Response to: ‘Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) induced by immune checkpoint inhibitors’ by Delyon
<i>et al</i>

Kostine, Marie; Schaeverbeke, Thierry

doi:10.1136/annrheumdis-2018-213895

Cited by 6 publications

(1 citation statement)

References 7 publications

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“…A possible placebo effect of low-dose RT for the treatment of pain cannot be completely ruled out. Two randomized, blinded, and sham-controlled trials on knee and hand joint osteoarthritis were published recently and showed no significant difference in remission for RT groups compared to placebo groups [15, 16]. Despite the good study design, both studies are open to critique because of low patient numbers, short follow-up (3 months), and presumption of a very optimistic prognosis for the assessment of success.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy for painful benign skeletal disorders

Juniku¹,

Micke

Seegenschmiedt³

et al. 2019

Strahlenther Onkol

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PurposeThe aim of this retrospective clinical quality assessment was to evaluate the efficacy of low-dose radiotherapy (RT) for painful benign skeletal disorders.MethodsPatients with different painful benign skeletal disorders (arthrosis and enthesopathies) were recruited for this retrospective clinical quality assessment between January 2014 and December 2015. RT was applied with a linear accelerator. Single doses of 0.5 Gy (total dose 3.0–5.0 Gy) were used. Pain was measured before and immediately after RT (early response) by a 10-point visual analogue scale (VAS). We defined a VAS score of 0–2 as a good response. Pain relief was measured during follow-up.ResultsA total of 598 evaluable patients (394 females, 204 males) with a mean age of 61.4 years (range 33–81 years) were recruited. The median VAS score was 7.0 (interquartile range [IQR] 2) before treatment and 5.0 (IQR 4) upon completion of RT (p < 0.001). A good response was achieved upon completion of RT in 83 patients (13.9%), with a median follow-up of 38 months (range 29–47 months) in 373 patients (62.4%; p < 0.001). In general, RT had a better effect on enthesopathies than on arthrosis.ConclusionLow-dose RT is a very effective treatment for the management of painful benign skeletal disorders. Due to the delayed onset of analgesic effects, low-dose RT results in significantly improved long-term efficacy compared to the results immediately after RT. These findings confirm the results of other retrospective, prospective, and randomized trials.

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Section: Discussionmentioning

confidence: 99%

Radiotherapy for painful benign skeletal disorders

Juniku¹,

Micke

Seegenschmiedt³

et al. 2019

Strahlenther Onkol

View full text Add to dashboard Cite

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Low-dose radiotherapy for painful osteoarthritis of the elderly: A multicenter analysis of 970 patients with 1185 treated sites

et al. 2021

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Purpose Painful osteoarthritis is common in elderly patients, and low-dose radiotherapy has been demonstrated to provide effective symptomatic treatment. We examined the analgesic effects of low-dose radiotherapy for osteoarthritis in the elderly aiming to reveal potential differences in the response rates relating to increasing age. Methods A retrospective analysis was performed at two university hospitals including elderly patients (≥ 65 years) undergoing radiotherapy for osteoarthritis between 2008 and 2020. Pain intensity and response were quantified using the numerical rating scale (NRS) and the Pannewitz score. Age groups were defined for young old (65–74 years), older old (75–84 years), and oldest old patients (≥ 85 years). Results In all, 970 patients with 1185 treated sites and a median age of 76 years were analyzed. Mean NRS was 66 at baseline (t0), 53 after radiotherapy (t1), and 44 at first follow-up (t2) (p < 0.001 for t0–t1, t1–t2, and t0–t2). At t1, 1.5% exhibited a Pannewitz score of 0 (no pain), 58.5% of 1–2 (less pain), 36.1% of 3 (equal pain), and 3.9% of 4 (worse pain), while at t2, pain response shifted towards 6.9% (0), 58.6% (1–2), 28.1% (3), and 6.3% (4). Pain response did not differ between age groups at t1 (p = 0.172) or t2 (p = 0.684). In addition, pain response after re-irradiation (n = 384 sites) was 61.0% and was comparable between age groups (p = 0.535). Conclusion Low-dose radiotherapy results in pain reduction in about two-thirds of treated sites with no difference relating to increasing age, showing that radiotherapy is an effective analgesic treatment for osteoarthritis even at advanced ages.

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Radiotherapy for painful shoulder syndrome: a retrospective evaluation

Leist,

Micke,

Seegenschmiedt

et al. 2024

Strahlenther Onkol

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Purpose We evaluated the efficacy of low-dose radiotherapy for painful shoulder syndrome from an orthopedic perspective. Methods Patients with painful shoulder syndrome were recruited for this retrospective clinical quality assessment from January 2011 to December 2017. Patients were treated with a linear accelerator or an orthovoltage device at individual doses of 0.5–1.0 Gy and total doses of 3.0–6.0 Gy. To assess response, we used the von Pannewitz score with five levels: “worsened,” “unaffected,” “improved,” “significantly improved,” and “symptom free.” “Good treatment success” was defined as “significantly improved” and “symptom free.” Within-group and between-group differences were statistically evaluated. Results Of 236 recruited patients (150 women, 86 men; mean age 66.3 [range 31–96] years), 180 patients underwent radiotherapy with a linear accelerator and 56 with an orthovoltage device. Fractionation was 12 × 0.5 Gy in 120 patients, 6 × 0.5 Gy in 74, and 6 × 1 Gy in 42 patients. Treatments were completed in one series for 223 and in two series at least 6 weeks apart for 13 patients. Of the 236 patients, 163 patients (69.1%) agreed to be re-interviewed at a median of 10.5 (range 4–60) months after radiotherapy completion. Directly after radiotherapy, 30.9% (73 patients) had “good treatment success,” which had increased to 55.2% (90 patients) at follow-up. Conclusion Protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome. Patients with refractory pain because of subacromial syndrome or shoulder osteoarthritis should also be evaluated for radiotherapy.

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Response to: ‘Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) induced by immune checkpoint inhibitors’ by Delyon et al

Cited by 6 publications

References 7 publications

Radiotherapy for painful benign skeletal disorders

Radiotherapy for painful benign skeletal disorders

Low-dose radiotherapy for painful osteoarthritis of the elderly: A multicenter analysis of 970 patients with 1185 treated sites

Radiotherapy for painful shoulder syndrome: a retrospective evaluation

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