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Open Access Research

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

Stephanie Keller1, Klaus Müller2*, Rolf-Dieter Kortmann2, Ulrich Wolf2, Guido Hildebrandt3, André Liebmann2, Oliver Micke4, Gert Flemming5 and Dieter Baaske6

Author Affiliations

1 Department of Internal Medicine II- Gastroenterology / Hepatology / Oncology / Infectology / Tropical Medicine /Endocrinology / Diabetology, Klinikum Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Germany

2 Department of Radiotherapy, University Hospital of Leipzig, Stephan-Str. 9a, 04103, Leipzig, Germany

3 Department of Radiotherapy, University Medicine Rostock, Südring 75, 18059, Rostock, Germany

4 Department of Radiotherapy, Franziskus Hospital Bielefeld, Kiskerstraße 26, 33615, Bielefeld, Germany

5 Department of Radiology, Heliosklinikum Aue, Gartenstraße 6, 08280, Aue, Germany

6 Department of Radiotherapy, Klinikum Chemnitz GmbH, Flemmingstraße 2, 09116, Chemnitz, Germany

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Radiation Oncology 2013, 8:29  doi:10.1186/1748-717X-8-29

Published: 31 January 2013

Abstract

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.

Keywords:
Osteoarthritis; Knee; Radiotherapy; Irradiation; X-ray; Gonarthritis; Gonarthrosis; Osteoarthrosis