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Is it time to redefine the role of low-dose radiotherapy for benign disease?
  1. Angel Montero1,
  2. Sebastia Sabater2,
  3. Franz Rödel3,
  4. Udo S Gaipl4,
  5. Oliver J Ott4,
  6. Michael Heinrich Seegenschmiedt5,
  7. Meritxell Arenas6
  1. 1 Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Madrid, Spain
  2. 2 Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
  3. 3 Department of Radiotherapy and Oncology, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
  4. 4 Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
  5. 5 Department of Radiation Oncology, Strahlenzentrum Hamburg, Hamburg, Germany
  6. 6 Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, University of Rovira i Virgili, Tarragona, Spain
  1. Correspondence to Dr Meritxell Arenas, Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, University of Rovira i Virgili, Tarragona, Spain; meritxell.arenas{at}

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It is estimated that 24% of the general adult population is currently suffering from osteoarthritis (OA), affecting 10% of men and 18% of women over 60 years of age in high-income countries. A WHO report predicted that degenerative OA will become the fourth leading cause of disability by 2020.1 This may not only affect the individuals who suffer from the diseases, but will undeniably have an impact on national health systems in social and economic terms.

There is no specific or definitive treatment for the early and late stages of degenerative OA. Weight loss, maintaining moderate levels of exercise and physical rehabilitation approaches (local heat, magnetic therapy and shock waves, among others) are some of the conservative therapies applied. Analgesics and non-steroidal anti-inflammatory drugs, symptomatic slow-acting drugs for OA, corticosteroids, anaesthetics and other local injections have been proposed for the relief of the symptoms before a prosthetic replacement of the damaged joint would finally be carried out at the end of a long road. None of these options have demonstrated high efficacy, and even more importantly can provoke multiple side effects and acute and late morbidities (ie, gastrointestinal bleeding, kidney and cardiac disorders, and so on) which may become serious and even compromise the patient’s life.2

The clinical effectiveness of low-dose radiation therapy (LD-RT) in the range of 0.3–0.7 Gy single dose and 3–10 Gy total dose for pain relief and subsequent improvement of joint functionality has been recognised for several decades. Further, the anti-inflammatory efficacy of LD-RT has been confirmed in several experimental models, both in vitro and in vivo.3–7 The first clinical evidence of its efficacy in non-cancerous osteoarticular disorders dates from the end of the 19th century, although there has traditionally been some resistance for its widespread use due to the fear of its …

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  • Handling editor Josef S Smolen

  • Contributors All the authors wrote and reviewed the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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