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How soon until I will see RT effects
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08/12/2013 19:42
joshlin9693 
08/12/2013 19:42
joshlin9693 
Re: How soon until I will seenRT effects

I finished With the first 5 days of treatment on August 9th. I did a lot of driving for a minute of zapping! So far I don't feel any sort of side effect. No redness or dry skin. I think the cord may feel a bit different, less pronounced and smooth. It feels more bumpy, I guess. The nodule still feels sore from pressure or when I stretch my hand out too much. I am not feeling that itchy, crawly, sore, feeling in my whole palm anymore. I have another appointment in a month and I assume we will set up another session. The doctor said that the cells will continue to die off. I sure hope they do! Will keep you posted.

08/14/2013 18:50
Jolene 
08/14/2013 18:50
Jolene 
Re: How soon until I will see RT effects

Hello, Please, I am wondering where did you have your radiation done at? Did you have it on both hands? How many nodules and cord did you have done?
Thank you for your response

08/15/2013 01:59
stephenp 
08/15/2013 01:59
stephenp 
Re: How soon until I will see RT effects

I have had RT on both hands at different times. With both hands I noticed an effect after the first set of 5 treatments. There was less aching and reduced tightness that was noticeable about 1 week after treatment. By about 4 weeks after the second set of treatments I noticed a cord was becoming softer and about 4 weeks after that the nodules becoming flatter and smaller. In both hands the skin was dry and slightly red and responded to daily moisturising.

08/18/2013 11:29
tz_louisiana 
08/18/2013 11:29
tz_louisiana 
Re: How soon until I will see RT effects

lori:
I have attached pictures of my hand. The second picture is before treatment. the first picture is about 6 months after treatment. After the first round of RT, the nodule bagan to soften and all the pain went away. My hand continued to improve and I had more ability to grasp objects and to have more flexability as the year progressed.

I only have visable DD in one hand. Good luck with your RT.

Lori


Hi Lori
Your pictures look almost exactly like my hand. Just began to notice the nodule about a month ago and went to a hand specialist on Thursday. She diagnosed DD and didn't recommend anything except surgery when it begins to contract. My concern is that since I first noticed it, now I have another at my ring finger and a cord from the first nodule. I am a dental hygienist, 51, and don't have a wait and see personality. I am considering the RT.
How quickly did yours progress?
Thanks!

08/18/2013 14:32
callie 
08/18/2013 14:32
callie 
Re: How soon until I will see RT effects

tz,

If you are going to have RT it would most likely be now. However, RT is not always successful. My Dupuytren's developed faster than usual. My little finger went from 0 degrees contracture to over 90 degrees in about 18 months.

08/19/2013 12:23
Jolene 
08/19/2013 12:23
Jolene 
Re: How soon until I will see RT effects

tz_louisiana:
lori:
I have attached pictures of my hand. The second picture is before treatment. the first picture is about 6 months after treatment. After the first round of RT, the nodule bagan to soften and all the pain went away. My hand continued to improve and I had more ability to grasp objects and to have more flexability as the year progressed.

I only have visable DD in one hand. Good luck with your RT.

Lori


Hi Lori
Your pictures look almost exactly like my hand. Just began to notice the nodule about a month ago and went to a hand specialist on Thursday. She diagnosed DD and didn't recommend anything except surgery when it begins to contract. My concern is that since I first noticed it, now I have another at my ring finger and a cord from the first nodule. I am a dental hygienist, 51, and don't have a wait and see personality. I am considering the RT.
How quickly did yours progress?
Thanks!


Edited 08/19/13 15:28

08/19/2013 17:46
j2jenkins 
08/19/2013 17:46
j2jenkins 
Re: How soon until I will see RT effects

Hi, I am new to this website and still learning about this disease. I am very interested in RT but need to find out, for insurance purposes, if this therapy is considered experimental in the U.S.? Thank you!
~ Jan

08/19/2013 18:19
callie 
08/19/2013 18:19
callie 
Re: How soon until I will see RT effects

This is the best discussion about insurance coverage.

http://www.aetna.com/cpb/medical/data/800_899/0800.html

08/21/2013 04:45
moondanc 
08/21/2013 04:45
moondanc 
Re: How soon until I will see RT effects

callie:
This is the best discussion about insurance coverage.

http://www.aetna.com/cpb/medical/data/800_899/0800.html
Callie-- thank you SO much for posting this. You are right, it is very helpful and an astounding collection of studies and other information. I was particularly interested in the Seegenschmiedt et al (2001) study- excerpted below- because they also treated Stage 1 and Stage 2 patients with RT. Unfortunately, at least to my non-medical eye, the results are reported by treatment-either a 5 day, two time regimen- group A or a 7 day regimen- Group B and not by results achieved for the various DD stages. I wonder if the actual paper would give more details and/or could be obtained.

