3384 - Low-Dose Radiotherapy for Painful Musculoeskeltal Disorders: 10 Years Follow-Up
Presenter(s)
B. Alvarez1,2, A. Montero1,2, R. Alonso1, J. J. Valero3, R. Ciervide1, M. Lopez1, E. Sanchez1, O. Hernando1, C. Rubio1, and M. D. C. Saiz4; 1Department of Radiation Oncology, HM Hospitales, Madrid, Spain, 2Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain, 3University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain, 4Hospital Universitario HM Sanchinarro, Madrid, Spain
Purpose/Objective(s): Evaluation of painful musculoskeletal disorders (PMD) long-term response to low-dose radiotherapy (LDRT).
Materials/Methods: Patients enrolled in this prospective analysis underwent CT-based simulation. Planning target volumes including painful location and periarticular soft tissues were defined according to published atlas. Treatment was delivered in a LINAC and daily verified with orthogonal X-ray or KV-Conebeam-CT. 1Gy fractions were delivered every other day up to a total dose of 6Gy. Those patients achieving insufficient response were offered a second course of LDRT 10-12 weeks after finishing first course. Pain was measured before and after radiotherapy using the visual analogue scale (VAS), the functional von Pannewitz scale and determining variations in analgesics intake.
Results: Between April-2015 and June-2024, we treated 260 patients (207 women and 53 men) with a median age of 65 years old (range 30-90years) presenting with arthritis(68.5%), fasciitis(5.4%), bursitis(22.3%) or synovitis(3.8%). VAS before LDRT was =6 in 92% of patients. With a median follow-up of 6 years (0-10 years), 50% of patients showed an improvement of more than 5 points, being in 28% of the patients VAS 0-1. After 2, 3, 4 and 6 years, 80%, 78%, 75% and 68% of patients maintained response, respectively; 40% of the patients needed to take less analgesia after treatment. Best response was achieved in fasciitis treatments. In 161 cases, a second course was needed, attaining improvement of pain in 148 of them.
Conclusion: LDRT achieves significant pain relief in patients with PMD, being the pain controlled over time.