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Converting Stage II to Stage I and then getting RT
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09/26/2013 22:51
moondanc 
09/26/2013 22:51
moondanc 
Converting Stage II to Stage I and then getting RT

I found the statement below with regard to Radiation Therapy on the website of a hand surgeon doing NA and using Xiaflex. Can someone explain the part of the statement I've bolded? I understand the disease is staged by the amount of contraction but I always thought was in terms of natural progression of the contraction (not as corrected by needle or Xiaflex) and the state of the nodules and whether they were long standing enough to progress to cords--therefore a more advanced stage not suitable for RT. I don't understand how cutting or dissolving the cords and then getting NA can prevent progression.

"Radiation Therapy

Radiation therapy is helpful in preventing progression of the disease and may have some use in preventing contractures or keeping fingers straight after treatment[67-69]. Radiotherapy should be done when the fingers are straight and therefore preliminary needle aponeurotomy or enzyme treatments would be necessary to straighten the fingers. Radiotherapy would then be performed to prevent recurrence although 31% of patients with Dupuytren’s continued to progress despite radiation[67].

Betz et al in 2010 reported on long term followup of radiation for Dupuytren's contracture. Sixty percent did very well long term if the disease was early. More advanced disease, such as stage II (over 45 degree contracture)usually continued to progress despite radiation. However, it is possible to convert stage II disease to stage I with needle, XIAFLEX, or both and then do radiation to help prevent progression of the disease."

09/27/2013 06:44
spanishbuddha 

Administrator

09/27/2013 06:44
spanishbuddha 

Administrator

Re: Converting Stage II to Stage I and then getting RT

I think they are just saying that you can improve contracture, from stage 2 to stage 1 via NA or Xiaflex, and then slow down or prevent further recurrence or progression via RT.

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Converting   treatments   preventing   disease   contraction   Radiotherapy   treatment[67-69]   progression   cords--therefore   contracture   Dupuytren’s   aponeurotomy   radiation[67]   recurrence   preliminary   Radiation   understand   contractures   Xiaflex   dissolving