Abstract
Background: In a retrospective study the efficacy of orthovoltage radiotherapy for refractory painful plantar heel spur was analyzed for 3 different radiation dose concepts. Patients and Methods: From 1.1.1984 through 1.3.1994, 182 patients with refractory painful heel symptoms and radiologically proven plantar heel spur received radiotherapy. A total of 141 patients and 170 heels (due to double-sided symptoms) were completely documented in long-term follow-up. Clearly defined semi-quantitative criteria (9-point score) were used to analyze heel pain and ankle function prior to RT, 6 to 12 weeks post-radiation, and at last follow-up. The treatment outcome, i.e. (un)favourable response, of 3 radiation dose concepts were compared: Group A (n = 72 heels) received 12 Gy total radiation dose in 3 fractions per week and 2 series (6 x 1 Gy per series) separated by 6 weeks; group B (n = 98 heels) received 3 Gy total radiation dose in 10 fractions of 0.3 Gy (n = 50) or 5 Gy (10 x 0.5 Gy) (n = 48) with conventional fractionation in 1 series. Results: Radiotherapy was very effective: at last follow-up 67% (group A) and 71% (group B) remained completely free of pain. The rate of 'complete pain relief' (i.e. free of any pain symptoms) was not different between the 3 radiation concepts. However, significant differences were observed with regard to 'incomplete or insufficient pain relief', i.e. a subjective pain relief of less than 80%, a delayed pain relief after more than 4 weeks or a relapse of pain symptoms in long-term follow-up. More favourable results were achieved in patients receiving 5 Gy or 12 Gy total dose, while patients with 3 Gy total dose had significantly worse results. Prognostic factors for 'complete pain relief' were short duration of pain symptoms and acute pain symptoms prior to radiotherapy; with regard to 'incomplete or insufficient pain relief' the total dose was found to be a prognostic parameter. Conclusions: Patients with refractory heel pain can yield a high response to radiotherapy even after failing various conventional treatments previously. Thus, radiotherapy should not be solely regarded as a last resort due to its low costs and high efficacy at low radiation doses.
| Translated title of the contribution | Radiotherapy of plantar heel spur: Indication, technique and clinical results for different dose concepts |
|---|---|
| Original language | German |
| Journal | Strahlentherapie und Onkologie |
| Volume | 172 |
| Issue number | 7 |
| Pages (from-to) | 376-383 |
| Number of pages | 8 |
| ISSN | 0179-7158 |
| Publication status | Published - 27.07.1996 |
