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What are the indications to treat Dupuytren's disease with radiation?
Would you treat Dupuytren’s disease shortly after surgery or wait till the patient develops new contracture? What dose and fractionation do you use?
This question is part of our collaboration with ASTRO 2025 to highlight impactful trial data from this year's meeting. This question is inspired by the Clinical Trials Session Presentation "Toxicities and Quality of Life Following Observation or Radiation Therapy for Dupuytren's Disease in the International DEPART Randomized Trial" by Dr. Jarad Martin.
Answer from: Radiation Oncologist at Academic Institution
I would not offer any radiation therapy after a surgical procedure for Dupuytren's contracture. Should the patient develop recurrent nodules that progress more than 6 months following surgery, then I would consider definitive split-course electron beam therapy to deliver 30 Gy at 3 Gy per fraction w...
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Answer from: Radiation Oncologist at Community Practice
My only experience has been in patients who have previously undergone surgery and recurred, as per @Aaron H. Wolfson's recommendations. The most popular fractionation schedule used in Germany (where much of the research on XRT for benign diseases comes from) is a split-course regimen where 5 fractio...
Answer from: Radiation Oncologist at Community Practice
Patients who require surgery for contracture have an extremely high recurrence rate. Hence, I wait about 2 weeks for healing, then deliver 250 cGy x 10 with an electron beam, and have had a high success rate in preventing a recurrence. No split course.
James PeltonBellevue, WA
Answer from: Radiation Oncologist at Community Practice
Radiotherapy is most effective for early, progressive disease—before fixed flexion contracture develops. I frame indications using the Tubiana staging system, which grades total finger flexion deficit across the MCP and PIP joints:
Tubiana Stage
Total Flexion Deformity
Typical...