18 min
Those "negative" randomized control trials everyone likes to cite and say "LDRT doesn't work" are really, really bad (Radiotherapy for Arthritis: The Miniseries) out.of.the.basement / radiation.medicine
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- Medicina
Episode Four (part...one?) of the “Real World LDRT” miniseries (sponsored by Xstrahl) gets more into the evidence behind LDRT. Specifically, the two RCTs out of the Netherlands published a few years back showing that LDRT had no benefit in osteoarthritis.
So...couple small problems with that. Namely, the trials had less than 30 patients in each arm, used too high of a dose, used only half the standard treatment, and...oh, yeah. In the LDRT arm in one of the trials, 2/3rds of the patients had >5/10 pain for >15/30 days per month despite analgesics/therapy for >5 years. That's VERY severe pain, by any definition.
...and:
One of the primary outcome criteria was "greater than 50% relative improvement in pain/function AND >20 points in absolute improvement" on their specific measurement tool.
...and:
"...both studies were powered to detect a large effect of low-dose radiation therapy. Using the primary outcome, allowing for a 15% dropout rate, [they] aimed to include 27 patients per group, assuming an expected difference of 40% in the proportion of responders between the low-dose radiation therapy and sham intervention groups, 80% power and 5% α level, and that 40% of the sham intervention group would be responders..."
Is there any intervention on Planet Earth that would show a positive signal with a design like this?
Please. Please. Please stop citing these trials.
***
Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at https://xstrahl.com/
***
OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support.
jason@coldlight.org
---
Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support
Episode Four (part...one?) of the “Real World LDRT” miniseries (sponsored by Xstrahl) gets more into the evidence behind LDRT. Specifically, the two RCTs out of the Netherlands published a few years back showing that LDRT had no benefit in osteoarthritis.
So...couple small problems with that. Namely, the trials had less than 30 patients in each arm, used too high of a dose, used only half the standard treatment, and...oh, yeah. In the LDRT arm in one of the trials, 2/3rds of the patients had >5/10 pain for >15/30 days per month despite analgesics/therapy for >5 years. That's VERY severe pain, by any definition.
...and:
One of the primary outcome criteria was "greater than 50% relative improvement in pain/function AND >20 points in absolute improvement" on their specific measurement tool.
...and:
"...both studies were powered to detect a large effect of low-dose radiation therapy. Using the primary outcome, allowing for a 15% dropout rate, [they] aimed to include 27 patients per group, assuming an expected difference of 40% in the proportion of responders between the low-dose radiation therapy and sham intervention groups, 80% power and 5% α level, and that 40% of the sham intervention group would be responders..."
Is there any intervention on Planet Earth that would show a positive signal with a design like this?
Please. Please. Please stop citing these trials.
***
Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at https://xstrahl.com/
***
OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support.
jason@coldlight.org
---
Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support
18 min