ESTRO 2025 - Abstract Book

S1607

Clinical – Mixed sites & palliation

ESTRO 2025

study aims to evaluate the effectiveness of ionizing radiation in treating cases of Ledderhose disease that are refractory to conventional medical treatments. Material/Methods: Between October 2020 and October 2024, patients over 35 with Ledderhose disease who had been refractory to non-surgical treatments were included in the study. Two radiotherapy cycles were carried out, 10 – 12 weeks apart, resulting in a total dose of 30 Gy (3 Gy per fraction over five consecutive days per cycle). Treatment planning involved immobilization with a thermoplastic mask and CT scan (5 mm slices). For nodule delineation, margins of 2.5 cm were applied in the proximal-distal direction and 1.5 cm in all other directions. A linear accelerator VMAT technique was employed. Pain was evaluated using the Visual Analog Scale (VAS) before treatment, one month after the first cycle, and at 3, 6, and 12 months after the second. Response was defined as reduced pain at six months, with VAS classified as mild (0-3), moderate (4-7), or severe (8-10). Reirradiation was excluded. Results: A total of 24 patients with plantar fibromatosis were evaluated, and the 34 feet, 21 left and 13 right, were treated. 9 patients received bilateral treatment. Table 1 shows demographic and clinical characteristics. The mean age was 56 (range: 44 – 65), with a predominance of females (70.6%). Most patients baseline pain was moderate (61.8%, 21 patients) or severe (29.4%, 10 patients) VAS scores. The treatment protocol prescribed was completed by all patients. At six months post-treatment, VAS ratings were mild in 18 patients (52.9%), moderate in 11 (32.4%), and severe in 5 (14.7%). After 12 months, these ratings were mild in 18 (60%), moderate in 7 (23.33%), and severe in 5 (16.67%). With a mean follow-up of 20.90 months (range: 3 – 36), only one patient required surgery due to persistent pain and functional limitation.