Muecke Ralph, Micke Oliver, Reichl Berthold, Heyder Rainer, Prott Franz-Josef, Seegenschmiedt M Heinrich, Glatzel Michael, Schneider Oliver, Schäfer Ulrich, Kundt Guenther
Department of Radiotherapy, St. Josefs-Hospital, Wiesbaden, Germany.
Acta Oncol. 2007;46(2):239-46. doi: 10.1080/02841860600731935.
A total of 502 patients treated between 1990 and 2002 with low-dose radiotherapy (RT) for painful heel spurs were analysed for prognostic factors for long-term treatment success. The median follow-up was 26 months, ranging from 1 to 103 months. Events were defined as (1) slightly improved or unchanged pain after therapy, or (2) recurrent pain sensations during the follow-up period. Overall 8-year event-free probability was 60.9%. Event-free probabilities of patients with one/two series (414/88) were 69.7%/32.2% (p<0.001); >58/ < or = 58 years (236/266), 81.3%/47.9% (p=0.001); high voltage/orthovoltage (341/161), 67.9%/60.6% (p=0.019); pain anamnesis < or = 6 months/ >6 months (308/194), 76.3%/43.9% (p=0.001); single dose 0.5/1.0 Gy (100/401), 86.2%/55.1% (p=0.009); without/with prior treatment (121/381), 83.1%/54.9% (p=0.023); men/women (165/337), 61.2%/61.5% (p=0.059). The multivariate Cox regression analysis with inclusion of the number of treatment series, age, photon energy, pain history, single-dose and prior treatments revealed patients with only one treatment series (p<0.001), an age >58 years (p=0.011) and therapy with high voltage photons (p=0.050) to be significant prognostic factors for pain relief. Overall low-dose RT is a very effective treatment in painful heel spurs.
对1990年至2002年间接受低剂量放射治疗（RT）的502例足跟痛患者进行分析，以确定长期治疗成功的预后因素。中位随访时间为26个月，范围为1至103个月。事件定义为：（1）治疗后疼痛略有改善或无变化；或（2）随访期间疼痛复发。总体8年无事件概率为60.9%。接受一个/两个疗程（414/88）治疗的患者无事件概率分别为69.7%/32.2%（p<0.001）；年龄>58/<或=58岁（236/266），分别为81.3%/47.9%（p=0.001）；高电压/低电压（341/161），分别为67.9%/60.6%（p=0.019）；疼痛病史<或=6个月/>6个月（308/194），分别为76.3%/43.9%（p=0.001）；单次剂量0.5/1.0 Gy（100/401），分别为86.2%/55.1%（p=0.009）；未接受/接受过先前治疗（121/381），分别为83.1%/54.9%（p=0.023）；男性/女性（165/337），分别为61.2%/61.5%（p=值0.059）。多因素Cox回归分析纳入治疗疗程数、年龄、光子能量、疼痛病史、单次剂量和先前治疗情况，结果显示仅接受一个疗程治疗的患者（p<0.001）、年龄>58岁（p=0.011）以及采用高电压光子治疗（p=0.050）是疼痛缓解的重要预后因素。总体而言，低剂量放射治疗对足跟痛是一种非常有效的治疗方法。
