Low-dose radiation therapy for COVID-19 pneumonia: Comparison of dosimetry and life-time attributable risk of cancer with conventional AP-PA fields and bone marrow sparing VMAT.
Humans
COVID-19
/ prevention & control
Radiotherapy, Intensity-Modulated
/ methods
Middle Aged
Radiotherapy Dosage
Male
Organs at Risk
/ radiation effects
Adult
Radiotherapy Planning, Computer-Assisted
/ methods
Bone Marrow
/ radiation effects
Female
SARS-CoV-2
Lung
/ radiation effects
Radiometry
/ methods
Tomography, X-Ray Computed
/ methods
Neoplasms, Radiation-Induced
/ etiology
Journal
Journal of cancer research and therapeutics
ISSN: 1998-4138
Titre abrégé: J Cancer Res Ther
Pays: India
ID NLM: 101249598
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
03
04
2024
accepted:
22
04
2024
medline:
18
7
2024
pubmed:
18
7
2024
entrez:
18
7
2024
Statut:
ppublish
Résumé
Low-dose radiation therapy (LDRT) to lungs did show encouraging results in COVID-19 patients in some clinical trials. However, there has been some concern regarding the long-term risk of radiation-induced cancer (RIC). Compared to the conventional AP-PA field technique, volumetric modulated arc therapy (VMAT) can potentially reduce the dose to the marrow and other organs at risk (OARs) and thus minimize the risk of cancer. We designed a dosimetry study to study if VMAT can reduce the exposure to the marrow and other OAR doses and curtail the estimated life-time attributable risk (LAR) of cancer. We retrieved the computed tomography scan data of 10 patients (aged 40-60 years, median 48 years) who have been already treated for any malignancy in the region of the thorax. A dose of 1.0 Gy in single fraction was prescribed to both lungs. All the organs were delineated as per the established guidelines. The dosimetry achieved by the two plans was compared to find the difference. Mean OAR doses were used to estimate the LAR for both plans and compared. Planning target volume coverage parameters like conformity index and homogeneity index were significantly better with VMAT (P value < 0.05 for all). The mean dose to most OARs was significantly lower with VMAT (P value < 0.05 for all). The mean dose to the marrow was significantly lower with VMAT (59.05 vs 81.9 cGy with P value < 0.05). The overall LAR was significantly lower with VMAT as compared to the conventional plan (0.357% vs 0.398%, P value < 0.05). Compared to the conventional technique, VMAT provides better OAR dosimetry for lung irradiation (a prescription dose of 1.0 Gy or more) in COVID-19 pneumonia. VMAT significantly reduces the risk of RIC. We therefore suggest if lung LDRT is used for COVID-19 patients, VMAT is the preferred technique for a prescription dose of ≥1.0 Gy.
Identifiants
pubmed: 39023602
doi: 10.4103/jcrt.jcrt_656_24
pii: 01363817-202420030-00034
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
943-948Informations de copyright
Copyright © 2024 Copyright: © 2024 Journal of Cancer Research and Therapeutics.
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