Keloid scars: a new method of treatment combining surgery with interstitial radiotherapy

A method is described for the treatment of the linear keloid scar, by surgical excision and post-operative irradiation delivered locally to the base of the sutured edges of the scar, by an iridium-192 wire. The wire is after-loaded into a plastic tube using the technique described by Paine (1972). A dose of 2000 rad is delivered at a point 2-5 mm from the axis of the wire, opposite its mid-point. Thirty cases have been treated by this method with a follow-up period of two years or longer; five recurrences were found at six months, and a further one by two years. No complications were observed. It is suggested that this represents a rather lower recurrence rate than has been achieved by other methods, and that the dose to the tissue surrounding the scar is less than that which would be the case with conventional superficial radiotherapy - an important consideration in the treatment of young patients, with benign conditions, by irradiation.