ESTRO 2023

Session Item

Monday

May 15

16:30 - 17:30

Business Suite 1-2

Lung 2

Chair: , France

Session Type: Poster Discussion

Track: Clinical

Journey:

Treatment of COVID-19 pneumonia with low-dose radiotherapy in frail patients

Barbara Antonia Malave Chacon, Spain

Presentation Number: PD-0968

Abstract

Abstract Title:

Treatment of COVID-19 pneumonia with low-dose radiotherapy in frail patients

Authors:

Barbara Antonia Malave Chacon¹, Johana Cristina Acosta Arteaga¹, Berta Piqué², Laura Torres-Royo¹, Elisabet Rodríguez-Tomás³, Rocio Benavides⁴, Gabriel De Febrer⁵, Pablo Araguas¹, Junior Anderson Gomez¹, Miguel Arquez¹, Victor David Calderon¹, Manel Algara⁶, Angel Montero⁷, David Parada², Francesc Riu², Andrea Jiménez⁸, Carlos Vasco⁵, Sebastià Sabater⁹, Jordi Camps³, Jorge Joven³, Meritxell Arenas Prat¹⁰

¹Sant Joan de Reus University Hospital, Radiation Oncology, Tarragona, Spain; ²Sant Joan de Reus University Hospital, Pathology, Tarragona, Spain; ³Rovira i Virgili University, Biomedical Research Unit, Pere Virgili Health Research Institute, Tarragona, Spain; ⁴Sant Joan de Reus University Hospital, Pere Virgili Health Research Institute. Radiation Oncology, Tarragona, Spain; ⁵Sant Joan de Reus University Hospital, Geriatric and Palliative Care, Tarragona, Spain; ⁶Institute of Medical Research, Hospital del Mar, Autonomous University of Barcelona, Radiation Oncology, Barcelona, Spain; ⁷HM Hospitals, Radiation Oncology, Madrid, Spain; ⁸Rovira i Virgili University, Pere Virgili Health Research Institute, Tarragona, Spain; ⁹Complejo Hospitalario de Albacete, Radiation Oncology, Albacete, Spain; ¹⁰Sant Joan de Reus University Hospital, Pere Virgili Health Research Institute, Rovira i Virgili University, Radiation Oncology, Tarragona, Spain

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Purpose or Objective

To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia.

Material and Methods

Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5 Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia, not candidates for admission to Intensive Care Unit (ICU) for mechanical ventilation.

Results

Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group was observed after one month (473 vs. 302 mmHg; p<0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than control patients at one week (405 vs. 334 mmHg; p = 0.0157) and one month after LD-RT (462 vs. 326 mmHg; p<0.0001). All other time-point measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; p=0.047). Fifteen and 24 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; p=0.1). LD-RT was associated with a decreased Odds Ratio (OR) for one-month COVID-19 mortality (OR=0.302 [0.106 – 0.859]; p=0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared with the control group (log-rank p=0.027). No adverse events related to radiation treatment have been observed.

Conclusion

Treatment of frail patients with COVID-19 pneumonia with SoC plus LD-RT 0.5 Gy single dose improved respiratory parameters, reduced period of hospitalization, decreased rate of one-month mortality, and prolonged actuarial overall survival compared to SoC alone.