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Treating infections with ionizing radiation: a historical perspective and emerging techniques
B van Dijk1, J V C Lemans2, R M Hoogendoorn2
1Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands. b.vandijk-8@umcutrecht.nl.
Radiation therapy offers a promising alternative for treating antibiotic-resistant infections, particularly orthopedic infections. While historical use showed mortality reduction, further research into long-term effects and targeted internal radiation is needed.
Area of Science:
- Infectious Diseases
- Oncology
- Medical Physics
Background:
- Antibiotic resistance is rising, complicating treatment of implant-associated infections like periprosthetic joint infections.
- New antibiotic development is declining, necessitating alternative therapeutic strategies.
- Ionizing radiation, historically used, is explored as a treatment for infectious diseases, especially orthopedic infections.
Observation:
- A systematic review of 216 publications on radiation for infections was conducted, analyzing 182 on external and 34 on internal radiation.
- External radiation therapy demonstrated mortality reduction in pre-antibiotic era infections but lacked long-term follow-up.
- Internal radiation with targeted radionuclides shows potential for treating microbial infections with minimized collateral damage.
Findings:
- External radiation therapy showed significant mortality reduction in certain infections historically.
- Long-term effects and malignancy risks of external radiation were not adequately investigated.
- Internal radiation, using targeted alpha and beta emitters, shows promise for bacterial and fungal infections.
Implications:
- Radiation therapy presents a feasible strategy for combating planktonic and biofilm-related microbial infections.
- Further investigation into radiation treatment for infections is warranted.
- Individual patient risk assessment is crucial when considering radiation therapy for infections.
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