Skip to main content
Erschienen in: Strahlentherapie und Onkologie 3/2014

01.03.2014 | Original article

The Erlangen Dose Optimization trial for low-dose radiotherapy of benign painful elbow syndrome

Long-term results

verfasst von: PD Dr. O.J. Ott, S. Hertel, U.S. Gaipl, B. Frey, M. Schmidt, R. Fietkau

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Background and purpose

To evaluate the long-term efficacy of pain reduction by two dose fractionation schedules used for low-dose radiotherapy of painful elbow syndrome.

Patients and methods

Between February 2006 and February 2010, 199 evaluable patients were recruited for this prospective trial. All patients received low-dose orthovoltage radiotherapy. One course consisted of 6 fractions in 3 weeks. In the case of insufficient pain remission after 6 weeks, a second course was administered. Patients were randomly assigned to one of two groups to receive single doses of either 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before radiotherapy, as well as immediately after (early response), 6 weeks after (delayed response) and approximately 3 years after (long-term response) completion of radiotherapy using a questionnaire-based visual analogue scale (VAS) and a comprehensive pain score (CPS).

Results

Median follow-up was 35 months (range 9–57 months). The overall early, delayed and long-term response rates for all patients were 80, 90 and 94 %, respectively. The mean VAS scores before treatment and those for early, delayed and long-term response in the 0.5- and 1.0-Gy groups were 59.6 ± 20.2 and 55.7 ± 18.0 (p = 0.46); 32.1 ± 24.5 and 34.4 ± 22.5 (p = 0.26); 27.0 ± 27.7 and 23.5 ± 21.6 (p = 0.82) and 10.7 ± 15.0 and 21.5 ± 26.9 (p = 0.12), respectively. The mean CPS values before treatment and those for early, delayed and long-term response were 8.7 ± 2.9 and 8.1 ± 3.1 (p = 0.21); 4.5 ± 3.2 and 5.0 ± 3.4 (p = 0.51); 3.9 ± 3.6 and 2.8 ± 2.8 (p = 0.19) and 1.5 ± 2.3 and 2.4 ± 3.5 (p = 0.27), respectively. No significant differences in the quality of the long-term response were found between the 0.5- and 1.0-Gy arms (p = 0.28).

