title: Radiotherapy for benign calcaneodynia: long-term results of the Erlangen Dose Optimization (EDO) trial.
abstract: OBJECTIVE
  The goal of this work was to evaluate the long-term efficacy of two dose-fractionation schedules for radiotherapy of calcaneodynia.
  
  
  METHODS
  Between February 2006 and February 2010, 457 evaluable patients were recruited for this prospective trial. All patients received orthovoltage radiotherapy. One course consisted of 6 fractions/3 weeks. In case of insufficient remission of pain after 6 weeks a second series was performed. Patients were randomly assigned to receive either single doses of 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before, right after (early response), 6 weeks (delayed response), and approximately 2.5 years after radiotherapy (long-term response) with a questionnaire-based visual analogue scale (VAS) and a comprehensive pain score (CPS).
  
  
  RESULTS
  The median follow-up was 32 months (range 9-57 months). The overall early, delayed, and long-term response rates for all patients were 87, 88, and 95%. The mean VAS values before treatment, for early, delayed, and long-term response for the 0.5 and 1.0 Gy groups were 65.5 ± 22.1 and 64.0 ± 20.5 (p = 0.19), 34.8 ± 24.7 and 39.0 ± 26.3 (p = 0.12), 25.1 ± 26.8 and 28.9 ± 26.8 (p = 0.16), and 16.3 ± 24.3 and 14.1 ± 19.7 (p = 0.68). The mean CPS values before treatment, for early, delayed, and log-term response were 10.1 ± 2.7 and 10.0 ± 3.0 (p = 0.78), 5.6 ± 3.7 and 6.0 ± 3.9 (p = 0.34), 4.0 ± 4.1 and 4.3 ± 3.6 (p = 0.26), and 2.1 ± 3.3 and 2.3 ± 3.2 (p = 0.34), respectively. No significant differences in long-term response quality between the two arms were found (p = 0.50).
  
  
  CONCLUSIONS
  Radiotherapy is a very effective treatment for the management of benign calcaneodynia. For radiation protection reasons, the dose for a RT series should not exceed 3.0 Gy.
authors.affiliation: Dept. of Radiation Oncology, University Hospital Erlangen, Universitätsstraße 27, 91054, Erlangen, Germany, oliver.ott@uk-erlangen.de.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Ott
authors.forename: Carolin
authors.initials: C
authors.lastname: Jeremias
authors.forename: Udo S
authors.initials: US
authors.lastname: Gaipl
authors.forename: Benjamin
authors.initials: B
authors.lastname: Frey
authors.forename: Manfred
authors.initials: M
authors.lastname: Schmidt
authors.forename: Rainer
authors.initials: R
authors.lastname: Fietkau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D005534:Foot Diseases / Q000175:diagnosis* / Q000532:radiotherapy*; D006365:Heel / Q000528:radiation effects*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D016896:Treatment Outcome