Radiotherapy for Ledderhose disease
Although NICE provides guidance on using Radiotherapy for treating Dupuytren’s on the NHS, it is not mentioned for similar conditions such as Ledderhose or Plantar Fibromatosis. There are centres in the UK that treat Ledderhose with radiotherapy, both on the NHS or private. Click on the little map lower down this page to get a list, or go to our doctors page.
It is not fully understood how radiotherapy helps, but it works best when performed on nodules that are considered active i.e. growing. When cells are in their active phase they are most sensitive to radiation. Radiation affects the development of the cells and slows their growth and therefore slows progression in Dupuytren’s and Ledderhose. This is because the overall growth of nodules is dependent on cell growth being faster than cell death.
Radiotherapy can be carried out on its own or after surgery to reduce the chance of recurrence. It is usually performed daily for 5 days, and repeated eight to twelve weeks later. Acute (short-term) after-effects develop in roughly 25% of patients and typically include minor problems such as dry skin and a sunburn-like tanning of the skin. There is a possible longer term risk of cancer in the area as with all forms of radiotherapy, but the risks are minimal with the low dosages, minimal depth, and location away from vital organs.
In the book published in 2012 “Dupuytren’s Disease and Related Hyperproliferative Disorders” some results from treatment of Ledderhose with radiotherapy are discussed. Overall they saw that in the patients that had RT, 44% had a reduced number and/or size in nodules, however 90% of patients reported that they had an improvement with regards to symptoms, and only 7% showed progression. 83% of people who had pain on walking, and 68% of those who had pain at rest, said they had an improvement.
The chapter in the book concludes by saying that “Radiation Therapy is the most effective treatment for primary and recurrent Ledderhose Disease, due to very low progression or relapse rates.”
Radiotherapy is potentially a promising way of treating Ledderhose, as in most cases it shrinks the lumps although they don’t disappear completely, and pain is reduced. More research needs to be done to be able to give an estimate on how long the effect lasts, and whether the condition may recur or reactivate as is frequently seen after surgery.
There is an excellent blog by one of the UK’s leading radiation oncologists who treats Dupuytren’s and Ledderhose about what to expect after radiotherapy for Dupuytren’s or Ledderhose.
See also the discussion on Radiotherapy for treating Dupuytren’s in the hand.
A website about radiotherapy, how it works, what different types there are and what the effects and side effects might be.
A blog and link to a book chapter on radiotherapy in Dupuytren’s and Ledderhose written by one of Britains leading radiation oncologists in the field.
A patients story of radiotherapy for Ledderhose can be found on this page.
Where is the treatment available in the UK? To see a map of all Radiotherapy units in the UK and Ireland that we know of, that treat Dupuytren’s, Ledderhose, Peyronie’s and/or Plantar Fasciitis click on the picture with the map. Please be aware that all the blue markers indicate NHS facilities, the red markers are private clinics. (DD= Dupuytren’s Diseas, LD= Ledderhose Diseas, PD = Peyronie’s Disease, PF + plantar fasciitis.)