Heel spur radiotherapy and radiation carcinogenesis risk estimation

Surenkok, Serdar; Dırıcan, Bahar; Beyzadeoğlu, Murat; Oysul, Kaan

doi:10.1007/s11604-006-0075-5

Cited by 13 publications

(11 citation statements)

References 14 publications

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“…To date, possible carcinogenic risk of radiation therapy have been investigated in many trials, but, the risk was not as high as it was feared (Muecke et al, 2007; Surenkok et al, 2006). Radiotherapy fields used to treat plantar heel spurs are too small and the total doses are much lower than those used for malignant diseases.…”

Section: Discussionmentioning

confidence: 99%

Painful plantar heel spur treatment with Co-60 teletherapy: factors influencing treatment outcome

et al. 2014

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BackgroundPainful plantar heel spur (PPHS) is a benign disorder with painful heels as a result of plantar calcaneal bone spur. Exact etiological factors are still unclear. Treatment typically consists of osteoarthritis tretment schedules and surgical techniques. External radiotherapy is another treatment option. This study is aimed to determine effectiveness and treatment outcomes of external radiotherapy in patients with PPHS.MethodsSixty-two patients with PPHS were analysed for radiotherapy success and other possible prognostic factors. All patients were treated with Co-60 units from parallel opposed lateral portals, to a total dose of 8 Gy. Responses to radiotherapy was assessed by visual analogue scale (VAS) of pain. Follow-up completed in December 2012 with 28 months median duration (range 22 to 35 months). Age, sex, patient number, spur settlement site, prior treatments, time interval between diagnosis and radiotherapy, pain scores (before and after radiotherapy), plantar fat-pillow thickness (PFPT; thickness of the plantar fat pad) and Böhler’s angle estimations were analysed.ResultsStudy included 53 female and 9 male patients with median age 57 (range 43–70). Time interval between PPHS diagnosis and radiotherapy were median 33 months (range10-60). Radiotherapy response time interval were 6 months (range 3–10 months). Responses to radiotherapy were no response in 13 patients (21%), partial response in 13 patients (21%)- pain relief below 50% and complete response - no pain in 36 patients (58%) respectively. Median PFPT of patients were 3.5 cm (range 1.20–4.50 cm). Complete response rate was statistically significant in patients whom PFPT is greater than 3.5 cm. The Böhler’s angle range is about 20–40 deg. Complete response rates were higher in patients with degree of Böhler’s Angle 30 and below.ConclusionsSimplicity of treatment, lack of acute adverse effects and low cost, seem to make radiotherapy one of the safest, cheapest and also an effective treatment modality for PPHS.

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Section: Discussionmentioning

confidence: 99%

Painful plantar heel spur treatment with Co-60 teletherapy: factors influencing treatment outcome

et al. 2014

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“…However, no carcinogenesis was reported in our series, and decision making for management with RT should be individualized based on a harm to benefit ratio (35). Mechanism of action for RT has been extensively studied, and may be possibly through modulating the intensity of inflammation along with possible neurolysis of the sural and posterior tibial nerves responsible for dominant pain through the obstruction of the capillaries nourishing these nerves (8,15,16,(36)(37)(38).…”

Section: Discussionmentioning

confidence: 96%

“…Traditionally, RT has been reserved for refractory cases due to concerns about adverse radiation effects such as carcinogenesis (15). While several countries in Europe have adopted RT for the management of several benign conditions including musculoskeletal, degenerative, and inflammatory disorders with encouraging treatment outcomes, the use of RT for nonmalignant benign conditions have been considered skeptical as well by several centers (15,(30)(31)(32)(33)(34). Besides its utility in the management of several cancers throughout the whole human body, ionizing radiation may induce mutations and carcinogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…RT has a long history in the management of painful heel spur and plantar fasciitis. Accumulated data from several centers have consistently reported effective palliation of painful plantar fasciitis and heel spur; however, dose fractionation schemes and treatment fields may vary among the institutions and are typically based on retrospective data and experiences (2,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26).…”

