Low-dose radiotherapy for COVID-19 pneumonia treatment: case report, procedure, and literature review.
Anti-Bacterial Agents
/ therapeutic use
Antibodies, Monoclonal, Humanized
/ therapeutic use
Anticoagulants
/ therapeutic use
Antiviral Agents
/ therapeutic use
COVID-19
/ blood
Combined Modality Therapy
Compassionate Use Trials
Enoxaparin
/ therapeutic use
Humans
Hydroxychloroquine
/ therapeutic use
Male
Middle Aged
Oxygen Inhalation Therapy
Peru
Radiotherapy Planning, Computer-Assisted
Thrombophilia
/ drug therapy
Tomography, X-Ray Computed
COVID-19 Drug Treatment
COVID-19
Cytokine storm
Intensive care
Low-dose radiotherapy
Viral pneumonia
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
14
06
2020
accepted:
27
07
2020
pubmed:
21
8
2020
medline:
15
12
2020
entrez:
21
8
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic outbreak has set the emergency services in developing countries on major alert, as the installed response capacities are easily overwhelmed by the constantly increasing high demand. The deficit of intensive care unit beds and ventilators in countries like Peru is forcing practitioners to seek preventive or early interventional strategies to prevent saturating these chronically neglected facilities. A 64-year-old patient is reported after presenting with COVID-19 pneumonia and rapidly progressing to deteriorated ventilatory function. Compassionate treatment with a single 1‑Gy dose to the bilateral whole-lung volume was administered, with gradual daily improvement of ventilatory function and decrease in serum inflammatory markers and oxygen support needs, including intubation. No treatment-related toxicity developed. Procedures of transport, disinfection, and treatment planning and delivery are described. Whole-lung low-dose radiotherapy seems to be a promising approach for avoiding or delaying invasive respiratory support. Delivered low doses are far from meeting toxicity ranges. On-going prospective trials will elucidate the effectiveness of this approach.
Sections du résumé
BACKGROUND
The COVID-19 pandemic outbreak has set the emergency services in developing countries on major alert, as the installed response capacities are easily overwhelmed by the constantly increasing high demand. The deficit of intensive care unit beds and ventilators in countries like Peru is forcing practitioners to seek preventive or early interventional strategies to prevent saturating these chronically neglected facilities.
CASE PRESENTATION
A 64-year-old patient is reported after presenting with COVID-19 pneumonia and rapidly progressing to deteriorated ventilatory function. Compassionate treatment with a single 1‑Gy dose to the bilateral whole-lung volume was administered, with gradual daily improvement of ventilatory function and decrease in serum inflammatory markers and oxygen support needs, including intubation. No treatment-related toxicity developed. Procedures of transport, disinfection, and treatment planning and delivery are described.
CONCLUSION
Whole-lung low-dose radiotherapy seems to be a promising approach for avoiding or delaying invasive respiratory support. Delivered low doses are far from meeting toxicity ranges. On-going prospective trials will elucidate the effectiveness of this approach.
Identifiants
pubmed: 32816059
doi: 10.1007/s00066-020-01675-z
pii: 10.1007/s00066-020-01675-z
pmc: PMC7439803
doi:
Substances chimiques
Anti-Bacterial Agents
0
Antibodies, Monoclonal, Humanized
0
Anticoagulants
0
Antiviral Agents
0
Enoxaparin
0
Hydroxychloroquine
4QWG6N8QKH
tocilizumab
I031V2H011
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1086-1093Références
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