Also I was struck by the use of propylactic RT-- despite what I've read on this forum recently I KNEW there was a reason I (and my doc) decided to do more extensive areas of my hand when I received RT. Quoting "Seven of 60 patients with unilateral DC received prophylactic RT for the initially un-involved, contralateral hand due to progression of DC. The authors concluded that both prophylactic RT concepts have been well-accepted and well-tolerated by patients. Within the first year, they were equally effective to prevent further disease progression of DC and obtain considerable symptomatic improvement.

Full text of the pertinent study from the Aetna link:
Seegenschmiedt et al (2001) presented the 1-year results of a prospective randomized trial that compared two different RT dose concepts for early-stage DC. A total of 129 patients (62 females; 67 males) were entered in this study: 69 had bilateral and 60 unilateral involvement of DC accounting for 198 irradiated hands. According to Tubiana's classification, 73 hands had Stage N (nodules/cords, no extension deficit = flexion deformity), 61 had Stage N/I (less than or equal to 10 degrees deficit), 59 had Stage I (11 to 45 degrees deficit), and 5 had Stage II (46 to 90 degrees deficit) DC. Prophylactic RT was randomly delivered; in Group A, 63 patients (95 hands) received 10 x 3 Gy (total dose of 30 Gy) in 2 series (5 x 3 Gy) separated by 8 weeks; in Group B, 66 patients (103 hands) received 7 x 3 Gy (total dose of 21 Gy) in 1 series within 2 weeks. Ortho-voltage RT (120 kV) was applied using standard cones and individual shielding of un-involved areas of the palm. Relevant patient and disease parameters were equally distributed in both groups. Evaluation (toxicity, efficacy) was performed at 3 and 12 months after RT. Subjective (patient's opinion) and objective parameters (measurements, palpation, and comparative photographs) were applied to assess treatment response. Minimum follow-up was 1 year. Acute toxicity was minimal, but slightly more pronounced in Group B. Seventy-six (38 %) hands developed skin reactions common toxicity criteria [CTC] 1 degrees (A, 30; B, 46); and 12 (6 %) had skin reactions CTC 2 degrees (A, 4; B, 8). Chronic side effects were limited to dryness, desquamation, skin atrophy, and change of sensation (LENT 1 degrees ) in 9 (5 %) sites without differences between the two groups. At 3 and 12 months after RT, subjective and objective reduction of symptoms, nodules, and cords occurred in both groups (p < 0.01) with no differences between the groups: in Group A, 55 (56 %) sites regressed, 35 (37 %) remained stable, and 7 (7 %) progressed, whereas in Group B, 55 (53 %) regressed, 39 (38 %) remained stable, and 9 (9 %) progressed at 12-month follow-yp (non-significant). Overall and mean number of nodules, cords, and skin changes decreased at 3 and 12 months. The "treatment failure" rate at 1 year was 16 of 198 (8 %), but only 4 (2 %) sites required hand surgery for disease progression. Seven of 60 patients with unilateral DC received prophylactic RT for the initially un-involved, contralateral hand due to progression of DC. The authors concluded that both prophylactic RT concepts have been well-accepted and well-tolerated by patients. Within the first year, they were equally effective to prevent further disease progression of DC and obtain considerable symptomatic improvement. Although 1-year results suggested similar response rates for both treatment groups, long-term follow-up of greater than 5 years has to be awaited for final assessment and recommendation of an optimized RT treatment schedule

Diane

08/22/2013 03:34
stephenp 
08/22/2013 03:34
stephenp 
Re: How soon until I will see RT effects

If anyone is interested I can email them a copy of the Seegenschmiedt 2012 paper which has data from a controlled RT trial with long term follow up.

In summary
RT produces a highly significant effect compared with no treatment
Early treatment and at an early stage (N) is highly significant
Effectiveness of RT decreases as the disease progresses
The difference between the 2 doses (21 v 30 Gy) was marginal with 30 possibly more effective.

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appointment   prophylactic   non-significant   effects   classification   treatment   patients   Seegenschmiedt   nodules   well-tolerated   recommendation   insurance   contracture   treatment-either   degrees   progression   contralateral   considering   radiation   well-accepted