Re-irradiation for osteoarthritis—retrospective analysis of 217 joints

Hautmann, Matthias G.; Rechner, Philipp; Hipp, Matthias; Neumaier, Ulrich; Steger, Felix; Pohl, Fabian; Weber, Markus; Kölbl, Oliver; Süß, Christoph

doi:10.1007/s00066-019-01500-2

Cited by 10 publications

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“…Hautmann et al. published an additional paper about re-irradiation in patients with insufficient response to the first radiotherapy series or recurrent pain and regarded a second series as very effective [ 23 ]. A systematic review was written by Minten et al.…”

Section: Discussionmentioning

confidence: 99%

ArthroRad trial: randomized multicenter single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis—final results after 12-month follow-up

Niewald,

Moumeniahangar,

Müller

et al. 2023

Strahlenther Onkol

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Objective Updated report about the randomized comparison of the effect of radiotherapy on painful osteoarthritis (OA) applying a standard dose vs. a very low dose regime after a follow-up of 1 year. Patients and methods Patients presenting with OA of the hand/finger and knee joints were included. After randomization (every joint region was randomized separately) the following protocols were applied: (a) standard arm: total dose 3.0 Gy, single fractions of 0.5 Gy twice a week; (b) experimental arm: total dose 0.3 Gy, single fractions of 0.05 Gy twice a week. The dosage was blinded for the patients. For evaluation the scores after 1‑year visual analog scale (VAS), Knee Injury and Osteoarthritis Outcome Score–Short Form (KOOS-PS), Short Form Score for the Assessment and Quantification of Chronic Rheumatic Affections of the Hands (SF-SACRAH) and 12-item Short-Form Health Survey (SF-12) were used (for further details: see [1]). Results The standard dose was applied to 77 hands and 33 knees, the experimental dose was given to 81 hands and 30 knees. After 12 months, the data of 128 hands and 45 knees were available for evaluation. Even after this long time, we observed a favorable response of pain to radiotherapy in both trial arms; however, there were no reasonable statistically significant differences between both arms concerning pain, functional, and quality of life scores. Side effects did not occur. The only prognostic factor was the pain level before radiotherapy. Conclusions We found a favorable pain relief and a limited response in the functional and quality of life scores in both treatment arms. The possible effect of low doses such as 0.3 Gy on pain is widely unknown.

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Section: Discussionmentioning

confidence: 99%

ArthroRad trial: randomized multicenter single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis—final results after 12-month follow-up

Niewald,

Moumeniahangar,

Müller

et al. 2023

Strahlenther Onkol

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“…All of these authors state a significant response of pain to radiotherapy. Hautmann et al published an additional paper about re-irradiation in patients with insufficient response to the first radiotherapy series or recurrent pain, and regarded a second series as very effective [17]. A systematic review was written by Minten et al [18].…”

Section: Discussionmentioning

confidence: 99%

ArthroRad trial: multicentric prospective and randomized single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis depending on the dose—results after 3 months’ follow-up

et al. 2021

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Purpose Randomized comparison of the effect of radiotherapy on painful osteoarthritis (OA) applying a standard-dose vs. a very-low-dose regime Patients and methods Patients with OA of the hand and knee joints were included. Further inclusion criteria: symptoms for more than 3 months, favorable general health status, age above 40 years. Patients with prior local radiotherapy, trauma, rheumatoid arthritis, or vascular diseases were excluded. After randomization (every joint was randomized separately), the following protocols were applied: standard arm: total dose 3.0 Gy, single fractions of 0.5 Gy twice weekly; experimental arm: total dose 0.3 Gy, single fractions of 0.05 Gy twice weekly. The dosage was not known to the patients. The patients were examined 3 and 12 months after radiotherapy. Scores like VAS (visual analogue scale), KOOS-SF (the knee injugy and osteoarthritis outcome score), SF-SACRAH (short form score for the assessment and quantification of chronic rheumatic affections of the hands), and SF-12 (short form 12) were used. Results A total of 64 knees and 172 hands were randomized. 3.0 Gy was applied to 87 hands and 34 knees, 0.3 Gy was given to 85 hands and 30 knees. After 3 months, we observed good pain relief after 3 Gy and after 0.3 Gy, there was no statistically significant difference. Side effects were not recorded. The trial was closed prematurely due to slow recruitment. Conclusion We found favorable pain relief and a limited response in the functional and quality of life scores in both arms. The effect of low doses such as 0.3 Gy on pain is widely unknown. Further trials are necessary to compare a conventional dose to placebo and to further explore the effect of low doses on inflammatory disorders.

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“…Therapieserie kann dem Patienten nach minimal 3 Monaten eine weitere Serie mit gleicher Dosierung angeboten werden. Ein positiver Effekt ist durchaus zu erwarten [4][5][6]. Weitere Serien sollten individuell indiziert werden.…”

Section: Planung Und Durchführung Der Strahlentherapieunclassified

Analgetische Strahlentherapie gutartiger Erkrankungen des Skelettsystems

Niewald¹

2020

Arthritis und Rheuma

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ZusammenfassungDer entzündungshemmende Effekt kleiner Strahlendosen ist seit Langem bekannt und strahlenbiologisch gut untermauert. Zahlreiche retrospektive Arbeiten und einige randomisierte Studien weisen darauf hin, dass ein gutes Ansprechen bei Enthesiopathien wie der Fasciitis plantaris, der Achillodynie, der Epicondylitis und z. B. der Tendinitis calcarea der Schulter zu erzielen ist (Ansprechraten von 60–80 %). Auch bei Arthrosen weisen retrospektive Daten auf eine gute Wirksamkeit der Strahlentherapie hin, der randomisierte Nachweis wird derzeit diskutiert und ist Studienfrage. Indiziert ist die Strahlentherapie bei Patienten im Alter von > 40 Jahren und einer minimalen Anamnesedauer von 3–6 Monaten. In dieser Zeit sollten die konservativen Therapiemethoden durchgeführt worden sein. Eine Gesamtdosis von 3–6 Gy wird in zweimal wöchentlichen Sitzungen über 3 Wochen appliziert. Während und nach der Strahlentherapie kann es zu einer kurzzeitigen Schmerzzunahme kommen. Das Ansprechen ist frühestens 3 Monate nach Therapie zu beurteilen. Nebenwirkungen wie z. B. Hautreaktionen werden überaus selten gesehen. Ein vielfach diskutiertes Tumorrisiko liegt nach bisherigen Daten im Sub-Promillebereich.

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Re-irradiation for osteoarthritis—retrospective analysis of 217 joints

Cited by 10 publications

References 38 publications

ArthroRad trial: randomized multicenter single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis—final results after 12-month follow-up

ArthroRad trial: randomized multicenter single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis—final results after 12-month follow-up

ArthroRad trial: multicentric prospective and randomized single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis depending on the dose—results after 3 months’ follow-up

Analgetische Strahlentherapie gutartiger Erkrankungen des Skelettsystems

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