Mitigating Oxidative Stress and Lung Fibrosis with Low Dose Radiation Therapy in Paraquat Poisoning: A Case Series

Abstract

Paraquat poisoning, a frequent cause of fatalities in India, has become a significant public health issue, particularly among farmers. This herbicide, known for its high toxicity, results in severe pulmonary damage, with no specific antidote available. Ingestion of even small amounts of paraquat can lead to rapid multiorgan failure and death, largely due to its accumulation in the lungs, triggering oxidative stress and alveolar fibrosis. The toxicological mechanism involves the generation of free radicals that damage cellular membranes, eventually causing extensive lung fibrosis and alveolitis. Mortality rates remain high, with no definitive treatment. Recent advancements in low-dose radiotherapy (LDRT) have shown promise in treating lung injury caused by paraquat. LDRT’s anti-inflammatory properties have been previously explored in non-cancerous conditions like musculoskeletal disorders. Its ability to modulate inflammatory responses in lung tissue suggests potential benefits in mitigating paraquat-induced lung fibrosis. While preliminary evidence from small-scale studies has shown some improvement in patients treated with LDRT, the efficacy remains uncertain. At our center, we have treated five patients using LDRT, with mixed outcomes. Some patients showed improvement, while others succumbed to early pulmonary fibrosis. Further research is needed to establish the role of LDRT in managing paraquat poisoning. Larger studies are required to assess its ability to prevent lung fibrosis and improve long-term survival in patients with severe poisoning.