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Fibrosis, nerve and tendon damage due to RT?
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08/09/2012 19:13
elPepin 
08/09/2012 19:13
elPepin 
Fibrosis, nerve and tendon damage due to RT?

My Dr. is concerned that the electron radiation is going to cause, Fibrosis ,damage to my nerves and tendons causing, guess what?, contraction of my hand. He has never treated DP before but he is willing to do it if he gets a hand surgeon to back him up. So, has that ever happened to anyone? I've looked everywhere and haven't encoutered anyone with that outcome. As far as I understood the level of RT was too low to cause that kind of damage. Can anyone give me more info. on this? I would greatly appreciate it.

Edited 08/10/12 17:47

08/09/2012 22:09
Tusk 
08/09/2012 22:09
Tusk 
Re: Nerve and tendon damage due to RT?

Why don't you ask him to call or email any of the RT doctors who've treated this disease for years. http://www.dupuytren-online.info/radiotherapy_clinics.html They can reassure him. The only side effect I've seen relative to DD and RT is dry skin by a few folks.

If he is requiring your local hand surgeon to sign off on RT, I wish you good luck.

08/10/2012 04:33
Larry 
08/10/2012 04:33
Larry 
Not likely to have Nerve and tendon damage from RT!

I have asked this question before I got treated; Prof. Seegenschmiedt - who treated me on my two feet and one hand reassured me, that nerve damage can only occur at doses beyond 50Gy with a probability of 1% but he uses only 30Gy. So I guess that it will never occur, unless there is additional damage due to other disorders (e.g. perfusion changes)

So I think there is no concern with the "normal doses" of RT

Good luck, Larry

08/10/2012 05:30
wach 

Administrator

08/10/2012 05:30
wach 

Administrator

Re: Nerve and tendon damage due to RT?

For Dupuytren's RT that has never been heard of. Several publications explain potential side effects; they do not consider nerve/tendon damage and subsequent contracture a potential side effect. I am notaware of a single case where that has been reported. Your doctor might be too cautious in that respect (though it's always good to have a cautious doctor!).

Wolfgang

elPepin:
My Dr. is concerned that the electron radiation is going to cause damage to my nerves and tendons causing, guess what?, contraction of my hand. He has never treated DP before but he is willing to do it if he gets a hand surgeon to back him up. So, has that ever happened to anyone? I've looked everywhere and haven't encoutered anyone with that outcome. As far as I understood the level of RT was too low to cause that kind of damage. Can anyone give me more info. on this? I would greatly appreciate it.

08/10/2012 07:30
Lanod 
08/10/2012 07:30
Lanod 
Re: Nerve and tendon damage due to RT?

There is a possible RT sde effect of fibrosis as noted in the various published papers. For example Prof. Seegenschmiedt in his Phase III clinical study paper says:

"Ionizing radiation of 30 Gy induced only mild early or late radiogenic toxicity including minor effects
like dryness of the skin; major fibrosis has been observed only in few patients, especially in previously
operated sites."

The above did not deter me from choosing RT. Also, there are no reports of nerve damage or tendon damage or contracture resulting from RT treatment of hands at 30Gy.

Likde elPepin reported, my RT doctor did want me to see a hand surgeon before he agreed to giving me RT treatment for DD. However, the hand surgeon did not recommend RT treatment (as expected) but my RT doctor simply wanted the hand surgeon to confirm the DD diagnosis and to advise me on other options before I could decide on the RT route.

08/10/2012 13:16
Larry 
08/10/2012 13:16
Larry 
Find the best way of treatment ....

My recommendation: don't get treated by unexperienced and insecure doctors. And the PING-PONG between doctors of various disciplines is not helpful at all ...

You have your hands only once and they are really important for your whole life or the rest of it. So don't make experiments with them. I would get treated as early and as efficient as possible and by the most experienced person to solve my hands' problem. In early stage radiotherapy , for more advanced stage limited or minimal invasive surgery.

Even if health systems start to allow treatment of Dupuytren with radiation or other means , there will be still a significant lack of experience which is required to find the appropriate treatments for specific disease situations.

So sometimes the solution for the best of your body is to travel ....

08/10/2012 20:24
Lanod 
08/10/2012 20:24
Lanod 
Re: Fibrosis, nerve and tendon damage due to RT?

Larry, Thank you for your advice.

Only for this wonderful site - for most of us there would be a lot more 'ping ponging' between different doctors.

Can you please clarify - when you say:

"I would get treated ...... In early stage radiotherapy, for more advanced stage limited or minimal invasive surgery."

By 'limited or minimal invasive surgery' do you include NA and Xiaflex (Xiapex) in this or do your mean more formal surgery such as: segmented aponeurectomy, partial faciectomy etc.

Many thanks.

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