An effectiveness evaluation of the palmar fascia irradiation of patients suffering from Dupuytren’s disease

Abstract

Introduction. Dupuytren’s disease (DD) is a fibroproliferative disorder of an unknown etiology manifested by a progressive contracture of fingers. The basic method of the treatment is surgery. Among non-surgical treatments, radiotherapy (RT) represents a relevant method. The aim of the study was to evaluate the efficacy of palmar fascia irradiation in patients with Dupuytren’s Disease. Material and methods. The research included a group of 117 patients with Dupuytren’s disease irradiated in the Department of Radiotherapy in the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Gliwice. Patients’ medical records from the Institute of Oncology in Gliwice and the Provincial Hospital of Orthopedics and Trauma Surgery in Piekary Śląskie have been analysed retrospectively. The following were assessed: smoking history and the subjective evaluation of the effect of the therapy and its side effects before irradiation and check-up visits. All patients were irradiated to a total dose of 21 Gy given in 7 fractions. Results. After the RT, 35% of patients showed an improvement, in 58% of patients the disease progress stopped, whereas 7% of patients reported a deterioration. During the observation period, 7.5% of patients noted a deterioration of the contracture or the topical condition, in 35% stagnancy was observed, and 57.5% of patients showed a reduction of the contracture and an improvement in the topical condition. After the RT, 87.5% of patients had no side effects, in 7.5% there was a slight skin erythema, 2.5% had superficial epidermis exfoliation, and 2.5% reported dry skin. Conclusions. The obtained results allow one to conclude that palmar fascia irradiation is an effective method of treatment for patients with Dupuytren’s disease and it is characterised by a low proportion of complications.