Low-Dose Radiation Therapy for Peripheral Joint Osteoarthritis: Early United States Community Experience With Pain, Function, and Medication Outcomes

Purpose: This study aimed to evaluate the real-world effectiveness and feasibility of low-dose radiation therapy (LDRT) for peripheral joint osteoarthritis (OA) in a United States community oncology setting, focusing on pain, function, and analgesic outcomes. Methods and Materials: We retrospectively analyzed 30 consecutive patients (55 joints) treated with LDRT (3 Gy in 6 fractions; 0.5 Gy per fraction) for OA. Pain was assessed using a 0 to 10 numeric rating scale. Global improvement was captured with the von Pannewitz score (0-4; lower = greater improvement). Analgesic change was abstracted from the medical record. Paired tests compared pre- and posttreatment outcomes. Results: < .001). von Pannewitz score indicated improvement in 92% of treated joints. Twenty-three percent of patients reduced analgesic use; none required analgesic escalation. All patients completed treatment without interruptions, and no acute toxicities were recorded. Conclusions: In a community oncology setting, LDRT was feasible and associated with clinically meaningful reductions in pain and analgesic use for peripheral joint OA. These findings support prospective trials to validate benefits and define optimal patient selection and retreatment strategies.