Section: Original Articlementioning

confidence: 99%

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Evaluation of the radiotherapeutic management of refractory painful heel spur and plantar fasciitis: a single center experience of 45 years

Beyzadeoğlu¹,

Sager²,

Dincoglan³

et al. 2020

GMJ

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Aim: Heel spur is exostosis of the calcaneus. Plantar fasciitis and heel spur constitute a very common cause of plantar pain, which may be managed with radiation therapy (RT). In this study, we assessed the radiotherapeutic management of refractory painful heel spur and plantar fasciitis. Methods:In this retrospective study, we report our single center experience with RT for refractory painful heel spur and plantar fasciitis management over a period of 45 years and describe patient and treatment characteristics.Results: Between 1974 and 2019, a total of 4904 patients received RT at our department using cobalt-60 teletherapy machine for the management of refractory painful heel spur and plantar fasciitis. Out of the total 4904 patients, 2012 patients (41%) were male and 2892 patients (59%) were female. The median age was 51 (range: 41-85) years. All patients had received previous therapies for refractory painful heel spur and plantar fasciitis before the management with RT. Total RT dose was 8 Gy delivered in 2 consecutive days with daily fractions of 4 Gy using 2 opposing anterior-posterior RT fields to both heels without bolus material. Treatment response was assessed 3 to 5 weeks after the completion of RT. Response to RT was complete in 3579 patients (73%), partial in 1188 patients (24.2%), and none in 137 patients (2.8%). No therapyrelated toxicity was observed in the whole series. Conclusion:RT for refractory painful heel spur and plantar fasciitis may offer effective palliation of pain and may be considered as a viable therapeutic option for selected patients exhausted with other treatment modalities. ABSTRACT Date

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“…In according to literature, Miszczyk et al [29] considered that there are no acute or late toxicity in cases of plantar fasciitis patient irradiation [24,30,31]. Surenkok et al [32] valued a low risk of secondary cancer after irradiation therapy, and conclude that radiotherapy is an effective therapy solution for relieving pain in calcaneal spur patients. As well, according to Micke et al [30] an overall treatment risk appears to be very small.…”

Section: Radiotherapymentioning

confidence: 99%

Conservative Treatment of Plantar Fasciitis and Posterior Heel Pain: A Review

Bistolfi¹,

Zanovello²,

Vannicola³

et al. 2016

Int J Phys Med Rehabil

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This review focuses on the various techniques of conservative treatment of plantar fasciitis and posterior heel pain. Being the optimal therapy controversial, the intent is to drive surgeons and rehabilitation specialists in the choice of the strategies. The Data sources were MEDLINE, PubMed, CINAHL, EMBASE, and Psych INFO databases using the selected key words. Studies have been selected for review using as criteria English, adults, clinical population and intervention. Among several published studies about rehabilitation and fasciitis, only a few showed bases on scientific evidence. Moreover, many studies were heterogeneous and included different outcomes and evaluations. There is consensus that a specific rehabilitation program is necessary to avoid chronicity. However, the real efficacy of every specific treatment (orthoses, stretching, radiotherapy, botulin toxin, shock waves, corticosteroid therapy, and platelet rich plasma) is still questionable, and often related to the experience of the authors. In conclusion, patients undergoing physiotherapy obtain a better and faster outcome achievement than non-treated patients; however, evidence-based treatments, protocols and clinical trials are recommended.

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Heel spur radiotherapy and radiation carcinogenesis risk estimation

Abstract: Radiotherapy is an effective treatment modality for relieving pain in calcaneal spur patients. The estimated secondary cancer risk factor for irradiation of this benign lesion is not as high as was feared.

Cited by 13 publications

References 14 publications

Painful plantar heel spur treatment with Co-60 teletherapy: factors influencing treatment outcome

Painful plantar heel spur treatment with Co-60 teletherapy: factors influencing treatment outcome

Evaluation of the radiotherapeutic management of refractory painful heel spur and plantar fasciitis: a single center experience of 45 years

Conservative Treatment of Plantar Fasciitis and Posterior Heel Pain: A Review

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