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Efficacy of low-dose radiotherapy in painful gonarthritis: experiences from a retrospective East German bicenter study

January 31, 2013

PURPOSE:

To evaluate the efficacy of low-dose radiotherapy in painful gonarthritis.

METHODS:

We assessed the medical records of 1037 patients with painful gonarthritis who had undergone low-dose radiotherapy between 1981 and 2008. The subjective patient perception of the response to irradiation as graded immediately or up to two months after the completion of a radiotherapy series was evaluated and correlated with age, gender, radiological grading and the duration of symptoms before radiotherapy. Moreover, we performed a mail survey to obtain additional long-term follow-up information and received one hundred and six evaluable questionnaires.

RESULTS:

We assessed 1659 series of radiotherapy in 1037 patients. In 79.3% of the cases the patients experienced a slight, marked or complete pain relief immediately or up to two months after the completion of radiotherapy. Gender, age and the duration of pain before radiotherapy did not have a significant influence on the response to irradiation. In contrast, severe signs of osteoarthritis were associated with more effective pain relief. In more than 50% of the patients who reported a positive response to irradiation a sustained period of symptomatic improvement was observed.

CONCLUSIONS:

Our results confirm that low-dose radiotherapy is an effective treatment for painful osteoarthritis of the knee. In contrast to an earlier retrospective study, severe signs of osteoarthritis constituted a positive prognostic factor for the response to irradiation. A randomized trial is urgently required to compare radiotherapy with other treatment modalities.

Stephanie Keller, Klaus Müller,corresponding author Rolf-Dieter Kortmann, Ulrich Wolf, Guido Hildebrandt, André Liebmann, Oliver Micke, Gert Flemming & Dieter Baaske.

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