title: Low-Dose Radiation Therapy for Benign Painful Skeletal Disorders: The Typical Treatment for the Elderly Patient?
abstract: To prospectively evaluate the short-term and long-term efficacy of low-dose radiation therapy (RT) for calcaneodynia, achillodynia, painful gonarthrosis, and painful bursitis trochanterica in elderly patients aged ≥70 years.
  
  
  
  Between October 2011 and October 2013, patients aged ≥70 years with painful degenerative disorders of joints were recruited for a prospective trial. Single doses of 0.5 to 1.0 Gy and a total dose of 6.0 Gy per series were used. Pain was measured before and right after RT (early response) with a 10-point visual analogue scale. Additionally, pain relief was measured with the 4-point pain scale according to "von Pannewitz" immediately on completion of RT and during follow-up. We defined a good response as complete pain relief and markedly improved.
  
  
  
  A total of 166 evaluable patients with a mean age of 76.6 years (range, 70-90 years) with calcaneodynia (n=51), achillodynia (n=8), painful gonarthrosis (n=80), and painful bursitis trochanterica (n=27) were recruited. The mean visual analogue scale value before treatment was 6.38 and immediately upon completion of RT was 4.49 (P<.001). Concerning the von Pannewitz status immediately on completion of RT, 6 patients were free of pain, 56 were much improved, 47 reported slight improvement, and 57 experienced no change. After a median follow-up of 29 months, 109 patients could be reached for evaluation of follow-up results. Thirty-three patients were free of pain, 21 had marked improvement, 18 had some improvement, and 37 experienced no change. Therefore, a good response immediately on completion of RT could be achieved in 62 of 166 patients, and with the follow-up in 54 of 109 patients (P=.001).
  
  
  
  Low-dose RT is a very effective treatment for the management of painful degenerative disorders of joints in the elderly. Low-dose RT offers a low-risk, genuinely conservative, noninvasive therapeutic alternative for elderly patients.
authors.affiliation: Department of Radiotherapy and Radiation Oncology, Franziskus Hospital Bielefeld, Bielefeld, Germany. Electronic address: strahlenklinik@web.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Micke
authors.affiliation: Center for Radiotherapy and Radiation Oncology, Hamburg, Germany.
authors.forename: M Heinrich
authors.initials: MH
authors.lastname: Seegenschmiedt
authors.affiliation: Department of Radiotherapy and Radiation Oncology, Marien Hospital Herne, Ruhr University Bochum, Bochum, Germany.
authors.forename: Irenaeus A
authors.initials: IA
authors.lastname: Adamietz
authors.affiliation: Institute of Medical Informatics and Biometry, University Rostock, Rostock, Germany.
authors.forename: Guenter
authors.initials: G
authors.lastname: Kundt
authors.affiliation: Department of Radiotherapy and Radiation Oncology, Marien Hospital Herne, Ruhr University Bochum, Bochum, Germany.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Fakhrian
authors.affiliation: Department of Radiotherapy, Lippe Hospital Lemgo, Lemgo, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schaefer
authors.affiliation: Department of Radiotherapy and Radiation Oncology, Marien Hospital Herne, Ruhr University Bochum, Bochum, Germany; Private Practice for Radiotherapy RheinMainNahe, Bad Kreuznach, Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Muecke
mesh_terms: D000125:Achilles Tendon / Q000528:radiation effects; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000150:complications / Q000532:radiotherapy*; D002062:Bursitis / Q000150:complications / Q000532:radiotherapy; D002111:Calcaneus / Q000528:radiation effects; D005260:Female; D005269:Femur; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology / Q000532:radiotherapy*; D010147:Pain Measurement; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018709:Statistics, Nonparametric; D052256:Tendinopathy / Q000150:complications / Q000532:radiotherapy; D016896:Treatment Outcome