{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:49:49Z","timestamp":1790700589599,"version":"4.1.0"},"reference-count":8,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T00:00:00Z","timestamp":1601251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals of advanced age with comorbidities face a higher risk of death from coronavirus disease 2019 (COVID\u201019), especially once they are ventilator\u2010dependent. Respiratory decline in patients with COVID\u201019 is precipitated by a lung\u2010mediated aberrant immune cytokine storm. Low\u2010dose lung radiation was used to treat pneumonia in the pre\u2010antibiotic era. Radiation immunomodulatory effects may improve outcomes for select patients with COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010institution trial evaluating the safety and efficacy of single\u2010fraction, low\u2010dose whole\u2010lung radiation for patients with COVID\u201019 pneumonia is being performed for the first time. This report describes outcomes of a planned day 7 interim analysis. Eligible patients were hospitalized, had radiographic consolidation, required supplemental oxygen, and were clinically deteriorating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 9 patients screened, 5 were treated with whole\u2010lung radiation on April 24 until April 28 2020, and they were followed for a minimum of 7\u00a0days. The median age was 90\u00a0years (range, 64\u201094\u00a0years), and 4 were nursing home residents with multiple comorbidities. Within 24\u00a0hours of radiation, 3 patients (60%) were weaned from supplemental oxygen to ambient air, 4 (80%) exhibited radiographic improvement, and the median Glasgow Coma Scale score improved from 10 to 14. A fourth patient (80% overall recovery) was weaned from oxygen at hour 96. The mean time to clinical recovery was 35\u00a0hours. There were no acute toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a pilot trial of 5 oxygen\u2010dependent elderly patients with COVID\u201019 pneumonia, low\u2010dose whole\u2010lung radiation led to rapid improvements in clinical status, encephalopathy, and radiographic consolidation without acute toxicity. Low\u2010dose whole\u2010lung radiation appears to be safe, shows early promise of efficacy, and warrants further study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay Summary<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Researchers at Emory University report preliminary safety outcomes for patients treated with low\u2010dose lung irradiation for coronavirus disease 2019 (COVID\u201019) pneumonia.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Five residents of nursing or group homes were hospitalized after testing positive for COVID\u201019. Each had pneumonia visible on a chest x\u2010ray, required supplemental oxygen, and experienced a clinical decline in mental status or in work of breathing or a prolonged or escalating supplemental oxygen requirement.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>A single treatment of low\u2010dose (1.5\u2010Gy) radiation to both lungs was delivered over the course of 10 to 15\u00a0minutes. There was no acute toxicity attributable to radiation therapy. Within 24\u00a0hours, 4 patients had rapidly improved breathing, and they recovered to room air at an average of 1.5\u00a0days (range, 3\u201096\u00a0hours). Three were discharged at a mean time of 12\u00a0days, and 1 was preparing for discharge.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Blood tests and repeat imaging confirm that low\u2010dose whole\u2010lung radiation treatment appears safe for COVID\u201019 pneumonia. Further trials are warranted.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.33130","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T12:13:43Z","timestamp":1601295223000},"page":"5109-5113","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Low\u2010dose whole\u2010lung radiation for COVID\u201019 pneumonia: Planned day 7 interim analysis of a registered clinical trial"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4813-9442","authenticated-orcid":false,"given":"Clayton B.","family":"Hess","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary S.","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Stokes","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahseen H.","family":"Nasti","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5563-9325","authenticated-orcid":false,"given":"Jeffrey M.","family":"Switchenko","sequence":"additional","affiliation":[{"name":"Winship Cancer Institute Emory University Atlanta Georgia"},{"name":"Department of Biostatistics and Bioinformatics Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7992-1747","authenticated-orcid":false,"given":"Brent D.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen D.","family":"Godette","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Critical Care Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafi","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Winship Cancer Institute Emory University Atlanta Georgia"},{"name":"Department of Microbiology and Immunology Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Walter J.","family":"Curran","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad K.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30628-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2004500"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2307\/3577549"},{"key":"e_1_2_8_6_1","first-page":"555","article-title":"How radiotherapy was historically used to treat pneumonia: could it be useful today?","volume":"86","author":"Calabrese EJ","year":"2013","journal-title":"Yale J Biol Med"},{"key":"e_1_2_8_7_1","article-title":"Remdesivir for the treatment of Covid\u201019\u2014preliminary report","author":"Beigel JH","journal-title":"N Engl J 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