Lung Irradiation for COVID-19 Pneumonia

Exclusion Criteria

• •Prior or planned treatment with interleukin inhibitors (e.g., tocilizumab, canakinumab, sarilumab) or TNF-α inhibitors within 14 days of enrollment
• •Prior lobectomy or pneumonectomy
• •Prior thoracic radiotherapy with cumulative lung V20 \> 15% to either lung within 1 year of enrollment, or any radiotherapy resulting in a maximum lung dose of 100 cGy or higher within 14 days of enrollment
• •Prior chemotherapy or other systemic therapy with potential for pulmonary toxicity or radiosensitization within 14 days or 5 half-lives, whichever is greater, of enrollment, e.g., bleomycin or gemcitabine
• •Prior cancer immunotherapy with an immune checkpoint inhibitor within 60 days of enrollment
• •Severe pre-existing heart disease, e.g., New York Heart Association (NYHA) functional class ≥ 3 congestive heart failure
• •History of bone marrow or solid organ transplantation
• •Known history of autoimmune collagen vascular disease, e.g., scleroderma
• •Known hereditary syndrome with increased sensitivity to ionizing radiation, e.g., ataxia-telangiectasia or Fanconi anemia
• •Pregnancy
• •Inability to be positioned supine and flat for radiation planning and delivery
• •Inability to provide informed consent or lack of an authorized representative who can provide informed consent