Radiotherapy RADIO-LOG, Passau, Germany.
Department of Radiotherapy and Radiation Oncology, Franziskus Hospital Bielefeld, Bielefeld, Germany.
Strahlenther Onkol. 2019 Dec;195(12):1068-1073. doi: 10.1007/s00066-019-01514-w. Epub 2019 Aug 27.
The aim of this retrospective clinical quality assessment was to evaluate the efficacy of low-dose radiotherapy (RT) for painful benign skeletal disorders.
Patients with different painful benign skeletal disorders (arthrosis and enthesopathies) were recruited for this retrospective clinical quality assessment between January 2014 and December 2015. RT was applied with a linear accelerator. Single doses of 0.5 Gy (total dose 3.0-5.0 Gy) were used. Pain was measured before and immediately after RT (early response) by a 10-point visual analogue scale (VAS). We defined a VAS score of 0-2 as a good response. Pain relief was measured during follow-up.
A total of 598 evaluable patients (394 females, 204 males) with a mean age of 61.4 years (range 33-81 years) were recruited. The median VAS score was 7.0 (interquartile range [IQR] 2) before treatment and 5.0 (IQR 4) upon completion of RT (p < 0.001). A good response was achieved upon completion of RT in 83 patients (13.9%), with a median follow-up of 38 months (range 29-47 months) in 373 patients (62.4%; p < 0.001). In general, RT had a better effect on enthesopathies than on arthrosis.
Low-dose RT is a very effective treatment for the management of painful benign skeletal disorders. Due to the delayed onset of analgesic effects, low-dose RT results in significantly improved long-term efficacy compared to the results immediately after RT. These findings confirm the results of other retrospective, prospective, and randomized trials.
本回顾性临床质量评估旨在评估低剂量放疗（RT）治疗疼痛性良性骨骼疾病的疗效。
本回顾性临床质量评估于 2014 年 1 月至 2015 年 12 月期间纳入不同疼痛性良性骨骼疾病（关节病和肌腱病）患者。RT 使用直线加速器进行。单次剂量 0.5Gy（总剂量 3.0-5.0Gy）。RT 前后（早期反应）使用 10 分制视觉模拟量表（VAS）测量疼痛。我们将 VAS 评分 0-2 定义为良好反应。在随访期间测量疼痛缓解情况。
共纳入 598 例可评估患者（394 例女性，204 例男性），平均年龄 61.4 岁（范围 33-81 岁）。治疗前 VAS 评分中位数为 7.0（四分位距 [IQR] 2），RT 结束时为 5.0（IQR 4）（p<0.001）。RT 结束时 83 例（13.9%）患者获得良好反应，373 例（62.4%；p<0.001）患者中位随访 38 个月（范围 29-47 个月）。一般来说，RT 对肌腱病的疗效优于对关节病。
低剂量 RT 是治疗疼痛性良性骨骼疾病的一种非常有效的治疗方法。由于镇痛效果的延迟出现，与 RT 后即刻结果相比，低剂量 RT 导致显著改善的长期疗效。这些发现证实了其他回顾性、前瞻性和随机试验的结果。
