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Title: Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

Abstract

Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the followingmore » results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.« less

Authors:
 [1];  [2];  [3];  [4];  [5]; ; ; ; ;  [1]
  1. Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)
  2. Radiotherapy Center, Hamburg (Germany)
  3. Franziskus Hospital, Bielefeld (Germany)
  4. Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany)
  5. Lippe Hospital, Lemgo (Germany)
Publication Date:
OSTI Identifier:
22149627
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 4; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANALGESICS; FAILURES; PAIN; PATIENTS; PHOTON BEAMS; RADIATION DOSES; RADIOTHERAPY; SCREENING; STANDARDS

Citation Formats

Niewald, Marcus, E-mail: marcus.niewald@uks.eu, Seegenschmiedt, M. Heinrich, Micke, Oliver, Graeber, Stefan, Muecke, Ralf, Schaefer, Vera, Scheid, Christine, Fleckenstein, Jochen, Licht, Norbert, and Ruebe, Christian. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.06.022.
Niewald, Marcus, E-mail: marcus.niewald@uks.eu, Seegenschmiedt, M. Heinrich, Micke, Oliver, Graeber, Stefan, Muecke, Ralf, Schaefer, Vera, Scheid, Christine, Fleckenstein, Jochen, Licht, Norbert, & Ruebe, Christian. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up. United States. doi:10.1016/J.IJROBP.2012.06.022.
Niewald, Marcus, E-mail: marcus.niewald@uks.eu, Seegenschmiedt, M. Heinrich, Micke, Oliver, Graeber, Stefan, Muecke, Ralf, Schaefer, Vera, Scheid, Christine, Fleckenstein, Jochen, Licht, Norbert, and Ruebe, Christian. Thu . "Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up". United States. doi:10.1016/J.IJROBP.2012.06.022.
@article{osti_22149627,
title = {Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up},
author = {Niewald, Marcus, E-mail: marcus.niewald@uks.eu and Seegenschmiedt, M. Heinrich and Micke, Oliver and Graeber, Stefan and Muecke, Ralf and Schaefer, Vera and Scheid, Christine and Fleckenstein, Jochen and Licht, Norbert and Ruebe, Christian},
abstractNote = {Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.},
doi = {10.1016/J.IJROBP.2012.06.022},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}