Radiotherapy - a safe and successful treatment for plantar fasciitis.
PO-1445
Abstract
Radiotherapy - a safe and successful treatment for plantar fasciitis.
Authors: Tomasz Latusek1, Dorota Gabrys1, Grzegorz Wozniak1, Donata Graupner2, Aleksandra Krzywon3, Alexander Jorge Cortez3
1Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Radiotherapy Department, Gliwice, Poland; 2Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, III Department of Radiotherapy and Chemotherapy, Gliwice, Poland; 3Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Biostatistics and Bioinformatics, Gliwice, Poland
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Purpose or Objective
Plantar fasciitis (PF) is a skeletal disorder of the
plantar fascia which affects patients quality of life due to the pain and
mobility problems. Because it is one of the most common foot complaint it is a
significant social problem. Radiotherapy (RT) represents a relevant method. The
aim of the study was to evaluate efficacy and safety of RT in the treatment of
PF.
Material and Methods
From the patients treated at the single-institution we
retrospectively included 41 patients (54 cases) who were irradiated to a total
dose of 6Gy given in 6 fractions five times weekly. Several aspects concerning:
symptoms duration before RT, pain localization (the extent) and adverse effects
of RT were assessed. The effectiveness of radiotherapy was assessed using the numerical
pain rating scale NRS (NRS- numerical rating scale) and German Cooperative
Group on Radiotherapy for Non-malignant Diseases (GCG-BD).
Results
The follow-up was 2 years. Taking into account the NRS
scale, the mean value of pain after RT decreased in relation to the baseline
value during the follow-up period. Before RT, the mean NRS score was 8.5 (range
3-10). Immediately after RT and 3 months after RT, mean scores of 4.8 (range
0-10) and 1.1 were recorded, respectively. During the control period 6-24
months, the mean value of pain according to NRS was 1.1 and subsequently 1.5. Before
starting the therapy, the average value according to GCG-BD was 35,2 (range 5-59)
what was related to severe pain and significant quality of life deterioration.
Immediately after RT and 3, 6, 12 and 24 months after RT the mean value
according to GCG-BD was higher (symptoms deterioration and improvement of
function) at 59.4 (range 5-100), 88.5 (range 17-100), 88.6 (range 17-100), 92.4
(range 25-100) and 89.5 (range 24-100), respectively. After 24 months pain
relief was observed in 89% of patients, including 75.5% with complete pain
relief and quality of life improvement even higher than that achieved shortly
after RT. This confirms the need for longer time follow up and evaluation of
the response to treatment without additional unnecessary therapy since long
lasting effects can be found. Analysis of the prognostic factors has shown that
only localized pain significantly predicts greater pain relief effect of RT (p<0.05).
Other analysed factors for example: duration of symptoms, previous non-RT treatment,
type of professional activities were not significant. Mild skin dryness was the
only early side effect, observed only in 4% of cases. No late toxicity and
secondary malignances were observed.
Conclusion
Radiotherapy for Plantar Fascitis is an effective
treatment providing long lasting pain relief and functional improvement without
significant toxicity and secondary malignances. Localized pain seems to be
positive predictive factor for the effect of therapy.