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Radiotherapy guidance please
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12/01/2018 14:53
kevinp 
12/01/2018 14:53
kevinp 
Radiotherapy guidance please

After last May going through a surgical correction for my little finger (lefthand) - a significant contracture now 70% corrected. I have just had the last of five RT sessions on my right hand (paid for privately). I so do not want to have to go through surgery and hope that the RT will hold back or stop the issues I have with my right hand.

This time when I had the RT packing was put in between my fingers using damp gauze. I have noticed already that the skin on my hand is dry - likely to be the result of the RT. On the first treatment, five sessions of RT, this was not used and I had no obvious change to my hand.

It would be helpful to know if the packing (gauze) is now a new protocol for the RT treatment or maybe it was forgotten in July when I had the first treatment.

Kevin

12/01/2018 16:55
spanishbuddha 

Administrator

12/01/2018 16:55
spanishbuddha 

Administrator

Re: Radiotherapy guidance please

kevinp:
After last May going through a surgical correction for my little finger (lefthand) - a significant contracture now 70% corrected. I have just had the last of five RT sessions on my right hand (paid for privately). I so do not want to have to go through surgery and hope that the RT will hold back or stop the issues I have with my right hand.

This time when I had the RT packing was put in between my fingers using damp gauze. I have noticed already that the skin on my hand is dry - likely to be the result of the RT. On the first treatment, five sessions of RT, this was not used and I had no obvious change to my hand.

It would be helpful to know if the packing (gauze) is now a new protocol for the RT treatment or maybe it was forgotten in July when I had the first treatment.

Kevin
Hi Kevin

I can’t comment about the gauze, other than to say I have not heard of that before. Maybe ask your radiologist. One of the two UK private practitioners occasionally pops in on the BDS FB group.

I’ve had RT and do get dry hands. It was worse in the months after treatment, but now really only needs attention in winter. I wear gloves outside in winter and prefer to use hand lotion at night, and a cream if I get finger splits. Asda near me regularly mark down 75ml hand cream or lotion products throughout the year, and I’m always picking some up, for car, kitchen, bathroom, bedside etc.

Best wishes SB

Edited 12/01/18 18:56

12/02/2018 13:20
Prof.Seegenschmiedt 
12/02/2018 13:20
Prof.Seegenschmiedt 

Re: Radiotherapy guidance please - Postoperative Radiotherapy

Dear "kevinp" I would like to comment on Your previous postoperative radiotherapy treatment:

Apparently You have received 2 radiotherapy series after your corrective open hand surgery in May 2018; I do not know the RT dose concept (possibly 2 RT series with 5 fractions of 3Gy --> total dose 30Gy or any other concept ??).
The personal rationale was, to avoid a possible relapse after surgery

Generally, postoperative radiotherapy is not an established or scientifically accepted treatment concept but an experimental procedure not supported by published clinical studies, sofar. Thus, it is left to you and the discretion of the physician taking the full risk of possible early and late radiation effects. The informed consent has to include a hint on this uncalculable conditions. Has this been done in Your "case"?

When did You start radiotherapy after surgery (days, weeks, months after OP) ?
What was the radiation therapy technique (orthovolt photons or linac electrons) ?
What was the size of the treated area (only involved finger or whole hand palm) ?

With regard to the "packing with damp gauze" I have to note, that sometimes this "bolus" material is used to fill the interdigital space between the fingers, when the lower parts of the fingers are included in the radiation treatment field. This helps to improve the dose homogeneity in this area; otherwise an "under-dosage" can result at the digit area in comparison to the palm region.

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With gratitude for all affected patients & medical colleagues helping to advance patient care ...

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significant   Postoperative   Radiotherapy   sessions   correction   radiation   scientifically   uncalculable   practitioners   interdigital   radiologist   experimental   under-dosage   packing   treatment   homogeneity   occasionally   contracture   established   surgery