Main Session
Sep 30
PQA 08 - Gastrointestinal Cancer, Nonmalignant Disease, Palliative Care

3481 - Low Dose Cytokine Modulation and Anti-Inflammatory Radiotherapy in Osteoarthritis: Pioneering Pain Relief and Enhanced Quality of Life - First-of-Its-Kind Study in the Subcontinent

02:30pm - 03:45pm PT
Hall F
Screen: 25
POSTER

Presenter(s)

G Lohith, MD - HCG, ,

G. Lohith1, K. Sekar2, R. Krupesh3, H. G. ramesh Gowda4, and A. K. BS5; 1Immuno-Rad Lab , HCG Hospitals, BANGALORE, India, 2HCG Hospitals, Bengaluru, karnataka, India, 3HCG, Bangalore, India, 4HCG Hospitals, Bengaluru, Karnataka, India, 5Health Care Global Enterprises Ltd, Bangalore, India

Purpose/Objective(s): This prospective study, marking first in subcontinent, aimed to evaluate the dual impact of low-dose radiotherapy, serving both as an immune modulator and an anti-inflammatory agent, on pain relief and quality of life in patients with Grade 2–3 osteoarthritis of the knee and ankle. Its therapeutic effects are attributed to:

  • Immune Modulation: Decreasing pro-inflammatory (TNF-a, IL-1ß) and increasing anti-inflammatory (IL-10) cytokines.
  • Anti-inflammatory Action: Inhibiting leukocyte adhesion, endothelial activation, and shifting macrophages from M1 (pro-inflammatory) to M2 (anti-inflammatory).
  • Molecular Pathway Modulation: Suppressing NF-?B signaling to reduce pain mediators, inflammation, and tissue damage.

Materials/Methods: Eleven patients (7 females and 4 males) with radiographically confirmed Grade 2–3 osteoarthritis were enrolled at HCG Hospitals, Bangalore. Baseline assessments included X-ray evaluations for OA classification and grading. Each patient received a regimen of 0.5 Gy per fraction delivered over 6 fractions on Mondays and Fridays for 3 consecutive weeks using image-guided radiotherapy (IGRT).

Pain was quantified using a Numerical Pain Scale (1–10) before and after treatment, while overall quality of life was assessed using the SF-36 questionnaire, capturing domains such as physical functioning, vitality, and social well-being.Eight patients were treated exclusively for knee osteoarthritis, while three received treatment for both knee and ankle involvement. This targeted approach ensured that only red bone marrow–free zones were irradiated.

Results:

• Pain Reduction: Mean pre-treatment pain score was 7.8, which decreased to 1.6 post-treatment—an absolute reduction of approximately 6.3 points, translating to nearly an 80% decrease.
• Nine out of 11 patients achieved a post-treatment pain score of 2 or less, with some reporting complete pain relief.
• Quality of Life Improvement: The average SF-36 score significantly improved from 42.3 ± 7.2 at baseline to 75.5 ± 6.8 post-treatment (an ~80% improvement; p < 0.0001).
• Statistical Significance: Paired statistical analyses confirmed that both the reduction in pain and the improvement in SF-36 scores were highly significant (p < 0.0001).

Conclusion: This pioneering study demonstrates that low-dose immune modulation and anti-inflammatory radiotherapy can significantly reduce pain and markedly improve quality of life in patients with moderate to advanced osteoarthritis. The elucidated mechanisms—ranging from cytokine modulation to alterations in molecular signaling pathways—provide a robust scientific basis for the observed clinical benefits. As the first report of its kind in the subcontinent, these findings open new avenues for noninvasive osteoarthritis management and warrant further exploration into benign radiotherapy applications in musculoskeletal disorders.