Would you offer re-irradiation LDRT for someone with osteoarthritis or tendinitis if symptoms recur?

If yes, what time frame would you potentially offer this? If they had complete relief in one joint and partial relief in another after 2 courses, would you consider a 3rd course?

This question is part of our collaboration with ASTRO 2025 to highlight impactful trial data from this year's meeting. This question is inspired by the Clinical Trials Session Presentation "Clinical Effectiveness of Single Course Low-Dose Radiation Therapy in Knee Osteoarthritis: Short-term Results from the Randomized, Sham-Controlled Trial" by Dr. Byoung Hyuck Kim.

Answer from: Radiation Oncologist at Academic Institution

I have not personally offered a patient a third round of LDRT and do not know of any data that shows efficacy. However, I might offer a third round if a particular patient got adequate results with the first two and there was some separation in time (perhaps >1 year) since the last round.

Comments

Radiation Oncologist at Coastal Radiation Oncology
Is there any data for a second course?

Radiation Oncologist at Cancer & Blood Specialists of Arizona
Alvarez et al., PMID 34585316.

Answer from: Radiation Oncologist at Community Practice

Yes, this is commonly practiced and supported by large series showing additional responders with a second course and very low toxicity; I usually wait 12-16 weeks after the first course to allow full biological effect and to be sure the recurrence is durable. (Rühle et al., PMID 34342662). Dr. ...

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Would you offer re-irradiation LDRT for someone with osteoarthritis or tendinitis if symptoms recur?

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