Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: Short Course Results

Ameri, Ahmad; Rahnama, Nazanin; Bozorgmehr, Rama; Mokhtari, Majid; Farahbakhsh, Mohammad; Nabavi, Mahmood; Shoaei, Simin Dokht; Izadi, Hossein; Yousefi Kashi, Amir Shahram; Dehbaneh, Hadiseh Shabanpour; Taghizadeh-Hesary, Farzad

Abstract Purpose The COVID-19 outbreak is affecting people worldwide. Many of the infected patients suffer from respiratory involvement that may progress to acute respiratory distress syndrome. This pilot study aimed to evaluate the clinical efficacy of low-dose whole-lung radiotherapy in patients with COVID-19 pneumonia. Methods and Materials In this clinical trial, conducted in ***, we enrolled patients with COVID-19 who were older than 60 years and hospitalized to receive supplementary oxygen for their documented pneumonia. Participants were treated with whole-lung irradiation in a single fraction of 0.5 Gy plus the national protocol for the management of COVID-19. Vital signs (including blood oxygenation and body temperature) and laboratory findings (IL-6 and CRP) were recorded before and after irradiation. Results Between 21 May 2020 and 24 June 2020, five patients received whole-lung irradiation. They were followed for 5-7 days to evaluate the response to treatment and toxicities. The clinical and paraclinical findings of four of the five patients (patient #4 became worse and died on day 3) improved on the first day of irradiation. Patient #3 opted-out of the trial on the third day after irradiation. The mean time to discharge was 6 days for the other three patients. No acute radiation-induced toxicity was recorded. Conclusions With a response rate of 80%, whole-lung irradiation in a single fraction of 0.5 Gy had encouraging results in oxygen-dependent patients with COVID-19 pneumonia.