Hi Steven.

Whether RT for DD is considered untested or effective seems to depend on how one reads the data and on how open doctors are to facts that emerged after they finished their studies. German social security pays for it, so must consider it tested and effective enough.

RT after surgery probably only makes sense if there are signs the desease continues, such as the rapid growth of new nodules, or of nodules or if cords which were awoken by surgery.

How is your brother's other hand, though?

Stef

[56, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017 & 2018, night splint glove RH since 2015]

Thank you for the link which is very interesting.

Yes, I did ask this question previously. As I recall several people were considering this option so I am interested in hearing from anyone who has followed this path. What was the outcome? How long after surgery? Were there any problems? Was it hard to convince their practitioner?

To me this makes intuitive sense and I think it makes scientific sense provided healing is complete. RT may slow or stop any remodeling of scar tissue so timing may be critical. However remodeling may not be "normal" anyway.

My brother has both hands affected with a contraction in the other untreated hand.

Cheers

Stephen

Edited 11/12/18 00:45

Hi Steven. Your brother could also look into RT following an NA procedure on the contracted hand.

Stef

Radiotherapy after Surgery can be divided in two categories of indication (= justified clinical application).

(1) DELAYED POSTOPERATIVE RADIOTHERAPY

The performance of radiotherapy for postoperative relapse / progression of Dupuytren Disease (DD) after a previous minimal invasive surgical procedure (PNF) or open surgery: radiotherapy may be only applied in the "early phase" when new nodules - even outside the operated area - are developing and the function deficit of the involved fingers is less than 10 - 30° (Table Top Test !) - Radiotherapy may delay the progression, but there is still no prospective long-term literature data available on this experimental approach

--> PubMed:https://www.ncbi.nlm.nih.gov/pubmed/?ter...ve+radiotherapy

(2) EARLY POSTOPERATIVE RADIOTHERAPY

This indication is recently under clinical investigation and still not standard care. The principle idea and concept is to preserve the regained full function of the involved finger rays after a first operation (e.g. for a stage II disease = with about 90° bended finger) AND protect the uninvolved hand palm area from a "triggered progression" of DD.

In a multicenter study this approach is currently tested in a double-blind randomized study against sham treatment by Dr Jarad Martin, radiation oncologist, Genesis CancerCare, Newcastle NSW AU 2017.

(3) My personal experience with delayed postoperative radiotherapy (1) involves about 120 patients, while my current experience with selected patients with early postoperative radiotherapy involves about 35 patients since 2014. The "immediate postoperative RT" is applied between 4 - 6 weeks post-operatively after an open procedure with uncomplicated healing process. The radiation field encompasses the finger rays D2 (index finger) to D5 (little finger); the applied dose concept is 5 x 3Gy within one week, but NO second RT series. I am in the process to collect the follow-up data and plan to present this initial experience in 2019.

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With gratitude for all affected patients & medical colleagues who help to advance patient care. Prof. S.

Edited 12/02/18 15:18