Table 4.
Summary of results of radiotherapy treatment
| Author (year) Treatment | Total cohort of DD patients (hands) | Number of patients (hands) with early DD | Study type | Level of evidence (OCEBM) Prospective (P) Retrospective (R) Not stated (N) | Outcome measure | Results | Recurrence | Adverse events | ||
|---|---|---|---|---|---|---|---|---|---|---|
| Improved | No change | Deteriorated | ||||||||
| Keilholz (1996) [14] Radiotherapy | (142 hands) | (129 hands) | Case series | 4 (R) | Clinical assessment of consistency and size of nodule | 102 | 25 | 2 | Not reported | EORTCa Grade 1 and 2 toxicity for total cohort. |
| Lukacs (1978) [45] Radiotherapy | 36 | 32 | Case series | 4 (N) | Clinical assessment of softening of nodules, contracture improvement | 26 | 6 | 0 | Not reported | Not reported |
| Hesselkamp (1981) [46] Radiotherapy | 46 | 46 | Case series | 4 (N) | Clinical assessment of softening of nodules and cords | 24 | 19 | 3 | Not reported | 63 % dry skin with desquamation, 24 % skin atrophy, pigmentation and telangiectasia. |
| Adamietz (2001) [47] Radiotherapy | 99 (176 hands) | (156 hands) | Case series | 4 (R) | Tubiana grade | 18 | 79 | 59, (27 within and 32 outside RT field) | At 10 years >20 % N (n = 13), >20 % N/1 (n = 13), 65 % stage 1 (n = 30. | For total cohort of 176 hands at median 10 years, 44 reported strong desquamation and 15 cutaneous telangiectasia with subcutaneous atrophy. |
| Kohler (1984) [48] Radiotherapy | 29 (33 hands) | 29 (33 hands) | Case series | 4 (N) | Clinical assessment of softening of DD tissue | 7 | 20 | 6 | 1 outside the radiotherapy area. | Not reported |
| Weinzierl 1993) [49] Radiotherapy n = 34 | 39 (56 hands) | 39 (56 hands) | 2 Case series | 4 (N) | Clinical assessment of consistency and size of nodules | 3 | 14 | 17 | Not reported | 32 % had small but ongoing skin change (dry skin). |
| Injection Superoxide dismutase n = 22 | 7 | 9 | 6 | Not reported | No local or systemic adverse effects. | |||||
| Corsi (1966) [50] Radiotherapy, plesiotherapy plus vitamin E | 11 (13 hands) | 10 (11 hands) | Case series | 4 (N) | Clinical assessment of skin consistency, nodule size and digital extension. | 8 | 3 | 0 | Not reported | Temporary skin rash and epidermolysis noted at end of treatment (number affected not given). |
| Grenfell (2014) [51] Radiotherapy | 6 (4 hands) | 3 (4 hands) | Case series | 4 (N) | Clinical assessment whether nodule size and hardness | 4 | 0 | 0 | None at 34–42 months | Acute side effects: minimal fatigue, mild local oedema and erythema for total cohort. Number affected and duration not given. |
| Finney (1953) [52] Radiotherapy | 25 | 7 | Case series | 4 (N) | Clinical assessment of functional improvement | 6 | 1 | 0 | None at 2–10 years | 1st degree reaction: skin dryness, slight erythema for total cohort. Number affected not given. |
| Finney (1955) [53] Radiotherapy | 18 | 3 | Case series | 4 (N) | Clinical assessment of functional improvement | 3 | 0 | 0 | Not reported | 2nd degree reaction: skin dryness, persistent paraesthesia for total cohort. Number affected not given. Paraesthesia persisting up to 12 months in 2 cases. |
Summary of results of radiotherapy treatment for each study, including the number of patients with Dupuytren’s disease in the total cohort in each study, the number of patients with early disease within the total cohort, study type and design, level of evidence according to the Oxford Centre for Evidence Based Medicine (OCEBM) criteria, the outcome measure used and results. The number of hands (in brackets) is stated when availabl, with recurrence and adverse events where stated
aToxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)