Quality of Life and Toxicities Following Whole-Palm Versus Involved-Field Radiation Therapy for Dupuytren's Disease: A Substudy From a Randomized Trial
In brief
Whole-palm and targeted radiation yield similar function, with slightly more mild side effects
In 202 hands treated for early Dupuytren's disease, low-dose radiation delivered to the whole palm or only the involved area produced comparable pain scores and disability ratings through 36 months, and no severe toxicity occurred. Acute reactions were modestly more common with whole-palm treatment, while lasting side effects were rare and limited to under 5% reduced sweating.
- Journal
- Advances in radiation oncology (Q1)
- Published
- 11 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Renee Duvenage, Jarad M Martin, Tanya Burgess, Brett McClelland, David Christie, Paul M N Werker, et al.
- PMID
- 42746542
- DOI
- 10.1016/j.adro.2026.102083
Why clinicians should know about it
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (top studies of the week, 20 September 2026): Whole-palm vs IFRT RT well tolerated in Dupuytren's
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.