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Background <p>Osteoarthritis (OA) is the most prevalent form of arthritis and a major cause of disability worldwide. Conventional treatments often provide limited relief and carry long-term risks, highlighting the need for safer, non-pharmacologic alternatives. Low-dose radiotherapy (LDRT) has emerged as a potential option due to its anti-inflammatory effects and favorable safety profile.</p> Objectives <p>To evaluate the efficacy and safety of LDRT in managing OA-related pain and functional limitations, and to guide future research on its role in non-pharmacologic OA management.</p> Methods <p>This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD42024599334). A comprehensive search of five databases was conducted through June 2025 to identify studies evaluating LDRT for osteoarthritis. Eligible studies included human participants with clinically diagnosed OA, assessing LDRT efficacy or safety. Two reviewers independently screened and extracted data. Risk of bias was assessed using the Cochrane ROB 2 tool. A random-effects meta-analysis was performed using R software, with heterogeneity evaluated by I² and tau² statistics.</p> Results <p>Twelve studies involving 1,750 participants were included, with six eligible for meta-analysis. LDRT showed no significant benefit over sham treatment in reducing pain (SMD: -0.92; <i>P</i> = 0.13) or improving function (SMD: 0.22; <i>P</i> = 0.22). While most adverse events were similar between groups, nail reactions were significantly more common with LDRT (RR: 2.24; 95% CI: 1.13–4.45). Overall, adverse events were more frequent in the LDRT group (RR: 1.44; 95% CI: 1.08–1.92). No significant differences were observed in treatment response rates. Risk of bias was generally low, and evidence certainty ranged from moderate to high. GRADE assessment indicated high certainty for adverse events but moderate certainty for pain and functional outcomes.</p> Conclusion <p>This meta-analysis found that low-dose radiotherapy (LDRT) offers no significant benefit over sham treatment for osteoarthritis in terms of pain or function, despite mild adverse effects. Current evidence does not support its use over standard therapies, and due to clinical heterogeneity and limited follow-up, LDRT should remain investigational reserved for research or select refractory cases.</p>

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Efficacy, safety, and pain management of low-dose radiation therapy in osteoarthritis: a comprehensive systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年9月1日

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  • Bara M. Hammadeh,
  • Abdullah Yousef Aldalati,
  • Alzahra’a Al Matairi,
  • Mohamed Nasser Elshabrawi,
  • Fares A. Qtaishat,
  • Ahmad M. AL-Qunbar,
  • Abdulla Alzibdeh,
  • Yazan Abuodeh,
  • Fawzi Abuhijla

摘要

Background

Osteoarthritis (OA) is the most prevalent form of arthritis and a major cause of disability worldwide. Conventional treatments often provide limited relief and carry long-term risks, highlighting the need for safer, non-pharmacologic alternatives. Low-dose radiotherapy (LDRT) has emerged as a potential option due to its anti-inflammatory effects and favorable safety profile.

Objectives

To evaluate the efficacy and safety of LDRT in managing OA-related pain and functional limitations, and to guide future research on its role in non-pharmacologic OA management.

Methods

This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD42024599334). A comprehensive search of five databases was conducted through June 2025 to identify studies evaluating LDRT for osteoarthritis. Eligible studies included human participants with clinically diagnosed OA, assessing LDRT efficacy or safety. Two reviewers independently screened and extracted data. Risk of bias was assessed using the Cochrane ROB 2 tool. A random-effects meta-analysis was performed using R software, with heterogeneity evaluated by I² and tau² statistics.

Results

Twelve studies involving 1,750 participants were included, with six eligible for meta-analysis. LDRT showed no significant benefit over sham treatment in reducing pain (SMD: -0.92; P = 0.13) or improving function (SMD: 0.22; P = 0.22). While most adverse events were similar between groups, nail reactions were significantly more common with LDRT (RR: 2.24; 95% CI: 1.13–4.45). Overall, adverse events were more frequent in the LDRT group (RR: 1.44; 95% CI: 1.08–1.92). No significant differences were observed in treatment response rates. Risk of bias was generally low, and evidence certainty ranged from moderate to high. GRADE assessment indicated high certainty for adverse events but moderate certainty for pain and functional outcomes.

Conclusion

This meta-analysis found that low-dose radiotherapy (LDRT) offers no significant benefit over sham treatment for osteoarthritis in terms of pain or function, despite mild adverse effects. Current evidence does not support its use over standard therapies, and due to clinical heterogeneity and limited follow-up, LDRT should remain investigational reserved for research or select refractory cases.