Ledderhose Disease: Radiotherapy or Not?

Overview

The aim of the LedRad trial is to determine the efficacy and durability of radiotherapy as treatment for patients with Ledderhose disease and to compare this to the natural course of Ledderhose disease.

Full Title of Study: “Ledderhose Disease: Radiotherapy or Not? A Randomised, Multicentre, Prospective, Double Blind Phase III Trial Investigating the Effect of Radiotherapy on Patients With Ledderhose Disease”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Triple (Participant, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: August 15, 2021

Interventions

  • Radiation: Radiotherapy
    • Patients randomized to the Radiotherapy arm will be treated with electrons and receive a total dose of 30 Gy (two separate courses of five daily fractions of 3.0 Gy each).
  • Other: Sham Radiotherapy
    • Patients randomized to the sham-radiotherapy will not be treated and the radiotherapy treatment will only be simulated.

Arms, Groups and Cohorts

  • Experimental: Radiotherapy
    • Patients assigned to the Radiotherapy group are treated with electrons and will receive a total dose of 30 Gy.
  • Placebo Comparator: Sham Radiotherapy
    • Patients assigned to the sham-radiotherapy group will not actually receive radiation. For these patients the radiation is simulated.

Clinical Trial Outcome Measures

Primary Measures

  • Numeric Rating Scale
    • Time Frame: 12 months
    • Determine pain with the Numeric Rating Scale

Secondary Measures

  • Numeric Rating Scale
    • Time Frame: 6 and 18 months
    • Determine pain with the Numeric Rating Scale
  • Size of ledderhose nodules
    • Time Frame: 12 months
    • Determine the effect of radiotherapy on size of Ledderhose nodules with MRI and Ultrasound
  • Walking distance
    • Time Frame: 6, 12 and 18 months
    • Determine the effect of radiotherapy on walking distance with the 10 meter straight line walk test
  • Walking motion
    • Time Frame: 12 months
    • Determine the effect of radiotherapy on walking motion with the PEDAR-X® in shoe pressure measurement system
  • Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
    • Time Frame: 18 months
    • Assess the safety and toxicity of radiotherapy on this population by recording the toxicity of radiotherapy during the course of radiotherapy and thereafter measured by CT-CAE 4.0.
  • Quality of life (1)
    • Time Frame: 6, 12 and 18 months
    • Assess the impact on quality of life of radiotherapy as treatment for this study population with RAND-36 item Health Survey questionnaire
  • Quality of life (2)
    • Time Frame: 6, 12 and 18 months
    • Assess the impact on quality of life of radiotherapy as treatment for this study population with the brief pain inventory questionnaire
  • Quality of life (3)
    • Time Frame: 6, 12 and 18 months
    • Assess the impact on quality of life of radiotherapy as treatment for this study population with the EURO-Qol-5D questionnaire
  • Cost-effectiveness analysis (CEA)
    • Time Frame: 6, 12 and 18 months
    • The economic evaluation will be performed from a societal perspective, incorporating cost of travel to the hospital and cost of absence from work as well as direct medical cost of radiotherapy (cost of irradiation and outpatient visits). Questionnaires will be used to collect data regarding health care consumption, travel and time costs, and productivity loss at study entry and at 6-month intervals thereafter. In addition to the pain scores, quality of life will be assessed at 6-month intervals using the Rand-36 questionnaire. The utilities based on the results of the questionnaire will be used in a cost-utility analysis, calculating the ratio of incremental costs versus incremental quality-adjusted life-years (QALY).

Participating in This Clinical Trial

Inclusion Criteria

  • Patients with painful Ledderhose disease. The pain score measured with the VAS score and is at least 2 on the 11-point scale (0 = no pain to 10 = worst imaginable pain). – Age ≥ 18 years – WHO performance status 0, 1 or 2 (Appendix, section 18) – Before patient randomisation, written informed consent must be given according to ICH/GCP, and WMO requirements. – Controlling the Dutch language (speaking and reading). – Able and willing to complete quality of life questionnaires in Dutch – Must be accessible for treatment follow-up Exclusion Criteria:

  • Surgical intervention before for Ledderhose disease – Previous radiation treatment for Ledderhose disease – Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule – Not able to lay prone for at least fifteen minutes – Females who are pregnant at entry or who want to become pregnant within six months.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University Medical Center Groningen
  • Collaborator
    • Academisch Medisch Centrum – Universiteit van Amsterdam (AMC-UvA)
  • Provider of Information About this Clinical Study
    • Sponsor

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