DEGRO guidelines for the radiotherapy of non-malignant disorders

Ott, Oliver J.; Niewald, Marcus; Weitmann, Hajo-Dirk; Jacob, Ingrid; Adamietz, I.A.; Schaefer, U. W.; Keilholz, Ludwig; Heyd, Reinhard; Muecke, Ralph

doi:10.1007/s00066-014-0757-3

Cited by 69 publications

(69 citation statements)

References 17 publications

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“…In RT of plantar fasciitis, our group demonstrated the same treatment efficacy of RT with individualized, small fields in comparison to larger standard fields covering the entire calcaneus. However, in CMC I-OA, we found a significant reduction in therapeutic efficacy after irradiation with small fields/areas (just the thumb saddle joint), as recommended by the current German guidelines [19]. Several reasons may explain this surprising result.…”

Section: Discussionmentioning

confidence: 57%

The field size matters: low dose external beam radiotherapy for thumb carpometacarpal osteoarthritis

Kaltenborn

Bulling²,

Nitsche³

et al. 2016

Strahlenther Onkol

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The purpose of this work was to evaluate the efficacy of low-dose radiotherapy (RT) for thumb carpometacarpal osteoarthritis (rhizarthrosis). The responses of 84 patients (n = 101 joints) were analyzed 3 months after therapy (n = 65) and at 12 months (n = 27). Patients were treated with 6 fractions of 1 Gy, two times a week, with a linear accelerator. At the end of therapy, about 70 % of patients reported a response (partial remission or complete remission), 3 months later about 60 %, and 1 year after treatment 70 %. In univariate regression analysis, higher patient age and field size greater than 6 × 4 cm were associated with response to treatment, while initial increase of pain under treatment was predictive for treatment failure. Duration of RT series (more than 18 days), gender, time of symptoms before RT, stress pain or rest pain, or prior ortheses use, injections, or surgery of the joint were not associated with treatment efficacy. In multivariate regression analysis, only field size and initial pain increase were highly correlated with treatment outcome. In conclusion, RT represents a useful treatment option for patients suffering from carpometacarpal osteoarthritis. In contrast to other benign indications, a larger field size (>6 × 4 cm) seems to be more effective than smaller fields and should be evaluated in further prospective studies.

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Section: Discussionmentioning

confidence: 57%

The field size matters: low dose external beam radiotherapy for thumb carpometacarpal osteoarthritis

Kaltenborn

Bulling²,

Nitsche³

et al. 2016

Strahlenther Onkol

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“…Low-dose radiotherapy is another effective therapeutic option in the treatment of enthesiopathies, like PF, with a significant advantage in terms of pain control 27 . Physical therapy includes massage, manipulative or osteopathic treatments, ice treatments, stretching exercises for foot and lower limbs muscles.…”

Section: Treatment Of Pfmentioning

confidence: 99%

Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review

Petraglia

Ramazzina

Cipolla

2017

MLTJ

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SummaryBackground: Plantar fasciitis (PF) is reported in different sports mainly in running and soccer athletes. Purpose of this study is to conduct a systematic review of published literature concerning the diagnosis and treatment of PF in both recreational and élite athletes. The review was conducted and reported in accordance with the PRIS-MA statement. Methods: The following electronic databases were searched: PubMed, Cochrane Library and Scopus. As far as PF diagnosis, we investigated the electronic databases from January 2006 to June 2016, whereas in considering treatments all data in literature were investigated. Results: For both diagnosis and treatment, 17 studies matched inclusion criteria. The results have highlighted that the most frequently used diagnostic techniques were Ultrasonography and Magnetic Resonance Imaging. Conventional, complementary, and alternative treatment approaches were assessed. Conclusions: In reviewing literature, we were unable to find any specific diagnostic algorithm for PF in athletes, due to the fact that no different diagnostic strategies were used for athletes and non-athletes. As for treatment, a few literature data are available and it makes difficult to suggest practice guidelines. Specific studies are necessary to define the best treatment algorithm for both recreational and élite athletes. Level of evidence: Ib.

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“…According to a recent guideline from the German Society of Radiation Therapy and Oncology (DEGRO), single doses of 0.5–1.0 Gy (total doses of 3.0–6.0 Gy) and two or three fractions per week are recommended in patients with painful degenerative and inflammatory diseases (6, 8). By contrast, different schedules are advised when treating hyperproliferative diseases like DD, LD, and keloids (5, 25).…”

Section: Use Of Rt To Treat Benign Disordersmentioning

confidence: 99%

“…However, long-term experiences impressively indicated a clinical benefit for patients (4, 5). Accordingly, treatment with irradiation concepts not exceeding a single dose of 5 Gy and total doses of 30 Gy [low- or intermediate-dose RT (LD-RT)] is an established and effective modality in the management of a variety of non-cancerous inflammatory, degenerative, and hyperproliferative/fibroproliferative disorders (4–6). The latter include, among others, heterotopic ossifications, symptomatic vertebral hemangiomas, Gorham–Stout syndrome, prophylaxis of keloid relapse after surgical excision (7), and, most prominent, palmar and plantar fibromatosis also known as Dupuytren disease (DD) and Ledderhose disease (LD) (8).…”

Section: Introductionmentioning

confidence: 99%

Basics of Radiation Biology When Treating Hyperproliferative Benign Diseases

et al. 2017

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For decades, low- and moderate-dose radiation therapy (RT) has been shown to exert a beneficial therapeutic effect in a multitude of non-malignant conditions including painful degenerative muscoloskeletal and hyperproliferative disorders. Dupuytren and Ledderhose diseases are benign fibroproliferative diseases of the hand/foot with fibrotic nodules and fascial cords, which determine debilitating contractures and deformities of fingers/toes, while keloids are exuberant scar formations following burn damage, surgery, and trauma. Although RT has become an established and effective option in the management of these diseases, experimental studies to illustrate cellular composites and factors involved remain to be elucidated. More recent findings, however, indicate the involvement of radiation-sensitive targets like mitotic fibroblasts/myofibroblasts as well as inflammatory cells. Radiation-related molecular mechanisms affecting these target cells include the production of free radicals to hamper proliferative activity and interference with growth factors and cytokines. Moreover, an impairment of activated immune cells involved in both myofibroblast proliferative and inflammatory processes may further contribute to the clinical effects. We here aim at briefly describing mechanisms contributing to a modulation of proliferative and inflammatory processes and to summarize current concepts of treating hyperproliferative diseases by low and moderate doses of ionizing radiation.

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DEGRO guidelines for the radiotherapy of non-malignant disorders

Cited by 69 publications

References 17 publications

The field size matters: low dose external beam radiotherapy for thumb carpometacarpal osteoarthritis

The field size matters: low dose external beam radiotherapy for thumb carpometacarpal osteoarthritis

Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review

Basics of Radiation Biology When Treating Hyperproliferative Benign Diseases

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