Advances in radiation oncology · 2026
Quality of Life and Toxicities Following Whole-Palm Versus Involved-Field Radiation Therapy for Dupuytren's Disease: A Substudy From a Randomized Trial.
СтатьяНазвание и аннотация: Перевод в очереди
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Duvenage Renee, Martin Jarad M, Burgess Tanya, McClelland Brett, Christie David, Werker Paul M N, Rozen Warren, Steenbakkers Roel J H M, de Haan Anneke, Anoora Sreelakshmi, Sandoz Dion, Sappiatzer Joshua, Neville Katherine, Sampaio Sandy, Schlect David, Bucci Joseph, Hunter-Smith David, Dilley David
Аннотация
PURPOSE: The Dupuytren's disease Evaluation of Preventative or Adjuvant Radiation Therapy trial compared low-dose radiation therapy (LDRT) with observation for contracture prevention in early Dupuytren's disease. Guidelines vary regarding field selection due to concerns about toxicity in larger fields. In the LDRT arm of the prevention group, the permitted treatment fields were either whole-palm radiation therapy (WPRT) or involved-field radiation therapy (IFRT). This substudy compares quality-of-life and toxicity outcomes between WPRT and IFRT.
METHODS AND MATERIALS: This substudy analyzed 202 patients (202 treated hands) treated with LDRT (30 Gy in 10 fractions, split-course) in the Dupuytren's disease Evaluation of Preventative or Adjuvant Radiation Therapy trial prevention cohort. Quality of life was assessed using the pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main at baseline and at 6, 12, and 36 months post-treatment. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03.
RESULTS: Of 202 hands treated, 126 (62.4%) received WPRT and 76 (37.6%) received IFRT. Baseline characteristics were balanced between the groups. The pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main scores did not differ significantly between the groups at any time point. LDRT was well tolerated with no grade 3 or higher toxicity observed. Acute toxicity was low grade, as expected, and more frequently reported following WPRT than IFRT. Persistent late effects were uncommon, with a <5% incidence of low-grade reduced sweating in the WPRT cohort.
CONCLUSIONS: In early Dupuytren's disease, LDRT delivered using either WPRT or IFRT was well tolerated and associated with comparable patient-reported outcomes through 36 months. Acute toxicity was expected to be mild and more frequent following WPRT, whereas persistent late toxicity was infrequent, mild, and limited to a low rate of reduced sweating. Pending definitive data on the efficacy of LDRT in Dupuytren's disease, these findings support individualized field selection guided by disease distribution, clinical judgment, and patient preference.
METHODS AND MATERIALS: This substudy analyzed 202 patients (202 treated hands) treated with LDRT (30 Gy in 10 fractions, split-course) in the Dupuytren's disease Evaluation of Preventative or Adjuvant Radiation Therapy trial prevention cohort. Quality of life was assessed using the pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main at baseline and at 6, 12, and 36 months post-treatment. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03.
RESULTS: Of 202 hands treated, 126 (62.4%) received WPRT and 76 (37.6%) received IFRT. Baseline characteristics were balanced between the groups. The pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main scores did not differ significantly between the groups at any time point. LDRT was well tolerated with no grade 3 or higher toxicity observed. Acute toxicity was low grade, as expected, and more frequently reported following WPRT than IFRT. Persistent late effects were uncommon, with a <5% incidence of low-grade reduced sweating in the WPRT cohort.
CONCLUSIONS: In early Dupuytren's disease, LDRT delivered using either WPRT or IFRT was well tolerated and associated with comparable patient-reported outcomes through 36 months. Acute toxicity was expected to be mild and more frequent following WPRT, whereas persistent late toxicity was infrequent, mild, and limited to a low rate of reduced sweating. Pending definitive data on the efficacy of LDRT in Dupuytren's disease, these findings support individualized field selection guided by disease distribution, clinical judgment, and patient preference.