PO.CL08.02 · 临床研究

低剂量放射治疗外周关节骨关节炎：美国社区在疼痛、功能和用药结局方面的早期经验

Low-dose radiation therapy for peripheral joint osteoarthritis: Early U.S. community experience with pain, function, and medication outcomes

编号 5269 展板 6 时间 4/21 09:00–12:00 区域 Section 43 主讲 Emily Schwartz, No Degree

分会场 Effects of Ionizing Radiation on Normal Tissues and FLASH Radiation Research

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作者与单位 Authors & Affiliations

Emily Schwartz¹, Michael Anderson², Russell Nevins³, Kelsey Moakler², Andrew Cohen⁴, Michael Sinopoli⁴, Samuel Francis⁴, Bradley Newby², Matthew Schwartz⁵

¹University of Miami, Coral Gables, FL,²Comprehensive Cancer Centers of Nevada, Henderson, NV,³Desert Orthopaedic Center, Las Vegas, NV,⁴Comprehensive Cancer Centers of Nevada, Las Vegas, NV,⁵University of Nevada, Las Vegas (UNLV), Las Vegas, NV

摘要 Abstract

中文摘要

背景/意义：骨关节炎（OA）导致老年人慢性疼痛和功能减退，然而对于不能耐受长期NSAIDs或阿片类药物的患者，治疗选择有限。低剂量放射治疗（LDRT）在欧洲研究中已显示疗效，但美国的数据稀缺。本项由学生主导的研究报告了一家社区肿瘤诊所实施LDRT治疗OA的早期结局，重点关注疼痛、功能和镇痛药趋势。方法：30例OA患者（55个关节）接受LDRT治疗（3 Gy分5-6次照射，0.5 Gy/次）。在基线、治疗结束（EOT）和约1个月随访时，采用数字评分量表（NRS，0-10）评估疼痛，采用患者自评的von Pannewitz评分（VPS，0-4）评估整体改善。在两个时间点记录镇痛药使用情况。采用配对t检验和按关节部位的单因素方差分析评估变化。结果：基线NRS均值 = 8.0（±1.2）；随访 = 3.3（±2.1），平均降低4.7分（p < 0.001）。83%（25/30）达到≥2分改善；70%（21/30）达到≥3分；40%（12/30）达到≥5分。随访时VPS显示39%为中度改善，25%为优良，9%为完全缓解。23%（7/30）的患者镇痛药使用减少，且无患者需要升级用药或使用新药物。未发生≥2级毒性反应。结论：LDRT安全、可行，可提供显著的疼痛缓解和功能改善，同时伴随镇痛药使用的减少。用药未升级凸显了其作为OA疼痛非药物性、阿片节省性治疗的潜力。这些真实世界的美国数据支持对LDRT在老年疼痛管理中的进一步前瞻性评估。声明：无外部资助或利益冲突。本研究在教师指导下由学生研究者主导开展。

查看英文原文 English abstract

Background / Significance: Osteoarthritis (OA) causes chronic pain and functional decline in older adults, yet treatment options are limited for patients who cannot tolerate long-term NSAIDs or opioids. Low-dose radiation therapy (LDRT) has shown efficacy in European studies, but U.S. data are sparse. This student-led study reports early outcomes from a community oncology practice implementing LDRT for OA, focusing on pain, function, and analgesic trends. Methods: Thirty patients (55 joints) with OA were treated with LDRT (3 Gy in 5-6 fractions, 0.5 Gy/fraction). Pain was assessed using the Numeric Rating Scale (NRS, 0-10) and patient-assessed global improvement using the von Pannewitz Score (VPS, 0-4) at baseline, end of treatment (EOT), and ~1-month follow-up. Analgesic use was recorded at both time points. Paired t-tests and one-way ANOVA by joint site were used to assess changes. Results: Mean baseline NRS = 8.0 (±1.2); follow-up = 3.3 (±2.1), a mean reduction of 4.7 points (p < 0.001). Eighty-three percent (25/30) achieved ≥2-point improvement; 70% (21/30) ≥3 points; 40% (12/30) ≥5 points. VPS at follow-up indicated moderate improvement in 39%, excellent in 25%, and complete response in 9%. Analgesic use decreased in 23% (7/30), and no patients required escalation or new medications. No ≥ Grade 2 toxicities occurred. Conclusions: LDRT was safe, feasible, and provided substantial pain relief and improved function with parallel reductions in analgesic use. The absence of medication escalation underscores its potential as a non-pharmacologic, opioid-sparing therapy for OA pain. These real-world U.S. data support further prospective evaluation of LDRT in geriatric pain management. Disclosure: No external funding or conflicts of interest. Study conducted under student investigator leadership with faculty supervision.

利益披露 Disclosure

E. Schwartz, None.. M. Anderson, None.. R. Nevins, None.. K. Moakler, None.. A. Cohen, None.. M. Sinopoli, None.. S. Francis, None.. B. Newby, None.. M. Schwartz, None.

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