IntroductionThe COVID‐19 pandemic has caused significant morbidity and mortality thus far. Considering the historical uses of high‐voltage X‐ray beams for unresolvable pneumonia, we aimed to assess whether low‐dose whole‐lung irradiation (WLI) could provide any benefits for patients with refractory COVID‐19 pneumonia.MethodsEleven patients with refractory COVID‐19 pneumonia were treated with WLI to a total dose of 1 Gy and compared to 11 patients in a matched control group from June to November 2020. The study's primary endpoint was improvement of chest X‐ray severity score (CXRS), followed by changes in mean oxygen (O2) saturation and 28‐day mortality as secondary endpoints.ResultsThe final CXRS was significantly lower in the WLI group (8.7 ± 2.5) compared to the control group (12.3 ± 3.3) (P: 0.016). Change of CXRS from the first to the last chest X‐ray was −2.2 ± 3.1 for the WLI group and 0.7 ± 3.9 for the control group, which showed a trend for lower CXRS in the WLI group (U = 30, p: 0.085). Mean O2 saturation showed insignificant improvement in the first 24 hours after radiotherapy (mean difference: 2.5 ± 4.1, Z=−1.6, P value: 0.11). Overall survival after 28 days was 32% in the WLI group and 11% in the control group (P: 0.48). The reason for death in many patients was not merely respiratory failure, but also other adverse situations like pneumothorax, cardiogenic shock and pulmonary thromboembolism.ConclusionsLow‐dose WLI could improve the CXR severity score and O2 saturation in severely ill COVID‐19 patients, but larger studies are required to determine its impact on mortality.

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IntroductionPeripheral neuropathy is a dose-limiting adverse effect of oxaliplatin. The aim of this study was to evaluate the e cacy and safety of duloxetine in the prevention of oxaliplatin-induced peripheral neuropathy (OIPN). MethodCancer patients receiving oxaliplatin chemotherapy were randomized into two arms. Duloxetine 60 mg capsule was given in the rst 14 days of each chemotherapy cycle to one arm and placebo was similarly given to another arm. We compared the two arms based on the incidence of neuropathy and the results of the nerve conduction study. ResultsThirty two patients were randomized to duloxetine and placebo arms. Most of the patients had rectal cancer (90.6%). Compared with the placebo arm, patients in the duloxetine arm had a lower percentage of chemotherapy cycles (mean) in which they reported distal paresthesia (84% vs. 51%, P = 0.01) and throat discomfort (69% vs. 37%, P = 0.01). There was no difference in the percentage of cycles in which patients reported cold-induced dysesthesia. Highest grade of neuropathy in each cycle was not signi cantly different between the two arms. Six weeks after the last cycle of chemotherapy, nerve conduction velocity was signi cantly higher in duloxetine arm compared to the placebo arm in the deep peroneal nerve and tibial nerve. Duloxetine was safe and well-tolerated. ConclusionIn spite of small sample size, results of this study suggests potential e cacy of duloxetine in the prevention of OIPN, as indicated by objective measures of neurotoxicity and some patient-reported symptoms.