A case study of radiotherapy treatment for Dupuytren's contracture and Ledderhose disease.

Dupuytren's contracture (DC) and Ledderhose disease (LD) are benign conditions of the fascia in the hands and feet respectively, which result in contracture of the digits. Radiation therapy has been proven effective in treating early-stage DC and LD; however, the problem is that there is a paucity of literature regarding radiation therapy treatment set-up for Dupuytren's and Ledderhose patients. The purpose of this case study was to demonstrate treatment set-up considerations of 6 and 9 MeV for DC and LD cases in radiotherapy (RT). Two patients were selected from the same cancer center, each diagnosed with DC and LD. Treatment plans were established utilizing a clinical set-up, electron dose tables, bolus, and target volumes delineated by the radiation oncologist. For each patient, the radiation oncologist prescribed 2 treatment courses of 300 cGy in 5 fractions per treatment site. The radiation oncologist determined the desired depth of treatment, through the palpation of the nodules, and used electron depth dose tables to determine the energy, isodose lines, and bolus thickness necessary to treat the lesions to the appropriate depth. Doses delivered were verified with metal oxide semiconductor field effect transistors (MOS-FET) in vivo on the first day of treatment for each course. In this case study, researchers demonstrated clinical set-up for 2 patients treated for both DC and LD. The clinical set-up considerations resulted in successful treatment delivery with minor, but acceptable, variations during treatment.