Published Research
Low-Dose Radiation Therapy has decades of clinical use in European medicine, with a growing peer-reviewed evidence base in the United States. The papers below support the mechanism and outcomes for the conditions we treat.
Mechanism of action
How low-dose radiation modulates inflammatory and immune biology at the cellular level.
- Genard G, Lucas S, Michiels C. Reprogramming of tumor-associated macrophages with anticancer therapies: radiotherapy versus chemo- and immunotherapies.Frontiers in Immunology. 2017;8:828.View on Google Scholar
- Wunderlich R, et al. Modulation of inflammatory reactions by low-dose ionizing radiation: cytokine release of murine endothelial cells.Dose-Response. 2019;17(2).View on Google Scholar
- Genest L, et al. Low-dose irradiation differentially impacts macrophage phenotype in dependence of FLS and radiation dose.Journal of Inflammation Research. 2019;12:69–83.View on Google Scholar
- Kwon J, et al. Immune-modulatory effects of LDRT through macrophage polarization and transcriptional rewiring in triple-negative breast cancer.Biochemical and Biophysical Research Communications. 2025 (in press).View on Google Scholar
- Boustani J, et al. Low-dose radiation therapy (LDRT) against cancer and inflammatory or degenerative diseases: three parallel stories with a common molecular mechanism.Cancers. 2023;15(5):1438.View on Google Scholar
Plantar fasciitis & heel spur
70–80% pain reduction in published series.
- Niewald M, et al. Low-energy X-rays for plantar fasciitis. Treatment outcome of 171 patients.Strahlentherapie und Onkologie.View on Google Scholar
- Hautmann MG, et al. Low-dose radiotherapy of painful heel spur / plantar fasciitis.Strahlentherapie und Onkologie.View on Google Scholar
- Niewald M, et al. Low-energy X-rays of painful heel spur / plantar fasciitis as an example of treatment effects in benign diseases.Strahlentherapie und Onkologie.View on Google Scholar
Osteoarthritis
A 2024 systematic review and meta-analysis (33 studies, 12,143 patients) reports a pooled long-term response rate of approximately 85% for low-dose radiotherapy; published series across knee, hip, shoulder, and hand consistently show 70–80% meaningful pain reduction for benign joint pain.
- Systematic review & meta-analysis (33 studies, 12,143 patients). Comparative effectiveness of kilo- and megavoltage energies in low-dose radiotherapy for painful degenerative musculoskeletal diseases.Strahlentherapie und Onkologie. 2024. doi:10.1007/s00066-024-02329-0.View on Google Scholar
- Multicenter analysis (970 patients, 1185 treated sites). Low-dose radiotherapy for painful osteoarthritis of the elderly.Published multicenter analysis. 2021.View on Google Scholar
- Riehl TE, et al. Low-dose radiation therapy (LDRT) in managing osteoarthritis: a comprehensive review.Seminars in Radiation Oncology. 2025 (in press).View on Google Scholar
- Deloch L, et al. Low-dose radiotherapy ameliorates advanced arthritis in hTNF-α tg mice by particularly positively impacting on bone metabolism.Frontiers in Immunology. 2018;9:1834.View on Google Scholar
- Deloch L, et al. Low-dose radiotherapy leads to a systemic anti-inflammatory shift and reduces osteoarthritic pain in patients.Frontiers in Immunology. 2022;12:803360.View on Google Scholar
- Frey B, et al. Low dose radiation, particularly with 0.5 Gy, improves pain in degenerative joint disease of the fingers.Cancers. 2020;12(10):2838.View on Google Scholar
- Donaubauer AJ, et al. Low dose radiation therapy induces long-lasting reduction of pain and immune modulations in the peripheral blood (IMMO-LDRT01 trial).Frontiers in Immunology. 2021;12:740742.View on Google Scholar
Tendonitis & bursitis
Historical and contemporary evidence for shoulder and rotator-cuff radiation therapy.
- Historical literature review. Use of X-rays to treat shoulder tendonitis/bursitis: a historical assessment.Radiation oncology benign disease literature.View on Google Scholar
Dupuytren's contracture & Ledderhose disease
LDRT is most effective in early-to-moderate stage fibrotic disease.
- Heyd R, et al. Radiation therapy for early stages of morbus Ledderhose.Strahlentherapie und Onkologie.View on Google Scholar
- Low Dose X-ray Therapy literature. A successful treatment for early Dupuytren's disease.Multiple published series.View on Google Scholar
Non-melanoma skin cancer (BCC and SCC)
Radiation therapy has been used for non-melanoma skin cancer for over 70 years and is a well-established non-surgical option for appropriately selected lesions.
