Radiotherapy for painful benign skeletal disorders
Results of a retrospective clinical quality assessment
Nderim Juniku · OliverMicke ·M. Heinrich Seegenschmiedt · RalphMuecke
Received: 9 May 2019 / Accepted: 8 August 2019
© The Author(s) 2019
Purpose The aim of this retrospective clinical quality assessment was to evaluate the efficacy of low-dose radiotherapy
(RT) for painful benign skeletal disorders.
Methods 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 0.5Gy (total dose 3.0–5.0Gy) 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.
Results 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.
Conclusion 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.
Keywords Low Dose Radiotherapy · Health Service Research · Arthrosis · Enthesopathy · Visual-Analogue-Scale