aryan:

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Thank you for that answer. Maybe I'll ask Dr Shaffer about the discrepancy between RT treatment intervals. I don't want to appear critical in any way, especially as the first week of treatment appears to be working, but there is a big time difference and Prof S has been treating people for many years with great success. And as you say the more successful treatment in the UK becomes, the more likely it is that NICE will continue to approve RT treatment.

Edited 07/14/12 22:29

Hi Aryan

Looking at published data...

Comparisons of outcomes for "Stage N" using 5 x 3Gy - gap - 5 x 3Gy
===================================================================

Study 3 (Strahlenther Onkol. 2001 Nov;177(11):604-10)

http://dupuytrensfoundation.org/DupPDFs/2010_Medline_XRT.pdf

interval 6-8 weeks - 84% remained stable



"Group C" from Jan 2012 book - page 360

http://books.google.co.uk/books?id=0eKjm...p;q&f=false

interval 10-12 weeks - 96.5% remained stable



Have I misread this?

Al

Edited 07/16/12 03:12

Hi,

The second link that he posted was from this book http://www.amazon.co.uk/Dupuytrens-Disea...3225&sr=1-3

On page 360: Must admit that I am having problems accessing it on-line (through Google book and springer link), if you continue to have problems obtaining access to the data let me know and I will see what I can do as I own the book.

Gary

Charles Eaton, M. Heinrich Seegenschmiedt, Ardeshir Bayat, Giulio Gabbiani, Paul Werker and Wolfgang Wach, Dupuytren’s Disease and Related Hyperproliferative Disorders Principles, Research, and Clinical Perspectives, Jan 2012.

I can't get to the pages now either. However I did take a note of the information:

The 10-12 week gap is specified on page 355 "Group C".

Stage N is nodules and cords only. ie no deformation.

For the new book Jan 2012, the mean follow up time was 8.5 years.

The protocol was 5 x 3Gy, gap 10-12 weeks, 5 x 3Gy.

Page 360:
For the study for Group C following the above protocol the book
reported on 7 out of 199 hands at stage N progressing to the next stage
which is N/I ie some degree of involvment and deformity.

Therefore 3.5% progressed and 96.5% remained stable.

- Gary as you have the book can you confirm I've read this right please. It seems odd that no one is quoting 96.5% and yet this is published data.

These figures look really good. The last few percent could easily be technician error or some other reason, maybe hands on the margins of N/I, machine not working properly. Also for some of the failures the treatment area might not have been big enough.

It looks from the published data that Prof S switched to the 12 week format just before 1997, before that he was doing the 6 week version.

Although it is for Ledderhose this poster shows the 12 weeks:

http://www.dupuytren-online.info/ASTRO_2...se_ASTRO_06.JPG

Prof Seegenschmiedt uses the same treatment interval for Dupuyrens as Ledderhose.

- Aryan. I had one phase of treatments in Hamburg in June 2012 and the next phase is in Sept. The hand that is at a less progressed stage seems to be reacting better in that the unaided flexibility of the fingers seems to have improved slightly.

Edited 07/16/12 17:15

Thanks everyone, Alcook, Gary, Lanod for all the facts and figures on dosage intervals for RT. I agree it would be great to have the published paper on the 10-12 week gap or sight of the relevant pages of the book. I'm afraid I still can't get the link or bring up the correct pages on Amazon. Could you scan the pages in Gary? Sorry to ask you this after all you do already on this site!

I must say I now feel quite uneasy about having the second phase of treatment as early as 6 weeks, with all this positive info for 10/12 weeks. I guess 8 weeks would be a reasonable compromise. Its a bit embarrassing to question Dr Shaffer on this, but with published data I would feel more confident. And after all they are my hands and its my credit card!

Aryan