Heyd Reinhard, Tselis Nikolaos, Ackermann Hanns, Röddiger Sandra J, Zamboglou Nikolaos
Strahlenklinik, Klinikum Offenbach, Offenbach, Deutschland.
Strahlenther Onkol. 2006 Dec;182(12):733-9. doi: 10.1007/s00066-006-1569-x.
To evaluate results on the functional outcome and to determine prognostic factors and long-term response to low-dose megavoltage irradiation.
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.
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.
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.
评估低剂量兆伏级放疗对功能结局的影响，确定预后因素以及长期反应。
对305个部位（252例患者）给予总量6.0 Gy，每周分两次给予，每次1.0 Gy。6周后，97个部位（31.8%）接受了第二个放疗疗程。评估系统为功能评分，在放疗前、每个放疗疗程结束时、治疗后6周和6个月记录。经过≥24个月的观察期后，尝试进行随访检查以评估晚期反应。
在6个月随访时，85.6%的患者评分改善。135/305个部位（44.3%）结局为优（评分：90 - 100），60/305个部位（19.7%）为良（评分：70 - 85），63/305个部位（20.7%）为中（评分：45 - 65），47/305个部位（15.4%）为差（评分：0 - 40）。231/305个部位（75.7%）无疼痛或仅有轻度疼痛。296/305个部位（97.0%）工作无受限或仅有轻微受限，253/305个部位（82.9%）日常活动无受限或仅有轻微受限。255/305个部位（83.6%）步态无不适或仅有轻微不适。平均观察期48.4个月后的长期随访发现15例复发（7.3%）。患者的年龄、性别以及放疗开始前症状持续时间（≤6个月与＞6个月）未被证明是预后因素。未检测到与放疗使用相关的早期或晚期毒性反应。
兆伏级6 - MV光子束照射是治疗跟骨骨刺患者的一种安全、有效且长效的治疗方式。功能评分已被证明是临床实践中评估治疗结局的一种可行方法。