Conclusion

Low-dose radiotherapy is an effective treatment for the management of benign painful elbow syndrome. For radiation protection reasons, the dose for a radiotherapy series should not exceed 3.0 Gy.
Literatur
1.
Zurück zum Zitat Shiri R, Viikari-Juntura E (2011) Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol 25:43–57PubMedCrossRef Shiri R, Viikari-Juntura E (2011) Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol 25:43–57PubMedCrossRef
2.
Zurück zum Zitat Ott OJ, Hertel S, Gaipl US et al (2012) Benign painful shoulder syndrome: initial results of a single-center prospective randomized radiotherapy dose-optimization trial. Strahlenther Onkol 188:1108–1113PubMedCrossRef Ott OJ, Hertel S, Gaipl US et al (2012) Benign painful shoulder syndrome: initial results of a single-center prospective randomized radiotherapy dose-optimization trial. Strahlenther Onkol 188:1108–1113PubMedCrossRef
3.
Zurück zum Zitat Ott OJ, Jeremias C, Gaipl US et al (2013) Radiotherapy for calcaneodynia. Results of a single center prospective randomized dose optimization trial. Strahlenther Onkol 189:329–334PubMedCrossRef Ott OJ, Jeremias C, Gaipl US et al (2013) Radiotherapy for calcaneodynia. Results of a single center prospective randomized dose optimization trial. Strahlenther Onkol 189:329–334PubMedCrossRef
4.
Zurück zum Zitat Ott OJ, Jeremias C, Gaipl US et al (2013) Radiotherapy for achillodynia: results of a single-center prospective randomized dose-optimization trial. Strahlenther Onkol 189:142–146PubMedCrossRef Ott OJ, Jeremias C, Gaipl US et al (2013) Radiotherapy for achillodynia: results of a single-center prospective randomized dose-optimization trial. Strahlenther Onkol 189:142–146PubMedCrossRef
5.
Zurück zum Zitat Ott OJ, Hertel S, Gaipl US et al (2012) Benign painful elbow syndrome. First results of a single center prospective randomized radiotherapy dose optimization trial. Strahlenther Onkol 188:873–877PubMedCrossRef Ott OJ, Hertel S, Gaipl US et al (2012) Benign painful elbow syndrome. First results of a single center prospective randomized radiotherapy dose optimization trial. Strahlenther Onkol 188:873–877PubMedCrossRef
6.
Zurück zum Zitat Seegenschmiedt MH, Keilholz L (1998) Epicondylopathia humeri (EPH) and peritendinitis humeroscapularis (PHS): evaluation of radiation therapy long-term results and literature review. Radiother Oncol 47:17–28PubMedCrossRef Seegenschmiedt MH, Keilholz L (1998) Epicondylopathia humeri (EPH) and peritendinitis humeroscapularis (PHS): evaluation of radiation therapy long-term results and literature review. Radiother Oncol 47:17–28PubMedCrossRef
7.
Zurück zum Zitat Lodermann B, Wunderlich R, Frey S et al (2012) Low dose ionising radiation leads to a NF-kappaB dependent decreased secretion of active IL-1beta by activated macrophages with a discontinuous dose-dependency. Int J Radiat Biol (Epub ahead of print) Lodermann B, Wunderlich R, Frey S et al (2012) Low dose ionising radiation leads to a NF-kappaB dependent decreased secretion of active IL-1beta by activated macrophages with a discontinuous dose-dependency. Int J Radiat Biol (Epub ahead of print)
8.
Zurück zum Zitat Rodel F, Frey B, Gaipl U et al (2012) Modulation of inflammatory immune reactions by low-dose ionizing radiation: molecular mechanisms and clinical application. Curr Med Chem 19:1741–1750PubMedCrossRef Rodel F, Frey B, Gaipl U et al (2012) Modulation of inflammatory immune reactions by low-dose ionizing radiation: molecular mechanisms and clinical application. Curr Med Chem 19:1741–1750PubMedCrossRef
9.
Zurück zum Zitat Pannewitz G von (o J) Degenerative Erkrankungen. In: Diethelm I, Heuck F, Olsson O, Rauninger K, Strnad F, Vieten H, Zuppinger A (Hrsg) Handbuch der medizinischen Radiologie, Bd. 17. Springer, Berlin, S 73–107 Pannewitz G von (o J) Degenerative Erkrankungen. In: Diethelm I, Heuck F, Olsson O, Rauninger K, Strnad F, Vieten H, Zuppinger A (Hrsg) Handbuch der medizinischen Radiologie, Bd. 17. Springer, Berlin, S 73–107
10.
Zurück zum Zitat Rodel F, Frey B, Manda K et al (2012) Immunomodulatory properties and molecular effects in inflammatory diseases of low-dose x-irradiation. Front Oncol 2:120PubMedCentralPubMedCrossRef Rodel F, Frey B, Manda K et al (2012) Immunomodulatory properties and molecular effects in inflammatory diseases of low-dose x-irradiation. Front Oncol 2:120PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Trott KR, Kamprad F (2006) Estimation of cancer risks from radiotherapy of benign diseases. Strahlenther Onkol 182:431–436PubMedCrossRef Trott KR, Kamprad F (2006) Estimation of cancer risks from radiotherapy of benign diseases. Strahlenther Onkol 182:431–436PubMedCrossRef
Metadaten
Titel
The Erlangen Dose Optimization trial for low-dose radiotherapy of benign painful elbow syndrome
Long-term results
verfasst von
PD Dr. O.J. Ott
S. Hertel
U.S. Gaipl
B. Frey
M. Schmidt
R. Fietkau
Publikationsdatum
01.03.2014
Verlag
Springer-Verlag
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 3/2014
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0504-1

Weitere Artikel der Ausgabe 3/2014

Strahlentherapie und Onkologie 3/2014 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.