Mehmet Murat BEYZADEOĞLU, Bora UYSAL, Ferrat DİNÇOĞLAN, Ömer SAĞER, Selçuk DEMİRAL, Hakan GAMSIZ, Aybala Nur ÜÇGÜL, Galip Doğukan DOĞRU, Ahmet Oğuz TUĞCU, Esin GÜNDEM, Bahar DİRİCAN
Gulhane Medical Journal - 2026;68(1):54-58
Aims: Calcaneal spurs and plantar fasciitis cause intractable plantar pain amenable to radiation therapy (RT). However, because of individual variations in neural capillaries within the spurs, reirradiation may be needed to relieve recurrent pain from irradiated heel spurs and thereby achieve a better quality of life. The aim of this study is to document the benefit of reirradiation for recurrent heel spur pain. Methods: This single-center retrospective study included patients who underwent reirradiation between November 2016 and December 2024 for recurrent calcaneal spur pain after the first radiotherapy course. Patient inclusion criteria included a previous history of irradiation with recurrent pain; patients younger than 35 years or weighing more than 120 kg were excluded. A total RT dose of 8 Gy was delivered over 2 consecutive days. Treatment response was assessed at the eighth week after completion of reirradiation. The primary endpoint was pain relief for recurrent calcaneal spur, assessed using the Numeric Rating Scale pain intensity score at 6 months post-irradiation. Results: A total of 103 patients with calcaneal spur who were irradiated for recurrent pain were included in the study. The ages of the study group ranged from 36 to 77 years with a median age of 52 years (range 36-77, interquartile range: 14) and male to female ratio was 1:4. Most patients with a spur size of 6 mm or greater required reirradiation for recurrent pain. Reirradiation resulted in a complete response in 58 patients (56%), a partial response in 31 patients (30%), and no response in 14 patients (14%); no radiation-related adverse effects were observed. Conclusions: Reirradiation for recurrent calcaneal spur pain is an effective treatment option to relieve pain in selected patients where other treatment options do not work.
