Schäfer U, Micke O, Glashörster M, Rübe C, Prott F J, Willich N
Klinik und Poliklinik für Strahlentherapie-Radioonkologie, Westfälische Wilhelms-Universität Münster.
Strahlenther Onkol. 1995 Apr;171(4):202-6.
Many patients attend orthopedic departments complaining of pain on the plantar aspect of the calcaneum. The symptoms may subside spontaneously, but often persist. Treatment is usually by local injection of a corticosteroid, orthopedic devices or other standard treatment. If these methods fail, X-ray treatment may be considered. The efficacy of radiotherapy of the calcaneal spur was evaluated.
From April 1981 through December 1991, 18 patients with painful heel were irradiated mostly with the caesium or telecobalt unit, usually with a dose of 4 times 0.5 Gy. Among these patients, 12 could be followed up during a prolonged period on the basis of questionnaires.
According to the categories of v. Pannewitz 17% of the patients were pain-free by the end of the treatment course, 22% showed marked improvement, 33% showed improvement and in 28% the pain was not influenced. Over an average of 41.5 months 58% of the patients reported freedom from pain.
Low-dose radiotherapy appears to relieve the painful heel syndrome in a high proportion of patients. The overall treatment risk appears to be very small. The mechanism of low-dose radiotherapy is unknown.
许多患者前往骨科就诊，主诉跟骨足底侧疼痛。症状可能会自行缓解，但通常会持续存在。治疗通常采用局部注射皮质类固醇、矫形器械或其他标准治疗方法。如果这些方法无效，可以考虑进行X线治疗。对跟骨骨刺的放射治疗效果进行了评估。
1981年4月至1991年12月，18例足跟疼痛患者主要接受铯或远距离钴治疗机照射，通常剂量为4次0.5Gy。其中12例患者可根据问卷调查进行长期随访。
根据v. Pannewitz的分类，17%的患者在治疗疗程结束时疼痛消失，22%有明显改善，33%有改善，28%的疼痛未受影响。平均41.5个月后，58%的患者报告疼痛消失。
低剂量放射治疗似乎能使很大一部分足跟疼痛综合征患者得到缓解。总体治疗风险似乎非常小。低剂量放射治疗的机制尚不清楚。
