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Djiepmo F, Tamaskovics B, Bölke E, Peiper M, Haussmann J, Neuwahl J, Jazmati D, Maas K, Schmidt L, Gelzhäuser R, Schleich C, Corradini S, Orth K, van Griensven M, Rezazadeh A, Karimi K, Budach W, Matuschek C. Low-dose radiation treatment for painful plantar enthesophyte: a highly effective therapy with little side effects. Eur J Med Res 2022; 27:28. [PMID: 35197107 PMCID: PMC8867737 DOI: 10.1186/s40001-022-00642-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/13/2022] [Indexed: 12/02/2022] Open
Abstract
AIM Plantar enthesophyte is a common degenerative disorder. Surgical and medical treatment options are associated with either poor outcome or high percentage of relapse. Observations have indicated a beneficial effect of radiation therapy. We therefore wanted to evaluate pain reduction using orthovolt or cobalt-based radiation treatment for painful plantar enthesophyte and determine long-term response as well as prognostic parameters in this condition. METHODS We identified a total of 102 consecutive patients treated for a total of 117 symptomatic heel spurs. 59 patients were treated with cobalt radiation, 31 patients with orthovolt therapy and 12 patients with both radiation systems. Primary outcome measure was pain reduction being scored using the modified Rowe Score prior therapy, at the end of each treatment series as well as after 6 weeks. Secondary outcome measure was long-term outcome, evaluated in patients with a follow-up period of longer than 3 years. RESULTS Before radiation therapy, 61 patients (60.4%) had a score of 0, significant strong pain. At the time of completion of radiation treatment, 3 patients (2.7%) were pain-free (score of 30), whereas 8 patients (7.9%) had still severe pain (score 0). 6 weeks after radiation therapy, 33 patients (32.7%) were pain-free and 8 patients (7.9%) had severe pain (score 0), while at the time data of collection, 74 patients (73%) were free of pain and 1 patient (1%) had strong pain (score 0). Duration of pain before the start of radiation treatment was a significant prognostic factor (p = 0.012) for response to treatment. CONCLUSION Radiotherapy of painful plantar enthesophyte is a highly effective therapy with little side effects providing long-term therapeutic response. The only significant prognostic parameter for response to treatment is the duration of pre-radiation therapy pain. Early integration of radiation therapy in the treatment seems to result in superior pain reduction.
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Affiliation(s)
- Freddy Djiepmo
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Bálint Tamaskovics
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
- Klinik Für Strahlentherapie Und Radiologische Onkologie, Heinrich-Heine-Universität, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Matthias Peiper
- Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
| | - Jan Haussmann
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Judith Neuwahl
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Danny Jazmati
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Kitti Maas
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Roman Gelzhäuser
- Institute of Mathematical Statistics and Probability Theory, Heinrich-Heine-University, Dusseldorf, Germany
| | - Christoph Schleich
- Radiology Dusseldorf/Viersen, Ernst-Schneider-Platz 1, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Klaus Orth
- University of Hannover, Hannover, Germany
| | - Martijn van Griensven
- Department cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Amir Rezazadeh
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Kimia Karimi
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
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