Low-Dose radiation therapy for benign pathologies

Royò, Laura Torres; Redondo, Gabriela Antelo; Pianetta, Miguel Árquez; Prat, M. Arenas

doi:10.1016/j.rpor.2020.02.004

Cited by 54 publications

(35 citation statements)

References 24 publications

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“…It showed 80-85% rates of in ammatory relief success, and a mortality decrease from 30% to 10% (6). Besides, the use of RT in non-malignant in ammatory conditions (7) and its anti-in ammatory properties such as decreasing levels of pro-in ammatory cells including cytokines and macrophages (polarizing them toward an anti-in ammatory M2-like phenotype) have been considered in our study (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Early results of COVID-19 pneumonia cases treated with Ultra-Low doses of Radiotherapy (ULTRA-COVID study)

Moreno-Olmedo¹,

Suarez-Gironzini²,

Pérez³

et al. 2020

Preprint

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Introduction:Since the outbreak of COVID-19 pandemic, healthcare system has focused its effort to find a treatment to avoid the fatal outcome of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Benefits and risks of systemic treatments are unclear. Radiotherapy could play a role in reducing the inflammatory response in the lungs and relieve life-threatening symptomsMethods:We designed a prospective study of Ultra-Low-Doses of Therapy with Radiation Applied to COVID-19 (ULTRA-COVID) for patients that are no candidates for invasive mechanical ventilation and show no improvement with medical therapy. (ClinicalTrials.gov Identifier: NCT04394182)Results:We present the preliminary results of two patients diagnosed with COVID-19 pneumonia treated with ULTRA-COVID. Significant clinical response is accompanied by lower radiological one, both have happened, achieving hospital discharge after 1 radiotherapy session over a period of 8 and 14 days, respectively.Conclusion:Preliminary clinical and radiological results suggest a potential benefit of treating COVID-19 pneumonia with ultra-LDRT.

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Section: Introductionmentioning

confidence: 99%

Early results of COVID-19 pneumonia cases treated with Ultra-Low doses of Radiotherapy (ULTRA-COVID study)

Moreno-Olmedo¹,

Suarez-Gironzini²,

Pérez³

et al. 2020

Preprint

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show abstract

“…Indeed, experimental in vitro and in vivo studies have revealed a multilevel interrelationship between low-dose ionizing radiation and inflammatory cascades. These include, among others, modulation of the inflammatory properties of leukocytes, macrophages, fibroblasts, and endothelial cells, as well as of the secretion of cytokines/chemokines and growth factors (reviewed in [8,9]). In addition, the mechanisms explored so far display common dose-effect relationships, with a pronounced effect in the range between 0.3 and 0.7 Gy, as empirically identified to be the most effective in the clinical situation, including in historical treatment of pneumonia.…”

Section: Evidence On Low-dose Irradiation For Treatment Of Pneumoniamentioning

confidence: 99%

Low-dose radiation therapy for COVID-19 pneumopathy: what is the evidence?

et al. 2020

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In the current dismal situation of the COVID-19 pandemic, effective management of patients with pneumonia and acute respiratory distress syndrome is of vital importance. Due to the current lack of effective pharmacological concepts, this situation has caused interest in (re)considering historical reports on the treatment of patients with low-dose radiation therapy for pneumonia. Although these historical reports are of low-level evidence per se, hampering recommendations for decision-making in the clinical setting, they indicate effectiveness in the dose range between 0.3 and 1 Gy, similar to more recent dose concepts in the treatment of acute and chronic inflammatory/degenerative benign diseases with, e.g., a single dose per fraction of 0.5 Gy. This concise review aims to critically review the evidence for low-dose radiation treatment of COVID-19 pneumopathy and discuss whether it is worth investigating in the present clinical situation.

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“…Acute inflammation progresses in a cascade facilitated by inflammatory mediators, cell adhesion molecules, and interactions between endothelial cells and leucocytes. Low-dose radiotherapy decreases expression of molecules for cell adhesion, produces anti-inflammatory mediators like IL10 and transforming growth factor beta 1 (TGF-β1), increases apoptosis, and secondarily reduces leucocyte-endothelial cell interaction and vasodilation by inhibiting the expression of inducible nitric oxide synthase (iNOS), which contributes to reduced nitric oxide levels [5][6][7]. Additionally, low-dose radiotherapy can contribute to hyper-radiosensitivity, further enhancing apoptotic death [8].…”

mentioning

confidence: 99%