Miszczyk L, Jochymek B, Wozniak G
Radiotherapy Department, Centre of Oncology, M. Sklodowska-Curie Memorial Institute, Gliwice Branch, ul. Wybrzeze AK 15, 44-100 Gliwice, Poland.
Br J Radiol. 2007 Oct;80(958):829-34. doi: 10.1259/bjr/79800547. Epub 2007 Sep 17.
Plantar fasciitis is a common painful syndrome that is usually treated by irradiation with a fraction dose (fd) of 1 Gy up to a total dose (TD) of 6 Gy according to clinical experience. By analysing our experiences with numerous former patients, we have attempted to find the relationship between dose and effect. To evaluate the effectiveness of radiotherapy and assess the impact of fd and TD in plantar fasciitis radiotherapy, we assessed 1624 irradiations (856 patients) performed using a fd of 1-3 Gy and a TD of 1-45 Gy. Analysis was carried out on the 623 irradiations (327 patients) for which complete follow-up data were available. The mean follow-up period was 74 months. The following parameters were evaluated: pain relief level; period of anaesthetic effect preservation after treatment; presence of pain and the timing of its appearance; and the intake of analgesic drugs at the last follow-up. After treatment, 48% of the patients reported a lack of pain, 21% reported pain relief greater than 50% and 17% reported pain relief less than 50%. The mean pain relief duration was 72 months. The last follow-up found that pain at rest afflicted 25% of the patients, and pain during walking afflicted 32%. A dose-effect relationship was not found. In conclusion, radiotherapy is an effective treatment for plantar fasciitis. A fd of 1.5 Gy and TD of 9 Gy should probably not be exceeded.
足底筋膜炎是一种常见的疼痛综合征，根据临床经验，通常采用1 Gy的分次剂量（fd）进行照射，总剂量（TD）可达6 Gy。通过分析我们对众多既往患者的治疗经验，我们试图找出剂量与疗效之间的关系。为了评估放射治疗的有效性，并评估分次剂量和总剂量在足底筋膜炎放射治疗中的影响，我们评估了1624次照射（856例患者），分次剂量为1 - 3 Gy，总剂量为1 - 45 Gy。对其中623次照射（327例患者）进行了分析，这些患者有完整的随访数据。平均随访期为74个月。评估了以下参数：疼痛缓解程度；治疗后麻醉效果维持时间；疼痛的存在及其出现时间；以及最后一次随访时的镇痛药服用情况。治疗后，48%的患者报告无疼痛，21%的患者报告疼痛缓解超过50%，17%的患者报告疼痛缓解低于50%。平均疼痛缓解持续时间为72个月。最后一次随访发现，25%的患者有静息痛，32%的患者有行走痛。未发现剂量 - 效应关系。总之，放射治疗是治疗足底筋膜炎的有效方法。分次剂量1.5 Gy和总剂量9 Gy可能不应超过。
