189 - Multicenter Patterns of Care Study - Quality of Radiotherapy for Dupuytren's Disease (DD) and Ledderhose (LD)

11:45am - 11:55am ET

Room 160

Presenter(s)

Fränze Linke, MD - ergea MVZ Strahlentherapie Aalen, Aalen, Baden-Wurt

F. A. Linke¹, H. M. Seegenschmiedt², S. Roddiger³, R. Kurek⁴, W. Kleppmann⁵, and M. Stuschke⁶; ¹RadioOnkologieNetzwerk, Radiation Therapy Ostalb, Aalen, Germany, ²MVZ RON ERGÉA STRAHLENTHERAPIE, AALEN, GERMANY, Germany, ³MVZ RON ERGEA, Aalen, Germany, ⁴MVZ RON ERGEA Nordwurttemberg Strahlentherapie GmbH, Aalen, Baden-Wurt, Germany, ⁵Highschool Aalen, Aalen, Germany, ⁶Department of Radiation Therapy, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany

Purpose/Objective(s): The goal of radiotherapy for palmar and plantar fibromatosis is to halt further progression in the early stages and prevent functional deficits. A multicenter retrospective study was conducted in 16 practices and 624 patients to evaluate the quality of care (as a Patterns of Care study [PCS]).

Materials/Methods:

The goal of radiotherapy for palmar and plantar fibromatosis is to halt further progression in the early stages and prevent functional deficits. A multicenter retrospective study was conducted in 14 practices and 646 patients to evaluate the quality of care (as a Patterns of Care study).

Methodology:

Patients from 14 radiation oncology practices diagnosed with palmar [DD]/plantar [LD] fibromatosis and treated with radiotherapy between January 2012 and December 2022 were retrospectively analyzed with regard to indication, treatment planning, treatment quality, and recording of clinical outcomes in comparison to the DEGRO guideline (version 3.0). The study, approved by the Baden-Württemberg Medical Association (ÄKBW F-2024-3), used questionnaires, self-examinations, telephone interviews, and electronic medical records as data sources, which were statistically analyzed. The primary endpoint was the number of progressive disease courses after > 1 year. Any clinical progression (nodules, cords, contractures, and/or clinical symptoms in the hands and feet) was considered a relapse.

Results:

A total of 646 patients (DD 441 / 189 women; 252 men // LD 140 / 85 women; 55 men) were recorded. However, only 135 (21%) questionnaires returned.A total of 219 patients were included in the final analysis. The cohort thus comprised 334 hands and feet (DD 269, bilateral 97) // LD 65; bilateral 18). A total of 303 hands/feet received radiotherapy, of which 269 were primarily prophylactic. The evaluation revealed 182 (67%) with DD stage N, 42 (16%) with N/I, 20 (7%) with I, and 10 with stage > I. The staging for LD was 34 (52%) stage I, 25 (39%) stage II, and 2 stage III. Radiation was administered to 299 (99%) with a single dose of 3 Gy and to 264 (87%) with a total dose of 30 Gy (in two series). Long-term evaluation showed no more symptoms in 14%, significant functional improvement in 35%, slight improvement in 18%, and no improvement/status idem in 19%; only 8% showed functional progression. 38 (21%) (30 DD / 8 LD) showed objective progression at follow-up.

Conclusion: This is largest (inter)national PCS to date which yielded good clinical results but also revealed significant potential for improvement in documentation and follow-up care within the multinetwork.