Low-dose radiotherapy is a safe, effective treatment for mild-to-moderate osteoarthritis, three research teams reported in San Francisco at the annual meeting of the American Society for Radiation Oncology (ASTRO).
In a randomized trial from Korea involving 114 volunteers with knee arthritis, significant reductions in pain and improved physical function were reported by those who received a low 3 Gy dose of radiation over the course of six sessions. Radiation doses after surgery for breast and head and neck cancers, by comparison, typically range from 45 to 60 Gy.
After four months, meaningful improvement in at least two of three areas - pain, physical function and overall condition – was achieved by 70% after low-dose radiation compared with 42% after a sham procedure.
A very-low-dose of radiation (0.3 Gy) was no better than the sham procedure, the researchers also found.
Separately, U.S. researchers reported that among 103 patients receiving radiation for osteoarthritis of the hands, knees or other sites, 84% experienced pain improvement, with rates of pain relief consistent across joints, genders, and body weights.
Low-dose radiation is regularly used for joint pain in Europe, but high-quality evidence from randomized trials has been limited until now, Dr. Byoung Hyuck Kim of Seoul National University College of Medicine, who led the Korean study, said in a statement.
In addition to radiation doses for arthritis being much lower than doses for cancer, targeted joints are usually far from vital organs, lowering the risk of side effects, Kim said.
German researchers who tracked more than 4,600 older patients treated with radiation for arthritis between 1994 and 2010 saw only three possibly related solid-tumor cancer diagnoses during 15 years of follow-up, two of which were skin cancers known as basal cell carcinomas, they reported.
The findings suggest that radiation doses used to treat benign musculoskeletal pain in elderly individuals carry "an almost negligible risk of inducing solid malignancies," the researchers concluded.
However, 1.4% of patients developed blood cancers, particularly when treatment had been directed near blood-cell-producing bone marrow, suggesting radiation in shoulder and trunk regions should be used cautiously, they advised.
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