Efficacy of low-dose radiotherapy in painful gonarthritis: experiences from a retrospective East German bicenter study.
OBJECTIVE
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.
Department of Internal Medicine II- Gastroenterology / Hepatology /Oncology / Infectology / Tropical Medicine /Endocrinology / Diabetology, Klinikum Chemnitz gGmbH, Flemmingstraße 2, Chemnitz 09116, Germany.
Stephanie
S
Keller
Klaus
K
Müller
Rolf-Dieter
RD
Kortmann
Ulrich
U
Wolf
Guido
G
Hildebrandt
André
A
Liebmann
Oliver
O
Micke
Gert
G
Flemming
Dieter
D
Baaske
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult