| 刘佳,王兰,郭春辉,等.低剂量放疗治疗8例重型/危重型新冠肺炎的初步临床观察[J].中华放射医学与防护杂志,2024,44(5):374-378.Liu Jia,Wang Lan,Guo Chunhui,et al.Preliminary clinical observations of low-dose radiotherapy for eight cases of severe/critical COVID-19[J].Chin J Radiol Med Prot,2024,44(5):374-378 |
| 低剂量放疗治疗8例重型/危重型新冠肺炎的初步临床观察 |
| Preliminary clinical observations of low-dose radiotherapy for eight cases of severe/critical COVID-19 |
| 投稿时间：2023-08-10 |
| DOI：10.3760/cma.j.cn112271-20230810-00039 |
| 中文关键词: 新型冠状病毒 低剂量放射治疗 肺炎 |
| 英文关键词:COVID-19 Low-dose radiotherapy Pneumonia |
| 基金项目:江苏省卫生健康委员会重点科研项目(ZD2021053);江阴市科技局社会发展科技示范项目(JY0603A021014210005PB);国家自然科学基金青年项目(82000012);无锡市卫生健康委中青年拔尖人才资助计划(BJ2023101);放射医学与辐防护国家重点实验室科研创新项目(GZC00402);无锡市卫生健康委员会青年科研项目(Q202333) 临床试验注册: 中国临床试验注册中心,ChiCTR2300070643 |
| 作者 | 单位 | E-mail | | 刘佳 | 南通大学附属江阴医院放疗科, 江阴 214400 | | | 王兰 | 南通大学附属江阴医院呼吸科, 江阴 214400 | | | 郭春辉 | 南通大学附属江阴医院感染性疾病科, 江阴 214400 | | | 焦旸 | 苏州大学苏州医学院放射医学与防护学院 省部共建放射医学与辐射防护国家重点实验室, 苏州 215123 | | | 孙亮 | 苏州大学苏州医学院放射医学与防护学院 省部共建放射医学与辐射防护国家重点实验室, 苏州 215123 | | | 夏林云 | 南通大学附属江阴医院放疗科, 江阴 214400 | | | 秦建军 | 南通大学附属江阴医院放疗科, 江阴 214400 | | | 居敏 | 南通大学附属江阴医院放疗科, 江阴 214400 | | | 蔡依玲 | 南通大学附属江阴医院放疗科, 江阴 214400 | | | 王坚 | 南通大学附属江阴医院放疗科, 江阴 214400 | 1627879372@qq.com |
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| 中文摘要: |
| 目的 探讨全肺低剂量放疗(LDRT)治疗重型/危重型新型冠状病毒(COVID-19)肺炎的疗效和不良反应。方法 本研究为单臂Ⅰ期临床研究,对2023年1月至6月南通大学附属江阴医院收治的经内科治疗后病情恶化或无改善的8例重型/危重型新型COVID-19肺炎患者行全肺LDRT。患者取仰卧或俯卧位,前后对穿照射,剂量权重为1∶1,全肺LDRT剂量0.5~1.5 Gy。分析患者放疗前后氧合状况、炎症指标和影像学变化,观察患者急性放射性不良反应。结果 LDRT后1周,7例(87.5%)患者的SaO2/FiO2或PaO2/FiO2指标上升,7例(87.5%)患者C反应蛋白(CRP)、白介素6(IL-6)等炎性指标下降,胸部CT/胸片扫描显示5例(62.5%)肺部炎症受累范围显著减少。未观察到明显急性放射性不良反应。结论 对内科治疗效果欠佳的重型/危重型新型COVID-19肺炎患者进行全肺0.5~1.5 Gy剂量的LDRT治疗,有助于降低炎症指标,改善临床症状,促进炎症吸收且无明显急性不良反应。 |
| 英文摘要: |
| Objective To investigate the efficacy and adverse reactions of whole-lung low-dose radiotherapy (LDRT) in patients with severe/critical coronavirus disease 2019 (COVID-19). Methods Eight patients with severe/critical COVID-19 treated in the Jiangyin Hospital Affiliated to Nantong University from January to June 2023 who were treated with whole-lung LDRT after deteriorating or failing to improve post-medical treatment were enrolled in this single-arm phase I clinical trial. They received anterior-posterior penetrating radiation in a supine or prone position, with a total dose range from 0.5 to 1.5 Gy and a dose weight ratio of 1∶1. The oxygenation status, inflammatory markers, and imaging changes before and after radiotherapy were analyzed, and patients were followed up for acute radiation-induced adverse reactions. Results One week after LDRT, the SaO2/FiO2 or PaO2/FiO2 indices increased in seven patients (87.5%), inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6) decreased in seven patients (87.5%), and chest CT/chest radiographs revealed a significant reduction in the extent of pneumonia involvement in 5 patients (62.5%). No evident acute radiation-related adverse reactions were observed. Conclusions Whole-lung LDRT with a dose range from 0.5 to 1.5 Gy can reduce inflammatory markers, improve clinical symptoms, and promote inflammatory absorption in patients with severe/critical COVID-19 who responded poorly to medical treatment while not inducing acute adverse reactions. |
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