Patients with heel spurs felt less pain during follow-up after receiving a standard dose of radiation therapy compared with a low dose, according to a study.
Researchers randomly assigned 29 patients with painful heel spurs to receive standard-dose radiation therapy (6 Gy in 6 single fractions of 1.0 Gy applied twice weekly) and 33 patients to receive low-dose therapy (0.6 Gy in 6 single fractions of 0.1 Gy applied twice weekly). Lateral opposing 4-MV to 6-MV photon beams were used. After 3 months, researchers concluded the treatment phase of the study and continued follow-up to 1 year. Reirradiation with the standard dosage was offered to patients with insufficient pain relief after 3 months.
After 3 months, patients in the low-dose group experienced a mean difference in visual analogue scale scores of –20 compared with the values before radiation therapy, whereas the standard-dose group experienced a –43.39 difference. Similarly, the mean difference of Calcaneodynia sum scores amounted to 24.76 in the low-dose group vs. 35.58 in the standard-dose group.
Significantly fewer patients had to be reirradiated in the standard-dose group (17.24%) vs. the low-dose group (63.6%). Patients who were reirradiated in the low-dose group showed equally favorable results compared with patients in the standard-dose group who were not reirradiated, suggesting that reirradiation in the low-dose group after treatment failure acts like a salvage therapy, according to the researchers. Patients who experienced a favorable result after 3 months continued to show favorable results after 12 months. Worsening of pain during radiation therapy had no correlation with the influence on the final pain relief, according to the study.
The study was published in the advanced online publication of International Journal of Radiation Oncology, Biology and Physics.
For more information:
Niewald M, Seegenschmiedt MH, Micke O, et al. 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. Int J Radiation Oncol Biol Phys. July 24, 2012.
Disclosures: The researchers had no financial disclosures.