Demographic, clinical and treatment related predictors for event-free probability following low-dose radiotherapy for painful heel spurs – a retrospective multicenter study of 502 patients

Figures & data

Figure 1.  Kaplan-Meier curve for pain control of all patients (393 censored cases).

Table I.  Univariate analyses of prognostic factors.

Variables	Number of patients	Event free probability (follow-up)	p-value
number of series
two vs. one	88 vs. 414	32.2% (103 months) vs. 69.7% (103 months)	<0.001
age
≤ 58 years vs. >58 years	266 vs. 236	47.9% (103 months) vs. 81.3% (103 months)	0.001
photon energy
ortho voltage vs. high voltage	161 vs. 341	60.6% (103 months) vs. 67.9% (63 months)	0.019
pain anamnesis
> 6 month vs. ≤6 month	194 vs. 308	43.9% (86 months) vs. 76.3% (103 months)	0.001
dose regime (single dose)
1.0 Gy vs.0.5 Gy	401 vs. 100	55.1% (103 months) vs. 86.2% (63 months)	0.009
prior treatment
with vs. without	401 vs. 100	54.9% (103 months) vs. 83.1% (63 months)	0.023
gender
female vs. male	337 vs. 165	61.5% (103 months) vs. 61.2% (63 months)	0.059

Figure 2.  Univariate analysis (log-rank) for pain control related to number of treatment series (upper curve: 1 series [343 censored cases]; lower curve: 2 series [50 censored cases]).

Figure 3.  Univariate analysis (log-rank) for pain control related to age of patients (upper curve:>58 years [202 censored cases]; lower curve: ≤58 years [191 censored cases]).

Figure 4.  Univariate analysis (log-rank) for pain control related to photon energy (upper curve: megavolt [276 censored cases]; lower curve: orthovolt [117 censored cases]).

Table II.  Multivariate analysis of prognostic factors.

Variables	Adjusted hazard ratio	95% confidence interval	p-value
number of series
two vs. one*	2.41	1.62–3.60	<0.001
age
≤ 58 years vs. > 58 years*	1.71	1.13–2.60	0.011
photon energy
ortho voltage vs. high voltage*	1.51	1.0–2.28	0.05
pain anamnesis
> 6 month vs. ≤6 month*	1.42	0.95–2.10	0.085
dose regime
1.0 Gy vs. 0.5 Gy*	1.7	0.86–3.35	0.127
prior treatment
with vs. without*	1.57	0.91–2.71	0.107

* reference category.

Table III.  Overview of pertinent literature.

Author	Patients	Heels	Type of radiotherapy	Response-rate (%)	CR (%)	PR (%)	NC (%)
Richarz (1924) [39]	5	5	OV	100	80	20
Pannewitz (1933) [36]	88	88	OV	92
Cocchi (1943) [6]	6	6	OV	83	33	50
Mitrov (1967) [33]	1520	1520	OV	88	50	38	12
Zschache (1972) [55]	49	49	OV	86	12	74	14
Mantell (1978) [26]	17	26	240-300 kV	65	53	12	35
Basche (1980) [1]	102	102	120 kV	90	32	58	10
Sautter-Bihl (1993) [41]	15	15	HV	80	60	20	20
Schäfer (1995) [42]	18	21	Cobalt-60	67	58	8	33
Seegenschmiedt (1996) [49]	141	72 Pat 12 Gy /98 Pat 3-5 Gy	200-250 kV	100/95	67 72	33 23	0 5
Oehler (2000) [35]	212	258	OV	88	81	7	12
Koeppen (2000) [22]	673	673	250 kV	78	13	65	22
Schreiber (2000) [48]	70	87	6 MV	86	67	29	14
Heyd (2001) [14]	105	127	6 MV	88	46	42	12
Glatzel (2001) [10]	141	161	175 kV	89	63	26	11
Schlehuber (2001) [45]	63	63	6 Mv	67	33	34	33
Mücke (2003) [34]	117	136	6 MV	90	75	15	10
Schneider (2004) [46]	141	161	OV	89	18	64	18
Kiffer (2004) [20]	29	29	MV	89	65	24	11
PCS Painful heel [31]	7947		HV, MV, OV, Co-60	70			15

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