Radiation Therapy for mild to moderate OA

Started by lobelsteve
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the study as presented in the article was actually pretty well done. it was randomized with low dose, treatment dose and sham radiation and was blinded. it was clinically significant; however, a significant portion of placebo patients also got better. (70% compared to 42%)

technically it is a lot of radiation, but only 1 shot.

fwiw, 3Gy = 300 rem. typical knee xray is 0.05 rem.


seems like the next studies should focus on the long term effects of radiation to that knee.

and how to harness placebo effect.
 
Not gonna lie, I immediately looked into seeing if this is something we could offer when I first heard about this. We don’t have the right equipment and it would cost millions.
 
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Saw this when it first came out and then there was this just recently that's tangentially related:


"Complicating matters, a number of people have advocated for something called hormesis, in which small doses of radiation purportedly promote the cellular repair of damage from other sources. The evidence for this is even spottier, and when the NRC was petitioned to adopt hormesis as part of its scientific framework during Trump’s first term, it rejected the petition."

The whole idea of the LNT model makes me challenged to support this, especially with the long-term effects of spine bone irradiation being increased fractures, but I suspect my biases are towards my procedures more than theirs.

I mean it can't be worse than the copper or magnets
 
Not gonna lie, I immediately looked into seeing if this is something we could offer when I first heard about this. We don’t have the right equipment and it would cost millions.
Just buy a fake machine and give them placebo radiation for half price.

Win/win!
 
I could give them homeopathic dosing radiation 😉 extra dilute for extra potency
 
apparently according to article from Pain Physician, a LESI is about 0.191mGy-m2, which is 19.1 mrem. knee xray is 0.05 mrem. this treatment is 300 rem or 300,000 mrem.

in an above post, i typed the wrong amount. a knee xray is 5 mrem.
 
I recently saw a patient who suffered a traumatic BKA about 20 years ago. Very short stump due to location of injury. X-rays show severe tricompartmental knee DJD. Lack of benefit from c/s injections and was not considered TKA candidate due to BKA. Underwent 50cgy times 6 fractions without any relief. N=1.
 
I talked to my rad onc friend who brought this up recently. they are struggling to find new ways of business, as CAR-T and other revolutionary treatments of cancer are obviating the need of radiation therapy in cancer treatment.
 
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I could give them homeopathic dosing radiation 😉 extra dilute for extra potency
microdosing rads, adding to their stack
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