[Functional outcome after megavoltage irradiation for heel spurs].
OBJECTIVE
To evaluate results on the functional outcome and to determine prognostic factors and long-term response to low-dose megavoltage irradiation.


METHODS
A total dose of 6.0 Gy given in two weekly fractions of 1.0 Gy was applied to 305 sites (252 patients). After 6 weeks, 97 sites (31.8%) received a second radiotherapy (RT) course. Assessment system was a function score which was documented before RT, at the end of each RT course, and at 6 weeks and 6 months after treatment. After an observation period of >/= 24 months, a follow-up examination was attempted to evaluate the late response.


RESULTS
At 6-month follow-up, 85.6% responded with a score improvement. The outcome was excellent (score: 90-100) in 135/305 sites (44.3%), good (score: 70-85) in 60/305 sites (19.7%), moderate (score: 45-65) in 63/305 (20.7%) sites, and poor (score: 0-40) in 47/305 sites (15.4%). 231/305 sites (75.7%) had no or mild pain. 296/305 (97,0%) had no or only slight limitations in work and 253/305 (82,9%) in daily activities. 255/305 (83,6%) had no or slight discomfort in gait. The long-term follow-up after a mean observation period of 48.4 months revealed 15 recurrences (7.3%). The patients' age, sex, and the duration of symptoms before initiation of RT (</= 6 months vs. > 6 months) did not prove to be prognostic factors. No early or late toxicity related to the use of RT was detected.


CONCLUSIONS
Megavoltage 6-MV photon-beam irradiation is a safe, effective and long-acting treatment modality in the management of heel spur patients. The function score has been proven to be a feasible method in clinical practice for evaluation of treatment outcome.
Heyd
Reinhard
R
Strahlenklinik, Klinikum Offenbach, Offenbach, Deutschland. Reiniheyd@aol.com
Tselis
Nikolaos
N
Ackermann
Hanns
H
Röddiger
Sandra J
SJ
Zamboglou
Nikolaos
N
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D036982:Heel Spur / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D017785:Photons / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D019233:Retreatment; D016896:Treatment Outcome