Abstract
Low-dose radiation therapy (LDRT) has been successfully established for decades as an alternative analgesic treatment option for patients suffering from chronic degenerative and inflammatory diseases. In this study, 483 patients were undergoing LDRT for degenerative joint disease of the fingers and thumb at the University Hospital Erlangen between 2004 and 2019. Radiotherapy was applied according to the German guidelines for LDRT. Several impact factors on therapeutic success, such as the age and gender, the number of affected fingers, the single and cumulative dose, as well as the number of series, were investigated. In summary, 70% of the patients showed an improvement of their pain following LDRT. No significant impact was found for the factors age, gender, the number of series or the cumulative dosage. Patients with an involvement of the thumb showed a significantly worse outcome compared to patients with an isolated affection of the fingers. In this cohort, patients receiving a single dose of 0.5 Gy reported a significantly better outcome than patients receiving 1.0 Gy, strongly suggesting a reduction in the total dose. In summary, LDRT is a good alternative treatment option for patients suffering from degenerative and inflammatory joint disease of the fingers.
Highlights
As the median age of the population in the western world is constantly rising, arthritis as the leading degenerative joint disease is showing increasing prevalence
Low-dose radiation therapy (LDRT) has been applied as an alternative treatment option for patients suffering from painful arthritis for several decades
A recently published prospective trial demonstrated that LDRT is leading to a significant pain relief and gain of functionality in patients suffering from refractory finger osteoarthritis [15]
Summary
As the median age of the population in the western world is constantly rising, arthritis as the leading degenerative joint disease is showing increasing prevalence. Amongst the different forms of arthritis, osteoarthristis is the most common form, leading to destructive processes in numerous tissues of the affected joints during progression [1]. While not being attributed to a specific cause, the development of osteoarthritis and degenerative joint disease of the fingers in general, seems to be supported by multiple risk factors. Amongst these risk factors, a high age, female gender, obesity and mechanical forces are the most prominent ones. Osteoarthritis and degenerative joint disease of the fingers are causing pain as well as a loss of strength, flexibility and function in the affected joint [2,3]
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