Dupuytren's disease | GenesisCare

Fascial fibromatosis

Dupuytren’s contracture is a common condition that causes thickening and tightening of the fibrous tissue or fascia beneath the skin on the palm of the hand, resulting in a permanently bent finger as well as limiting mobility and function of the hand. It is also known as Viking disease, Celtic hand, or palmar fibromatosis.

A number of treatments on established, or progressed, disease have been used to improve the quality of life of patients with Dupuytren’s Disease. These include surgery, collagenase injections and needle aponeurotomy to help open the contracted fingers. However, all treatments have been found to have moderate rates of recurrence and none are useful as a preventative treatment in the early stages of the disease process.

Low dose radiation therapy may be a treatment option for Dupuytren’s disease both as a preventative measure for early stage disease as well as an adjuvant treatment following surgery, collagenase or needle aponeurotomy for more advanced disease. International literature suggests radiotherapy’s effectiveness in outcomes with minimal side effects, however greater, more robust and reliable research is required to develop and support the body of evidence.

GenesisCare is currently undertaking a Randomised Controlled Trial to further investigate the effectiveness of radiotherapy in the treatment of Dupuytren’s Disease. The study looks at radiotherapy as a preventative treatment or as an adjuvant therapy following surgery, needle aponeurotomy or collagenase injection for progressed disease. The Study aims to recruit 1120 patients, with half of these participants receiving radiotherapy and the other half following current standard of care, that is, observation for early stages or surgery, collagenase or needle aponeurotomy followed with observation in the later stages.

How long does the treatment take and how is it delivered?

Radiotherapy is delivered once a day for one week (five business days), followed with a gap of around six weeks and then a second week of treatment.
A planning appointment is needed a few days before starting, and each day in the department will be less than an hour.
The toxicity from treatment is limited, there may be a slight colour change and dryness to the skin in the treated area only which can be managed with a moisturising cream. Treatment is unlikely to cause significant discomfort.

Treatments we cover

Radiation therapy, also called radiotherapy, is used in the early stages of Dupuytren’s disease. It is delivered using a superficial energy called ‘Electrons’ (meaning the radiation is deposited at a shallow depth beneath the skin’s surface to treat the affected fascia). In cooperation with Hand Surgeons, we are also exploring the use radiation therapy as an adjuvant therapy with surgery, needle aponeurotomy or collagenase injection for progressed disease in an attempt to reduce the risk of contracture recurrence.

References

^{Radiotherapy in fascial fibromatosis: C case series, literature review and considerations for treatment of early stage disease. Grenfell S, Borg M, JMIRO 58 (2014): 641-647}

Author: A/Prof Michael Izard ADM The Master and Macquarie University Hospital

Fascial fibromatosis

How long does the treatment take and how is it delivered?

Treatments we cover

Radiation therapy

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References