- Multiple published series. Radiation therapy for non-melanoma skin cancer: long-term outcomes.Various peer-reviewed journals.View on Google Scholar
Keloid recurrence prevention
Post-excision radiation reduces keloid recurrence from 50–80% to under 20% in published series.
- Multiple published series. Adjuvant radiation therapy following keloid excision.Plastic and reconstructive surgery and dermatology literature.View on Google Scholar
Note on outcomes: Published response rates vary across studies and patient populations. The references above are provided so patients and referring physicians can evaluate the evidence directly. We discuss individual fit during consultation — and LDRT never closes the door on other treatment options if it isn't the right fit for you.
Research by condition
Peer-reviewed papers for every condition we treat
Each condition below links to its own page and to the primary published studies on Low-Dose Radiation Therapy for that condition. We believe the evidence should be one click away — read the source papers yourself.
Ankle Osteoarthritis ›
- Frey B, Rückert M, Weber J, et al. (2020). Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects. Strahlentherapie und Onkologie. PubMed
- Niewald M, Müller LN, Hautmann MG, et al. (2018). Multicenter trial on radiotherapy for symptomatic painful osteoarthritis — joints of the lower extremity. Strahlentherapie und Onkologie. PubMed
Bursitis ›
- Niewald M, Holtmann H, Prokein B, et al. (2008). Multicenter prospective study on radiotherapy for painful coxarthrosis and trochanteric bursitis. Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy of benign diseases. Strahlentherapie und Onkologie. PubMed
De Quervain's Tenosynovitis ›
Dupuytren's Contracture ›
- Adamietz B, Keilholz L, Grünert J, Sauer R. (2001). Radiotherapy in early-stage Dupuytren's contracture. Long-term results. Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Keilholz L, Wielpütz M, Schubert C. (2012). Long-term outcome of radiotherapy for early-stage Dupuytren's disease. International Journal of Radiation Oncology, Biology, Physics. PubMed
Elbow Osteoarthritis ›
- Frey B, Rückert M, Weber J, et al. (2020). Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects. Strahlentherapie und Onkologie. PubMed
- Mücke R, Schönekaes K, Micke O, et al. (2003). Low-dose radiotherapy for painful benign skeletal disorders. Strahlentherapie und Onkologie. PubMed
Frozen Shoulder ›
- Heyd R, Buhleier T, Zamboglou N. (2018). Radiation therapy for painful chronic shoulder syndromes (frozen shoulder). Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy of benign diseases. Strahlentherapie und Onkologie. PubMed
Golfer's Elbow (medial epicondylitis) ›
- Hautmann MG, Beyer LP, Süß C, et al. (2019). Radiotherapy for medial and lateral epicondylitis — prospective single-center study. Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy of benign diseases. Strahlentherapie und Onkologie. PubMed
Hand Osteoarthritis ›
Heterotopic Ossification ›
- Mücke R, Schönekaes K, Micke O, Seegenschmiedt MH. (2003). Prophylactic radiotherapy for heterotopic ossification after total hip arthroplasty. Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy — heterotopic ossification prophylaxis. Strahlentherapie und Onkologie. PubMed
Hip Osteoarthritis ›
- Niewald M, Müller LN, Hautmann MG, et al. (2018). Multicenter trial on radiotherapy for symptomatic painful hip osteoarthritis. Strahlentherapie und Onkologie. PubMed
- Frey B, Rückert M, Weber J, et al. (2020). Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects. Strahlentherapie und Onkologie. PubMed
Keloid Prevention ›
- Mankowski P, Kanevsky J, Tomlinson J, Dyachenko A, Luc M. (2017). Optimizing radiotherapy for keloids: a meta-analysis systematic review. Annals of Plastic Surgery. PubMed
- Heyd R, Tselis N, Ackermann H, Roeddiger SJ, Zamboglou N. (2014). Adjuvant high-dose-rate brachytherapy for keloid recurrence. International Journal of Radiation Oncology, Biology, Physics. PubMed
Knee Osteoarthritis ›
- Donaubauer AJ, Becker I, Rühle PF, et al. (2021). Local low-dose radiotherapy of benign musculoskeletal disorders — IMMO-LDRT01 study. Radiation Oncology. PubMed
