Main Session
Sep
28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology
2715 - Low-Dose Radiation Therapy for Spinal Osteoarthritis: A Retrospective Review of Pain Outcomes
Presenter(s)
Seraphina Choi, MD - University of Southern California (USC) /LA General Medical Center, Los Angeles, CA
S. Choi, A. V. Ganesh, E. R. Zhang-Velten, J. C. Ye, D. C. Ling, E. L. Chang, M. L. Tao, and H. Matani; Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, CA
Purpose/Objective(s):
Low-dose radiation therapy (LDRT) has been used for chronic inflammatory conditions. However, evidence supporting its role in degenerative disease and osteoarthritis of the spine remains limited. We performed a retrospective analysis of patients enrolled in a clinical registry to assess short-term pain outcomes after LDRT to the spine for symptomatic osteoarthritis.Materials/Methods:
Ten patients who received twelve LDRT treatments for spinal osteoarthritis at a single institution were retrospectively reviewed. Median age was 78 years (range 63-89), with 8 females and 2 males. Treated spine levels included cervical (n=4), thoracic (n=1), and lumbar (n=7). All patients had a clinical diagnosis of osteoarthritis and received a total dose of 3 Gy delivered in 6 fractions 2-3 times a week. All patients received a pre-treatment X-ray confirming degenerative changes consistent with osteoarthritis and Kellgren-Lawrence grade was recorded when available. Pain was assessed using a 0–10 numeric rating scale at baseline, during treatment, at the end of treatment, and at 2-week follow-up. Baseline and post-treatment analgesic use, including oral pain medications (opioid vs non-opioid) and topical agents were recorded. History of prior interventions such as physical therapy, epidural injections, and surgery at the treated spinal site was also collected.Results:
Among those with documented Kellgren-Lawrence grades, all had scores =2, with a median score of 2. Prior to LDRT, 3 patients had received corticosteroid injections, 2 had undergone physical therapy, and 2 underwent surgical intervention. At baseline, 7 patients required non-opioid pain medications and 2 required opioid medications. The mean baseline pain score was 6.08 (SD 1.44), which decreased to 3.92 (SD 3.18) during treatment, 3.55 (SD 3.14) at the end of treatment, and 3.75 (SD 3.33) at 2-week follow-up. At the conclusion of treatment, 5 patients were managed with non-opioid medications, 3 required no oral analgesics, and 1 required opioid medications. No patients reported acute toxicity.Conclusion:
In this small retrospective series, LDRT for spine osteoarthritis was associated with clinically meaningful short-term pain reduction, reduced use of oral analgesics, and no acute toxicity. These findings suggest that LDRT may be a treatment option for selected patients with symptomatic osteoarthritis of the spine. Prospective studies with larger cohorts and longer follow-up are warranted to better define optimal patient selection and durability of response.| Median Age (Range) | 78 (63-89) |
| Sex Male Female | 2 8 |
| Spine Level Cervical Thoracic Lumbar | 4 1 7 |
| Mean Pain Score (SD) Baseline During OTV End of Treatment 2 Week Follow Up | 6.08 (1.44) 3.92 (3.18) 3.55 (3.14) 3.75 (3.33) |