Long-term results of radiotherapy for periarthritis of the shoulder: a retrospective evaluation.
BACKGROUND
To evaluate retrospectively the results of radiotherapy for periarthritis of the shoulder


METHODS
In 1983-2004, 141 patients were treated, all had attended at least one follow-up examination. 19% had had pain for several weeks, 66% for months and 14% for years. Shoulder motility was impaired in 137/140 patients. Nearly all patients had taken oral analgesics, 81% had undergone physiotherapy, five patients had been operated on, and six had been irradiated. Radiotherapy was applied using regular anterior-posterior opposing portals and Co-60 gamma rays or 4 MV photons. 89% of the patients received a total dose of 6 Gy (dose/fraction of 1 Gy twice weekly, the others had total doses ranging from 4 to 8 Gy. The patients and the referring doctors were given written questionnaires in order to obtain long-term results. The mean duration of follow-up was 6.9 years [0-20 years].


RESULTS
During the first follow-up examination at the end of radiotherapy 56% of the patients reported pain relief and improvement of motility. After in median 4.5 months the values were 69 and 89%, after 3.9 years 73% and 73%, respectively. There were virtually no side effects. In the questionnaires, 69% of the patients reported pain relief directly after radiotherapy, 31% up to 12 weeks after radiotherapy. 56% of the patients stated that pain relief had lasted for "years", in further 12% at least for "months".


CONCLUSIONS
Low-dose radiotherapy for periarthropathy of the shoulder was highly effective and yielded long-lasting improvement of pain and motility without side effects.
Niewald
Marcus
M
Dept, of Radiooncology, Saarland University Hospital, Kirrberger Str.1, D-66421, Homburg, Germany. ramnie@uniklinikum-saarland.de
Fleckenstein
Jochen
J
Naumann
Susanne
S
Ruebe
Christian
C
D000700:Analgesics / Q000627:therapeutic use; D002114:Calcinosis / Q000209:etiology / Q000532:radiotherapy; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D009043:Motor Activity; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy; D017060:Patient Satisfaction; D010489:Periarthritis / Q000503:physiopathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000528:radiation effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000700:Analgesics