Low-Dose Radiation Therapy for Hand Osteoarthritis

Hand osteoarthritis is where the LDRT evidence is most mixed. Prospective series report meaningful benefit; the one published randomized trial found no significant effect at 3 months.

Evidence

• Donaubauer et al.: 483 patients retrospective; 70% pain improvement at 3 months (short follow-up).
• Alvarez et al.: 100 patients prospective; VAS 8 → 4/3/3.5 at 3/6/12 months; 70% functional improvement; no toxicity.
• Rogers et al.: 99 patients prospective; pain relief and grip strength improvement by dynamometer.
• Minten et al. 2018 (RCT, null): 56 patients randomized; 31% responders (LDRT) vs 27% (control) — not significant. ARS AUC limitations: small sample, 3-month follow-up only, 1 Gy/fraction vs standard 0.5 Gy.

Clinical note: if DIP joints are involved, nail bed shielding may cause inadequate coverage of the treatment target — discuss this tradeoff with your radiation oncologist.

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Medically reviewed by: Robert Warren Floyd, M.D., Ph.D. — Resident Physician, Radiation Oncology, The University of Texas MD Anderson Cancer Center. Last reviewed: August 2, 2026. Independent personal project — not affiliated with or endorsed by MD Anderson Cancer Center. Funding & independence disclosure.