Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients

Arenas, Manuel; Pique, Berta; Torres-Royo, L.; Acosta, J.; Rodríguez-Tomàs, Elisabet; Febrer, Gabriel de; Vasco, C.; Araguas, P.; Gómez, Junior; Malave, Bárbara; Árquez, M.; Algara, Manel; Montero, Á.; Montero, María Milagro; Simó, Josep M.; Gabaldó, X; Parada, David; Riu, Francesc; Sabater, S.; Camps, Jordi; Joven, Jorge

doi:10.1007/s00066-023-02067-9

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Numerous studies have shown that whole-lung radiation (WLI) may quicken the recovery in radiographic and clinical settings at doses between 0.5 and 1.5 Gy without resulting in acute damage [20][21][22][23][24][25][26][27][28] .…”

Section: Low-dose Radiotherapy For Covid-19 Pneumoniamentioning

confidence: 99%

“…Researchers looked at the levels of antioxidant enzymes and inflammatory markers in COVID-19 pneumonia patients receiving LDRT 30 , based on the data collected from the IPACOVID trial 20 . Additionally, the relationship between these indicators and changes in lung imaging and clinical symptoms was evaluated.…”

Section: Biomarkers Of Inflammation In Low-dose Radiotherapy For Covi...mentioning

confidence: 99%

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The Influence of Low-Dose Radiotherapy on Paraoxonase-1 and Inflammatory Biomarkers in COVID-19 Pneumonia Patients

Royo,

Árquez,

Acosta

et al. 2024

MRAJ

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The COVID-19 pandemic will be remembered for its significant health and economic impact worldwide. Severe pneumonia could often progress to acute respiratory distress syndrome (ARDS), this being a critical complication characterised by an exaggerated inflammatory response, known as cytokine-release syndrome (CRS). Amid debates regarding the efficacy of conventional treatments, low-dose Radiotherapy (LDRT) has emerged as a potential therapy due to its anti-inflammatory effects. LDRT modulates immune responses by polarizing macrophages towards an anti-inflammatory phenotype and reducing oxidative stress. While studies investigating LDRT for COVID-19 pneumonia have shown promising results, conflicting data has been published and challenges persist in patient selection and treatment timing. Biomarkers such as paraoxonase-1 activity hold promise for predicting treatment outcomes. LDRT presents an alternative approach to modulating the immune response in COVID-19 pneumonia, offering hope for improved clinical outcomes. Further research is warranted to validate its efficacy and elucidate underlying mechanisms. This article provides summary of the radioimmunological mechanisms and the results of biomarkers research in this context.

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Section: Low-dose Radiotherapy For Covid-19 Pneumoniamentioning

confidence: 99%

Section: Biomarkers Of Inflammation In Low-dose Radiotherapy For Covi...mentioning

confidence: 99%

The Influence of Low-Dose Radiotherapy on Paraoxonase-1 and Inflammatory Biomarkers in COVID-19 Pneumonia Patients

Royo,

Árquez,

Acosta

et al. 2024

MRAJ

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“…Існуючих терапевтичних підходів для пацієнтів з COVID-19 й досі недостатньо, що призводить до високої летальності. Незважаючи на те, що щеплення доступні в усіх країнах, залишаються високими поширеність і смертність, швидко з'являються нові варіанти SARS-CoV-2 - усе це постійно поширюватиме його і загрожуватиме світу [25].…”

Section: історичні віхи становлення клінічного застосування радіотера...unclassified

Low-dose radiation therapy for COVID-19

Hladkykh,

Koshurba,

Kulinich

2024

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Background. Radiation therapy is one of the most effective treatments in patients with malignant neoplasms, it also plays an important role in the treatment of non-oncological diseases. The coronavirus disease 2019 (COVID-19) pandemic has prompted a review of the long-forgotten idea of using low-dose radiation therapy (LDRT) in patients with lobar and interstitial pneumonia. Historically, from 1905 to the mid-1940s, LDRT was used to treat pneumonia, and evidence suggests that it might improve survival and provide rapid relief of respiratory symptoms. The purpose was to summarize current information about using low-dose radiation therapy in the treatment of patients with COVID-19. Materials and methods. A selection of publications was carried out, which covered information on the possibilities of using low-dose radiation therapy in the treatment of patients with COVID-19. At the first stage, a search was conducted for literary sources using the keywords: COVID-19, low-dose radiation therapy. At the second stage, summaries of articles were studied and publications that did not meet the research criteria were excluded. At the third stage, the full texts of the selected articles were studied for compliance with the criteria for inclusion in the reference list and research relevance. Results. As of August 1, 2023, according to ClinicalTrials.gov, among 9,244 clinical trials associated with COVID-19, sixteen are currently being conducted. They examine the effectiveness of LDRT in the treatment of patients with COVID-19 and already involve 1,038 patients. The largest number of studies is conducted in European countries. It has been shown that LDRT selectively attenuates oxidative stress to an inflammatory stimulus and inhibits the nitric oxide production pathway. This may contribute to its anti-inflammatory and vascular effects. At the same time, heme oxygenase 1 and other antioxidants are induced, they are mediated by Nrf2, which is the main regulator of endogenous antioxidant, anti-stress, analgesic reactions, and is also closely related to nicotinamide adenine dinucleotide phosphate and the metabolic pathway of pentose phosphate. Nrf2 may be critical for pain relief associated with edema formation and possibly plays a major role in the effects of LDRT, whereas direct functional effects of low-dose radiation on the autonomic nervous system and nociception are likely to be smaller. Conclusions. From 1905 to 1946, researchers published the results of more than 15 clinical studies on the effectiveness of radiotherapy for inflammatory lung diseases, which included more than 850 patients and demonstrated the high therapeutic effectiveness of radiation therapy in the indicated pathology. Today, there are 16 ongoing clinical trials in the world devoted to the study of LDRT effectiveness in the treatment of patients with COVID-19, in which 1,038 patients have already been involved. The risk of radiation-induced lung and breast cancer in a 25-year-old woman exposed to 1 Gy whole chest radiation may be as high as 5.9 and 5.5 %, respectively.

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