Low dose radiotherapy for plantar fasciitis. Treatment outcome of 171 patients.

BACKGROUND: Although the effectiveness of low-dose radiotherapy for chronic degenerative and inflammatory diseases has been documented in previous studies, patient-reported clinical outcomes are rarely available. OBJECTIVE: This study aimed to determine the effect of low-dose radiotherapy on patients with painful plantar fasciitis. METHOD: From 2002 to 2008, 200 patients older than 65 years of age with painful plantar fasciitis were treated in our hospital. Records from 171 of these patients were available for analysis. All patients were treated with an identical dose of 3Gy using identical equipment and techniques. Response was evaluated with patient-reported questionnaires and clinical visits. RESULTS: Minimum-term follow-up was 18 months, with mean follow-up at 54 months. Three months after receiving low-dose radiotherapy, 67.3% of patients had no or mild pain, and 57.9% had no or discrete mobility restriction. At a mean of 54 months, 61.4% of patients had no or mild pain and 64.9% of patients had no or discrete mobility restriction; 60.8% of patients reported improved quality of life. CONCLUSION: Low-dose radiotherapy is effective in most patients with painful plantar fasciitis. Due to minimal side effects and low costs, it represents an excellent treatment option compared to conventional therapies or surgery.

Image-guided stereotactic radiosurgery for cranial lesions: large margins compensate for reduced image guidance frequency.

BACKGROUND: We investigated patient positioning during radiosurgery of cranial lesions, and calculated clinical target volume (CTV) to planning target volume (PTV) margins using a modified common margin recipe. We simulated CTV-to-PTV margins for reduced image guidance, and repositioning for the first table angle only. PATIENTS AND METHODS: Patients were immobilized with a thermoplastic mask. Positioning was verified and corrected using the ExacTrac/Novalis Body. Each patient was repositioned before each beam. A common margin recipe was adapted for estimation of CTV-to-PTV margins. Necessary margins were estimated to correct positioning for the initial table angle only in comparison. RESULTS: In total, 269 radiosurgery treatments with 967 different-angle setups (mean 3.6 different angles) were performed on 190 patients. Residual translational errors were (one standard deviation) 0.3 mm in left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions, with a mean three-dimensional vector of 0.5 mm. Margins for residual errors after correction were calculated in LR, SI, and AP directions as 0.8 mm. For simulated reduced frequency setup correction, we calculated CTV-to-PTV margins as 1.9, 1.9, and 1.6 mm, respectively. CONCLUSIONS: The ExacTrac/Novalis Body system allows for accurate positioning of the patient with a residual error comparable to invasive mask fixation. If verification is only performed after initial positioning, adaption of CTV-to-PTV margins should be considered.