2 results
The analgesic effect of low-dose radiotherapy in treating benign musculoskeletal painful disorders using different energies: A retrospective cohort study
- Ahmed Abdelmaqsoud, Natalia Vorotniak, Dirk Strauß, Bettina Hentschel
-
- Journal:
- Journal of Radiotherapy in Practice / Volume 22 / 2023
- Published online by Cambridge University Press:
- 15 February 2023, e78
-
- Article
- Export citation
-
Introduction:
This retrospective cohort study tries to determine if there is a correlation between the effectiveness of low-dose radiotherapy (LDRT) in treating painful inflammatory or degenerative musculoskeletal disorders (MSDs) and the applied radiotherapy energy.
Patients and Methods:Between September 2019 and January 2020, a total of 91 patients with either painful inflammatory or degenerative MSDs were treated with LDRT. The inclusion criteria were patients older than 40 years with either painful inflammatory disorders such as epicondylitis humeri, plantar fasciitis or degenerative osteoarticular disorders of the wrist or ankle joints. All patients were treated with a single dose of 0·5 Gy and a total dose of 6·0 Gy (2 to 3 fractions weekly). Patients were divided into two groups. Orthovolt group was treated with 200 Kv, 15 mA and 1 mm copper filtration with different tubes according to the site to treatment using direct fields. The second group included patients treated with Linac machines with opposing fields using energies between 6 and 18 MV. The pain was evaluated before and on the last day of treatment and 4–6 months later using the Numerical Rating Scale.
Results:91 patients compatible with the inclusion criteria were identified with a median of 60 years. The median duration of symptoms was 6 months. 46% of patients were males, and 54% were females. The Orthovolt group included 49% of the patients and the Megavoltage group 51%. Most of the patients (98%) were previously treated with other methods such as local corticosteroid injection, painkillers or physiotherapy. At the end of the treatment, 60% of the patient’s showed subjective pain relief and only 6% had a complete response. The follow-up conducted 4 to 6 months after the treatment showed that 65% of patients had a complete response and 8% had an improvement. The comparison between both studied groups shows that the used energy does not affect the response either at the end of the treatment or at the second control. The relationship between the aetiology and the early and late responses shows no difference in the early response but a better late response in patients suffering from inflammatory diseases with a p-value of 0·015. The response according to the treated location shows that patients with osteoarthritis of the ankle joint have a worse response in comparison to other examined joints and plantar fasciitis.
Conclusion:LDRT is an effective analgesic treatment option for both inflammatory and degenerative MSDs. There is no difference in response according to the used energy, and most of the patients show late responses 4 to 6 months after the treatment.
11 - Haemopoietic and lymphoreticular systems: anatomy, physiology and pathology
-
- By Dirk C Strauss, Department of Upper GI Surgery, Abraham J Botha, Department of Upper GI and General Surgery, St Thomas' Hospital, Irving Taylor, Department of Surgery, University College London Medical School, London, UK
- Edited by Andrew N. Kingsnorth, Derriford Hospital, Plymouth, Aljafri A. Majid
-
- Book:
- Fundamentals of Surgical Practice
- Published online:
- 15 December 2009
- Print publication:
- 27 April 2006, pp 199-229
-
- Chapter
- Export citation
-
Summary
INTRODUCTION
Whereas blood is something that most surgeons prefer not to see too much of whilst operating, we all depend heavily on normal quantities and qualities of the various components of circulating blood to ensure a successful outcome after surgery and to prevent peri-operative complications. The main functional components of blood that are important to the surgeon are:
oxygen (O2) carrying (haemoglobin);
haemostasis (endothelial cells, platelets, coagulation, fibrinolysis);
inflammation (granulocytes, humoral mediators, endothelial cells, fibroblasts);
immunity (lymphocytes, macrophages, antibodies).
On some occasions surgery is performed on patients with known deficiencies in one or several of their blood components and it is important to be aware of the potential intra-and post-operative problems which constitute a risk.
In this chapter the anatomy and physiology of the haemo-poietic and lymphoreticular systems, and abnormalities of these systems relevant to surgical practice are reviewed.
The haemopoietic system refers to the blood-forming aspects of the bone marrow and the released circulating cells. The lymphoreticular system refers to the secondary lymphoid tissues such as the spleen and lymph glands, as well as blood cells resident in the tissues such as macrophages, lymphocytes and mast cells. Although this is a somewhat artificial anatomical classification, it separates the functional components of blood cell formation (haemopoiesis) and blood cell function (immune response). Blood cells from both anatomical compartments interact and are involved with both haemopoiesis and immunity.