+49 711 991 1460
Strahlentherapien > Therapie gutartiger Erkrankungen
The wide treatment spectrum of radiotherapy.
The positive-acting, analgesic, anti-inflammatory and antiproliferative (= directed against tissue generation) effect of a radiation treatment in non-malignant diseases is not known to many people. Radiotherapy is usually only associated with cancer.
The very first beginnings of radiotherapy were, in fact, first of all in the treatment of non-malignant diseases. This is shown in an article by the physician Leopold Freund dated 6th of March 1897 in the Wiener Medizin Wochenschrift [Viennese Medical Weekly], entitled "A case of Nevus pigmentosus piliferus treated with X-ray", on the treatment of a five-year-old girl with extensive Tierfell nevus (large, hairy skin area).
Today, radiotherapy is used regularly in the treatment of non-malignant diseases.
Basic indication
It is firstly clarified in a consultation, as to whether radiotherapy would be an appropriate treatment. Even if the radiation exposure is very low, the benefits and risks of radiotherapy to treat non-malignant diseases must be carefully weighed against each other. For people under the age of 50, severe discomfort must be present and all other conservative treatment methods must be exhausted before radiotherapy should be considered. The clarification consultation also includes information on possible, but very rare, side effects or risks.
Anti-inflammatory treatment
Röntgen-Aufnahme eines Fersensporns (siehe Pfeil)
The long-known anti-inflammatory effect of low-dose radiotherapy is based on the modification of essential inflammatory mechanisms of the immune system. The causes of this inflammation can be increased physical stress, degenerative processes or may even be of a chemical or infectious nature.
We treat e.g.
-
Tennis elbow
-
Heel spur
-
Arthrosis of the small joints (e.g. of the hands)
-
Hip arthrosis
-
Knee arthrosis
-
'Shoulder syndrome'
In preparation for the radiotherapy, an individual plan is established for the patient concerned on the basis of the measurements of the joint to be treated. For painful joints, a low-dosage radiation treatment is used, usually two to three times a week with a total does of 0.5 Gy -3.0 Gy. The analgesic effect against the predominant joint inflammation usually occurs after about 6-8 weeks.
Bestrahlungsfeld für einen Fersensporn nach Plan
Anti-proliferation treatment against tissue generation in Morbus Dupuytren
In the early stages of lump formation in Dupuytren's disease, a further proliferation of connective tissue in the region of the fingers can be prevented by radiation treatment of the affected parts on the palm of the hand. Radiotherapy is anti-proliferative. As a result, a shortening of the fingers, which can only be treated surgically, can be prevented. The aim of the treatment is to prevent the curvature of the fingers and thus prevent the need for surgery.
To prepare for radiotherapy, an individual radiotherapy template is made in a special workshop after measuring the lumps (see illustration: black lines) and measuring the field size (blue solid lines and dashed lines), and an individual plan is made for the patient concerned.
Radiotherapy is performed in two batches, each of five times a week with a single dose of 3.0 Gy to 15 Gy. The second batch is given after 12 weeks of rest.
Morbus Ledderhose
M. Ledderhose is a disease very similar to M. Dupuytren, but occurs on the sole of the foot, i.e. in the area of the big toe and the 2nd and 3rd toes. The complaint is not so much affected by a toe flexion as by severe pressure pain while walking. Operative procedures do not usually lead to a satisfactory result.
According to current data, the same treatment concept as for the M. Dupuytren can be used for the radiation treatment of M. Ledderhose (see above).
The aim of the treatment is to reduce the formation of lumps and reduce pain so that surgery is not necessary.
Ossification prophylaxis
After accidents resulting in injuries in the area of the hip joint or after implantation of an artificial hip joint, depending on the individual risk profile, an excess formation of bone tissue can occur. If this external bone formation (= ossification) leads to movement restriction and pain of the affected hip, an operation must be performed. Therefore, a preventive treatment is intended to prevent an excess formation of bone tissue. This can be achieved either by the use of non-steroidal anti-inflammatory drugs (NSAIDs) or by a single dose of radiotherapy.
The indication for ossification prophylaxis by radiotherapy is given in close cooperation with the endoprosthetics center of the Diakonie Clinic.
On the day before the operation, the patient is informed about the benefits and risks, the course of treatment, and the possible side effects. A measurement of the joint to be treated is then carried out in preparation for the radiotherapy. An individual plan is created for the patient concerned.
The radiation treatment is performed on the day of surgery, usually before the operation, with a total dose of 1 x 7.0 Gy.
Keloid (= scarring) radiotherapy
Excess scar tissue formation (= keloid) can be a cosmetic, and very psychologically stressful problem. If the keloid formation cannot be satisfactorily removed in a purely operative procedure, and if a new operation for the removal of the keloid is planned, radiotherapy can be performed on the scar region after the old scar tissue has been removed as completely as possible, thus preventing further keloid formation.
The radiation treatment with a total dose of 3 x 4.0 Gy to 12.0 Gy starts within 24 hours after the operation, and is then continued on the next two days.
Grave's opthalmopathy is an autoimmune disease associated with thyroid disease which affects the eye muscles. The typical picture of the prominent eyeballs (exophthalmia) can lead to a great amount of stress in the affected person, due to cosmetic and aesthetic reasons. Double vision, and even crushing of the optic nerves, are further, more serious consequences of this disease.
If all drug-related, conservative measures are exhausted, the possibility of radiotherapy of the 'orbita apex' should be examined before surgery.
In an individual clarification consultation, in cooperation with the treating endocrinologist and the thyroid gland center of the Diakonie Clinic, a review is carried out to determine whether radiotherapy treatment is necessary, and the procedure will be explained as well as possible side effects and risks.
An MRI examination should be performed to assess the inflammatory activity.
In a preliminary CT examination, an individual radiation mask is prepared for the affected patient, in order to be able to carry out an exact radiotherapy treatment in a targeted manner.
Depending on the extent of the inflammation, different radiation dosage concepts are used from a total dose of 5 x 0.3 Gy / per week to a total dose of 2.4 Gy to 5 x 2.0 Gy / week, up to a total dose of 20 Gy.
Very rare non-malignant diseases
Further, very rare non-malignant diseases such as desmoids, symptomatic vertebral hemangioma, induratio penis plastica, pigmented villonodular synovitis, and Gorham Stout syndrome are also diseases that can be treated by radiotherapy. We would be happy to advise you in a personal consultation.