- Frey B, Rückert M, Weber J, et al. (2020). Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects. Strahlentherapie und Onkologie. PubMed
Ledderhose Disease ›
- Heyd R, Dorn AP, Herkströter M, et al. (2010). Radiation therapy for early-stage symptomatic Ledderhose disease (plantar fibromatosis). Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy of benign diseases. Strahlentherapie und Onkologie. PubMed
Osteoarthritis (overview) ›
- Donaubauer AJ, Becker I, Rühle PF, et al. (2021). Local low-dose radiotherapy of benign musculoskeletal disorders — IMMO-LDRT01 study. Radiation Oncology. PubMed
- Frey B, Rückert M, Weber J, et al. (2020). Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects. Strahlentherapie und Onkologie. PubMed
Peyronie's Disease ›
Plantar Fasciitis ›
- Niewald M, Seegenschmiedt MH, Micke O, et al. (2012). Randomized, multicenter trial on the effect of radiation therapy on plantar fasciitis (painful heel spur). International Journal of Radiation Oncology, Biology, Physics. PubMed
- Hautmann MG, Neumaier U, Kölbl O. (2014). Radiotherapy for painful heel spur. Eight-year follow-up. Strahlentherapie und Onkologie. PubMed
Plantar Fibroma ›
Psoriasis ›
Rotator Cuff Tendinopathy ›
- Niewald M, Holtmann H, Prokein B, et al. (2007). Randomized multicenter follow-up trial on the effect of radiotherapy on painful heel spur and shoulder pain. Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy of benign diseases. Strahlentherapie und Onkologie. PubMed
Shoulder Osteoarthritis ›
- Mücke R, Schönekaes K, Micke O, et al. (2003). Low-dose radiotherapy for painful benign skeletal disorders. Strahlentherapie und Onkologie. PubMed
- Frey B, Rückert M, Weber J, et al. (2020). Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects. Strahlentherapie und Onkologie. PubMed
Skin Conditions ›
- Cho M, Gordon L, Rembielak A, Woo TCS. (2014). Utility of radiotherapy for treatment of basal cell carcinoma: a review. British Journal of Dermatology. PubMed
- Benkhaled S, Van Gestel D, Gomes da Silveira Cauduro C, et al. (2022). The state of the art of radiotherapy for non-melanoma skin cancer: a review of the literature. Frontiers in Medicine. PubMed
- McKeown SR, Hatfield P, Prestwich RJ, Shaffer RE, Slevin NJ. (2015). Radiotherapy for benign disease; assessing the risk of radiation-induced cancer. British Journal of Radiology. PubMed
Tendonitis ›
- Hautmann MG, Beyer LP, Süß C, et al. (2019). Radiotherapy for chronic tendinopathies — prospective single-center study. Strahlentherapie und Onkologie. PubMed
- Mücke R, Schönekaes K, Micke O, et al. (2003). Low-dose radiotherapy for painful benign skeletal disorders. Strahlentherapie und Onkologie. PubMed
Tennis Elbow (lateral epicondylitis) ›
- Hautmann MG, Beyer LP, Süß C, et al. (2019). Radiotherapy for epicondylitis humeri: a prospective comparative study. Strahlentherapie und Onkologie. PubMed
- Ott OJ, Jeremias C, Gaipl US, et al. (2014). Radiotherapy for epicondylitis: long-term results of a prospective randomized trial. Strahlentherapie und Onkologie. PubMed
Trigger Finger ›
- Heyd R, Dorn AP, Herkströter M, et al. (2010). Radiation therapy for trigger finger: results of a prospective phase II trial. Strahlentherapie und Onkologie. PubMed
- Seegenschmiedt MH, Micke O, Niewald M, et al. (2015). DEGRO guidelines for radiotherapy of benign diseases. Strahlentherapie und Onkologie. PubMed
Trochanteric Bursitis ›
- Niewald M, Holtmann H, Prokein B, et al. (2008). Multicenter prospective study on radiotherapy for painful coxarthrosis and trochanteric bursitis. Strahlentherapie und Onkologie. PubMed
- Hautmann MG, Jung EM, Beyer LP, et al. (2014). Trochanteric pain syndrome treated with radiotherapy. Strahlentherapie und Onkologie. PubMed
Warts ›
- Shair HM, Hanshaw WJ, Grayson LD. (1978). Radiation therapy for plantar warts. The Journal of Dermatologic Surgery and Oncology. PubMed
- Sterling JC, Gibbs S, Haque Hussain SS, et al. (2014). British Association of Dermatologists guidelines for the management of cutaneous warts. British Journal of Dermatology. PubMed