2C_Troy%3B_Switchenko%2C_Jeffrey_M.%3B_Buchwald%2C_Zachary_S.%3B_Stokes%2C_William%3B_Weinberg%2C_Brent_D.%3B_Rouphael%2C_Nadine%3B_Steinberg%2C_James_P.%3B_Godette%2C_Karen_D.%3B_Murphy%2C_David%3B_Ahmed%2C_Rafi%3B_Curran%2C_Walter_J.%3B_Khan%2C_Mohammad_K.>
?:doi	10.1016/j.ijrobp.2020.12.011
?:doi	<https://research.tib.eu/covid-19/entity/10.1016/j.ijrobp.2020.12.011>
?:journal	Int_J_Radiat_Oncol_Biol_Phys
?:license	no-cc
?:pdf_json_files	document_parses/pdf_json/c7f6a383fea50878971d363f708f12e79fda03c0.json; document_parses/pdf_json/2b8789c43232d3245e64aa3a2a3cfe569bb77eb7.json
?:pmc_json_files	document_parses/pmc_json/PMC7832642.xml.json
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7832642>
?:pmid	<https://research.tib.eu/covid-19/entity/33340603.0>
?:pmid	33340603.0
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
?:sha_id	<https://research.tib.eu/covid-19/entity/c7f6a383fea50878971d363f708f12e79fda03c0%3B%202b8789c43232d3245e64aa3a2a3cfe569bb77eb7>
?:source	Elsevier; Medline; PMC
?:title	Immunomodulatory Low-Dose Whole-Lung Radiation for Patients with Coronavirus Disease 2019–Related Pneumonia
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-12-16

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Value

?:abstract

PURPOSE: Phase 1 clinical trials have established low-dose, whole-lung radiation therapy (LD-RT) as safe for patients with coronavirus disease 2019 (COVID-19)-related pneumonia. By focally dampening cytokine hyperactivation, LD-RT may improve disease outcomes through immunomodulation. METHODS AND MATERIALS: Patients with COVID-19–related pneumonia were treated with 1.5 Gy whole-lung LD-RT, followed for 28 days or until hospital discharge, and compared with age- and comorbidity-matched controls meeting identical disease severity criteria. Eligible patients were hospitalized, severe acute respiratory syndrome coronavirus 2 positive, had radiographic consolidations, and required supplemental oxygen but had not rapidly declined on admission or before drug therapy or LD-RT. Efficacy endpoints were time to clinical recovery, radiographic improvement, and biomarker response. RESULTS: Ten patients received whole-lung LD-RT between April 24 and May 24, 2020 and were compared with 10 control patients blindly matched by age and comorbidity. Six controls received COVID-19 drug therapies. Median time to clinical recovery was 12 days in the control cohort compared with 3 days in the LD-RT cohort (hazard ratio 2.9, P = .05). Median time to hospital discharge (20 vs 12 days, P = .19) and intubation rates (40% vs 10%, P = .12) in the control and LD-RT cohorts were compared. Median time from admission to recovery was 10 versus 13 days (P = .13). Hospital duration average was 19 versus 22.6 days (P = .53). Average hospital days on supplemental oxygen of any duration was 13.1 versus 14.7 days (P = .69). Average days with a documented fever was 1 versus 4.3 days (P = .12). Twenty-eight–day overall survival was 90% for both cohorts. The LD-RT cohort trended toward superior rates of improved radiographs (P = .12) and delirium (P < .01). Statistically significant reductions were observed in numerous hematologic, cardiac, hepatic, and inflammatory markers. CONCLUSIONS: A prospective cohort of predominantly elderly hospitalized patients with COVID-19–related pneumonia were recovered to room air quicker than age- and comorbidity-matched controls, with trending or significant improvements in delirium, radiographs, and biomarkers, and no significant acute toxicity. Low dose whole-lung radiation for patients with COVID-19–related pneumonia appears safe and may be an effective immunomodulatory treatment. Larger prospective randomized trials are needed to define the efficacy of LD-RT for COVID-19.

is ?:annotates of