NICE interventional procedure guidance
Issued: November 2010
IPG368

Radiation therapy for early Dupuytren's disease

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This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/ipg368

1 Guidance

  1. Evidence on the safety of radiation therapy for early Dupuytren's disease is limited in quantity but does not raise any serious safety concerns. The evidence on efficacy is limited in quantity and there is uncertainty about the natural history of early Dupuytren's disease, which makes evaluation of the effect of the procedure difficult. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit or research.

  2. Clinicians wishing to undertake radiation therapy for early Dupuytren's disease should take the following actions.

    • Inform the clinical governance leads in their Trusts.

    • Ensure that patients understand the uncertainty about the procedure's efficacy, the unpredictability of progression of early Dupuytren's disease, and that there is a theoretical risk of malignancy in the long term after any type of radiation therapy. Clinicians should provide patients with clear written information. In addition, the use of NICE's information for patients ('Understanding NICE guidance') is recommended.

    • Audit and review clinical outcomes of all patients having radiation therapy for early Dupuytren's disease (see section 3.1).

  3. Further research would be useful, particularly comparing the long-term efficacy of radiation therapy against the natural history of Dupuytren's disease. Both short- and long-term safety outcomes, such as dry hands and development of neoplastic disease, should be reported.