Is there any supportive evidence for low dose radiotherapy for COVID-19 pneumonia?
Autor: | Nobuyuki Hamada, Simon Bouffler, Elisabeth Cardis, Sisko Salomaa, Michael J. Atkinson |
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Rok vydání: | 2020 |
Předmět: |
Oncology
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Pneumonia Viral 030218 nuclear medicine & medical imaging Betacoronavirus 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Animals Humans Radiology Nuclear Medicine and imaging Low dose radiotherapy Pandemics Clinical Trials as Topic Lung Radiological and Ultrasound Technology SARS-CoV-2 business.industry Bacterial pneumonia COVID-19 Cancer Radiotherapy Dosage medicine.disease Covid-19 Pneumonia Low Dose Radiotherapy Clinical Trials Adaptive Response Clinical trial medicine.anatomical_structure Radiology Nuclear Medicine and imaging 030220 oncology & carcinogenesis Animal studies Coronavirus Infections business |
Zdroj: | International Journal of Radiation Biology Int. J. Radiat. Biol. 96, 1228-1235 (2020) |
ISSN: | 1362-3095 0955-3002 |
Popis: | Since early April 2020, there has been intense debate over proposed clinical use of ionizing radiation to treat life-threatening pneumonia in Coronavirus Disease 2019 (COVID-19) patients. At least twelve relevant papers appeared by 20 May 2020. The radiation dose proposed for clinical trials are a single dose (0.1-1 Gy) or two doses (a few mGy followed by 0.1-0.25 Gy involving a putative adaptive response, or 1-1.5 Gy in two fractions 2-3 days apart). The scientific rationale for such proposed so-called low dose radiotherapy (LDRT) is twofold (note that only doses below 0.1 Gy are considered as low doses in the field of radiation protection, but here we follow the term as conventionally used in the field of radiation oncology). Firstly, the potentially positive observations in human case series and biological studies in rodent models on viral or bacterial pneumonia that were conducted in the pre-antibiotic era. Secondly, the potential anti-inflammatory properties of LDRT, which have been seen when LDRT is applied locally to subacute degenerative joint diseases, mainly in Germany. However, the human and animal studies cited as supportive evidence have significant limitations, and whether LDRT produces anti-inflammatory effects in the inflamed lung or exacerbates ongoing COVID-19 damage remains unclear. Therefore, we conclude that the available scientific evidence does not justify clinical trials of LDRT for COVID-19 pneumonia, with unknown benefit and known mortality risks from radiogenic cancer and circulatory disease. Despite the significant uncertainties in these proposals, some clinical trials are ongoing and planned. This paper gives an overview of current situations surrounding LDRT for COVID-19 pneumonia. |
Databáze: | OpenAIRE |
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