Evidence map›Paper›PMID 34653525›Full record

ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2021

Whole-lung low-dose radiation therapy (LD-RT) for non-intubated oxygen-dependent patients with COVID-19-related pneumonia receiving dexamethasone and/or remdesevir.

Clayton B Hess, Tony Y Eng, Tahseen H Nasti, Vishal R Dhere, Troy J Kleber, Jeffrey M Switchenko, Brent D Weinberg, Nadine Rouphael, Sibo Tian, Soumon Rudra and 4 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04366791 (The RESCUE 1-19 Trial), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04366791 phase1 / phase2terminatednot on this map

The RESCUE 1-19 Trial: Radiation Eliminates Storming Cytokines and Unchecked Edema as a 1-Day Treatment for COVID-19

TypeinterventionalSponsorEmory UniversityRan2020 to 2022Enrolled47ConditionsPneumonia, Coronavirus Infection in 2019 (COVID-19), Severe Acute Respiratory Syndrome (SARS) PneumoniaArmsLow Dose Radiation Therapy
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Radiotherapy for non-cancer diseases: benefits and long-term risks.International journal of radiation biology · 2024
    Review
  7. Article
  8. Review
  9. In regard to Hess et al.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2022
    Article
  10. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Clayton B HessDepartment/Division of Radiation Oncology, Emory University, Atlanta, United States; Department/Division of Microbiology and Immunology, Emory University, Atlanta, United States.
Tony Y EngDepartment/Division of Radiation Oncology, Emory University, Atlanta, United States; Winship Cancer Institute, Emory University, Atlanta, United States.
Tahseen H NastiDepartment/Division of Microbiology and Immunology, Emory University, Atlanta, United States.
Vishal R DhereDepartment/Division of Radiation Oncology, Emory University, Atlanta, United States; Winship Cancer Institute, Emory University, Atlanta, United States.
Troy J KleberSchool of Medicine, Emory University, Atlanta, United States.
Jeffrey M SwitchenkoSchool of Biostatistics and Bioinformatics, Emory University, Atlanta, United States; Winship Cancer Institute, Emory University, Atlanta, United States.
Brent D WeinbergSchool of Radiology, Emory University, Atlanta, United States.
Nadine RouphaelSchool of Infectious Disease, Emory University, Atlanta, United States.
Sibo TianDepartment/Division of Radiation Oncology, Emory University, Atlanta, United States; Winship Cancer Institute, Emory University, Atlanta, United States.
Soumon RudraDepartment/Division of Radiation Oncology, Emory University, Atlanta, United States; Winship Cancer Institute, Emory University, Atlanta, United States.
Luisa S TavernaUndergraduate Scholarly Inquiry and Research Experience (SIRE), Emory University, Atlanta, United States.
Alvaro Perez DaissonUndergraduate Scholarly Inquiry and Research Experience (SIRE), Emory University, Atlanta, United States.
Rafi AhmedDepartment/Division of Microbiology and Immunology, Emory University, Atlanta, United States.
Mohammad K KhanDepartment/Division of Radiation Oncology, Emory University, Atlanta, United States; School of Medicine, Emory University, Atlanta, United States; Winship Cancer Institute, Emory University, Atlanta, United States. Electronic address: drkhurram2000@gmail.com.
Emory University · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

backgroundLow-dose radiotherapy (LD-RT) has produced anti-inflammatory effects in both animal models and early human trials of COVID-19-related pneumonia. The role of whole-lung LD-RT within existing treatment paradigms merits further study.

methodsA phase II prospective trial studied the addition of LD-RT to standard drug treatments. Hospitalized and oxygen-dependent patients receiving dexamethasone and/or remdesevir were treated with 1.5 Gy whole-lung LD-RT and compared to a blindly-matched contemporaneous control cohort.

resultsOf 40 patients evaluated, 20 received drug therapy combined with whole-lung LD-RT and 20 without LD-RT. Intubation rates were 14% with LD-RT compared to 32% without (p = 0.09). Intubation-free survival was 77% vs. 68% (p = 0.17). Biomarkers of inflammation (C-reactive protein, p = 0.02) and cardiac injury (creatine kinase, p < 0.01) declined following LD-RT compared to controls. Mean time febrile was 1.4 vs 3.3 days, respectively (p = 0.14). Significant differences in clinical recovery (7.5 vs. 7 days, p = 0.37) and radiographic improvement (p = 0.72) were not detected. On subset analysis, CRP decline following LD-RT was predictive of recovery without intubation compared to controls (0% vs. 31%, p = 0.04), freedom from prolonged hospitalizations (21+ days) (0% vs. 31%, p = 0.04), and decline in oxygenation burden (56% reduction, p = 0.06). CRP decline following 1st drug therapy was not similarly predictive of outcome in controls (p = 0.36).

conclusionsAdding LD-RT to standard drug treatments reduced biomarkers of inflammation and cardiac injury in COVID-19 patients and may have reduced intubation. Durable CRP decline following LD-RT predicted especially favorable recovery, freedom from intubation, reduction in prolonged hospitalization, and reduced oxygenation burden. A confirmatory randomized trial is now ongoing. CLINICAL

trial registrationNCT04366791.

Indexed as

COVID-19 Drug TreatmentDexamethasoneHumansLungOxygenProspective StudiesSARS-CoV-2Treatment OutcomeDexamethasoneOxygenCOVID-19Low-dose radiationPneumonia

Identifiers

PMID34653525
PMCPMC8511870
OpenAlexW3205439766

What OpenQuestion holds

Textmetadata
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.