Strahlentherapie beim Morbus Ledderhose—Indikation und klinische Ergebnisse

Abstract

Radiotherapy is effective in treating ML and may prevent otherwise necessary surgical interventions. Nodules, cords and symptoms regress, but long-term outcome of at least 5 years has to be awaited. Prospective phase III studies should confirm these results.

Radiation Therapy for Early Stages of Morbus Ledderhose

“…The results of Seegenschmiedt & Attassi [32] concerning local control, pain relief, and improvement of gait were confirmed in our study. Electron-beam RT, orthovoltage X-ray RT, as well as both fractionation schedules, were found to be effective in the treatment of ML.…”

“…A current literature review showed that after follow-up periods ranging from 1 to 19 years, the rate of local control varied from 60% to 100% [31]. Despite these favorable results for MD, the value of RT for the treatment of ML was, as by now, investigated in only one study [32]. Seegenschmiedt & Attassi analyzed the results in 25 patients (36 feet) after application of two RT courses of 5 × 3.0 Gy to a total dose 30.0 Gy.…”

“…The predominant complaints are tension and a burning of the sole causing a discomfort of gait [31,32]. In the majority of cases, the single or multiple nodules are localized on the central and medial bands of the plantar fascia, occupying the anterior third of the sole along the anterior margin of the arch of the foot [4,6,7].…”

“…Similar to MD, the formal pathogenesis of ML can be divided into three phases: (1) the initial phase is characterized by an increased evidence of fibroblasts, and the formation of nodules and cords; (2) in the involutional phase, differentiation into myofibroblasts begins; and (3) the residual phase is histologically dominated by collagen fibers [31,32].…”

“…Recently, the value of radiation therapy (RT) for primary treatment of ML has only been investigated in one study [32]. This retrospective multicenter analysis was conducted to obtain more clinical information concerning the efficacy of RT.…”