Patient-Reported Outcomes After Radiation Therapy for Dupuytren’s Contracture

Abstract

Purpose

Dupuytren’s contracture (DC) is a fibroproliferative disorder that can result in functional impairment of the hand. Radiation therapy (RT) is used to prevent disease progression and sometimes as adjuvant therapy after surgeries and recurrences. However, comprehensive data on patient-reported efficacy are limited. This study aimed to assess patient-reported outcomes in patients with DC treated with primary and adjuvant RT.

Dupuytren’s contracture (DC) is a fibroproliferative disorder that can result in functional impairment of the hand. Radiation therapy (RT) is used to prevent disease progression and sometimes as adjuvant therapy after surgeries and recurrences. However, comprehensive data on patient-reported efficacy are limited. This study aimed to assess patient-reported outcomes in patients with DC treated with primary and adjuvant RT.

Methods and Materials

A single-institution retrospective study was conducted, including 22 patients treated with RT for DC between April 2017 and July 2022. Surveys to assess satisfaction, perceived effectiveness, and treatment burden used Likert scales and the post-RT Southampton Dupuytren’s Scoring Scheme. All patients received either 30 Gy in a split course or 21 Gy in continuous daily treatments.

A single-institution retrospective study was conducted, including 22 patients treated with RT for DC between April 2017 and July 2022. Surveys to assess satisfaction, perceived effectiveness, and treatment burden used Likert scales and the post-RT Southampton Dupuytren’s Scoring Scheme. All patients received either 30 Gy in a split course or 21 Gy in continuous daily treatments.

Results

Median follow-up was 4.3 years, and median age at diagnosis was 61 years. Sixty-three percent had undergone fasciectomy before RT. Seventy-seven percent expressed satisfaction with RT outcomes, and 68% perceived it as effective. Median post-RT Southampton Dupuytren’s Scoring Scheme score was 5 (IQR, 4-6), indicating mild functional limitations. Four patients (18%) experienced new nodules or cords, and only 1 patient (4.5%) required further surgery. Thirteen patients (59%) reported side effects from RT, most commonly mild dry skin. One patient developed severe dry skin, but there were no other severe toxicities or malignancies observed.

Median follow-up was 4.3 years, and median age at diagnosis was 61 years. Sixty-three percent had undergone fasciectomy before RT. Seventy-seven percent expressed satisfaction with RT outcomes, and 68% perceived it as effective. Median post-RT Southampton Dupuytren’s Scoring Scheme score was 5 (IQR, 4-6), indicating mild functional limitations. Four patients (18%) experienced new nodules or cords, and only 1 patient (4.5%) required further surgery. Thirteen patients (59%) reported side effects from RT, most commonly mild dry skin. One patient developed severe dry skin, but there were no other severe toxicities or malignancies observed.

Conclusions

RT for DC may be associated with high patient satisfaction and low toxicity. Although these findings are encouraging, they are hypothesis-generating and warrant confirmation in prospective studies with larger cohorts and systematic pretreatment and posttreatment assessments.

RT for DC may be associated with high patient satisfaction and low toxicity. Although these findings are encouraging, they are hypothesis-generating and warrant confirmation in prospective studies with larger cohorts and systematic pretreatment and posttreatment assessments.