From: Systematic review of non-surgical treatments for early Dupuytren’s disease
Author (year) Treatment | Total cohort of DD patients (hands) | Number of patients (hands) with early DD | Study type | Level of evidence (OCEBM) Prospective (P) Retrospective (R) Not stated (N) | Outcome measure | Results | Recurrence | Adverse events | ||
---|---|---|---|---|---|---|---|---|---|---|
Improved | No change | Deteriorated | ||||||||
Keilholz (1996) [14] Radiotherapy | (142 hands) | (129 hands) | Case series | 4 (R) | Clinical assessment of consistency and size of nodule | 102 | 25 | 2 | Not reported | EORTCa Grade 1 and 2 toxicity for total cohort. |
Lukacs (1978) [45] Radiotherapy | 36 | 32 | Case series | 4 (N) | Clinical assessment of softening of nodules, contracture improvement | 26 | 6 | 0 | Not reported | Not reported |
Hesselkamp (1981) [46] Radiotherapy | 46 | 46 | Case series | 4 (N) | Clinical assessment of softening of nodules and cords | 24 | 19 | 3 | Not reported | 63 % dry skin with desquamation, 24 % skin atrophy, pigmentation and telangiectasia. |
Adamietz (2001) [47] Radiotherapy | 99 (176 hands) | (156 hands) | Case series | 4 (R) | Tubiana grade | 18 | 79 | 59, (27 within and 32 outside RT field) | At 10 years >20 % N (n = 13), >20 % N/1 (n = 13), 65 % stage 1 (n = 30. | For total cohort of 176 hands at median 10 years, 44 reported strong desquamation and 15 cutaneous telangiectasia with subcutaneous atrophy. |
Kohler (1984) [48] Radiotherapy | 29 (33 hands) | 29 (33 hands) | Case series | 4 (N) | Clinical assessment of softening of DD tissue | 7 | 20 | 6 | 1 outside the radiotherapy area. | Not reported |
Weinzierl 1993) [49] Radiotherapy n = 34 | 39 (56 hands) | 39 (56 hands) | 2 Case series | 4 (N) | Clinical assessment of consistency and size of nodules | 3 | 14 | 17 | Not reported | 32 % had small but ongoing skin change (dry skin). |
Injection Superoxide dismutase n = 22 | 7 | 9 | 6 | Not reported | No local or systemic adverse effects. | |||||
Corsi (1966) [50] Radiotherapy, plesiotherapy plus vitamin E | 11 (13 hands) | 10 (11 hands) | Case series | 4 (N) | Clinical assessment of skin consistency, nodule size and digital extension. | 8 | 3 | 0 | Not reported | Temporary skin rash and epidermolysis noted at end of treatment (number affected not given). |
Grenfell (2014) [51] Radiotherapy | 6 (4 hands) | 3 (4 hands) | Case series | 4 (N) | Clinical assessment whether nodule size and hardness | 4 | 0 | 0 | None at 34–42 months | Acute side effects: minimal fatigue, mild local oedema and erythema for total cohort. Number affected and duration not given. |
Finney (1953) [52] Radiotherapy | 25 | 7 | Case series | 4 (N) | Clinical assessment of functional improvement | 6 | 1 | 0 | None at 2–10 years | 1st degree reaction: skin dryness, slight erythema for total cohort. Number affected not given. |
Finney (1955) [53] Radiotherapy | 18 | 3 | Case series | 4 (N) | Clinical assessment of functional improvement | 3 | 0 | 0 | Not reported | 2nd degree reaction: skin dryness, persistent paraesthesia for total cohort. Number affected not given. Paraesthesia persisting up to 12 months in 2 cases. |