Clinical and Translational Radiation Oncology · Published 2026-07-14 · DOI 10.1016/j.ctro.2026.101236
Manuel Novo-Rigueiro, Fabio Pires-Pereira, Ignacio Lete-Achirica, Antonio Gómez-Caamaño, Francisco Javier Rodríguez-Rigueiro, Jesús Rodríguez-Figueroa, Arturo González-Quintela, Ignacio Novo-Veleiro
Background: Refractory chronic plantar fasciitis remains a therapeutic challenge when symptoms persist despite conservative management and advanced physical therapies. Although low-dose radiotherapy has been used as an anti-inflammatory treatment for benign musculoskeletal disorders, integrated data combining clinical, functional, quality-of-life and imaging outcomes remain limited. Methods: A longitudinal observational study was conducted in 68 patients with MRI-confirmed refractory chronic plantar fasciitis who remained symptomatic despite conservative treatment and extracorporeal shock wave therapy. All patients received low-dose radiotherapy (3 Gy in 6 fractions of 0.5 Gy). Pain (VAS), function (FFI), and health-related quality of life (EQ-5D) were assessed at baseline and at 1, 3, 6, 12 and 24 months. MRI was performed at baseline and at 3 and/or 6 months after treatment. Global clinical response integrated pain, function and quality-of-life outcomes. Results: Low-dose radiotherapy was associated with rapid and sustained improvement in pain, function and health-related quality of life. At 6 months, 95.6% of patients met criteria for global clinical response, which remained stable up to 24 months. Exploratory analyses showed that 85.1% of patients achieved a good clinical response during long-term follow-up, while 35.8% achieved an excellent response. Concordance between clinical and MRI response was limited. No radiation-related acute or late adverse events were identified. Conclusion: Low-dose radiotherapy was associated with sustained clinical benefit in MRI-confirmed refractory chronic plantar fasciitis after failure of conservative treatment and extracorporeal shock wave therapy. Clinical improvement frequently exceeded structural MRI changes, suggesting that symptomatic recovery may occur despite persistent imaging abnormalities.
Abstract from DOAJ. Public domain (CC0 1.0).
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Novo-Rigueiro, M., Pires-Pereira, F., Lete-Achirica, I., et al. (2026). Efficacy and safety of low-dose radiotherapy in MRI-confirmed refractory chronic plantar fasciitis after extracorporeal shock wave therapy. Clinical and Translational Radiation Oncology. https://doi.org/10.1016/j.ctro.2026.101236