Post-keloidectomy irradiation using high-dose-rate superficial brachytherapy

Area of Science:

• Oncology
• Dermatology
• Radiation Oncology

Background:

• Keloids are benign fibrous growths resulting from abnormal wound healing.
• Recurrence rates after surgical excision alone can be high.
• Adjuvant therapies are crucial for improving keloid treatment outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of high-dose-rate superficial brachytherapy (HDR-SB) as an adjuvant treatment following keloidectomy.
• To assess recurrence rates and cosmetic results in patients treated with HDR-SB.

Main Methods:

• A prospective study involving 21 patients with 36 keloids treated with postoperative HDR-SB.
• Applicator placement on the skin over the surgical wound with a 5 mm spacer.
• Dose delivery of 20 Gy in 4 fractions or 15 Gy in 3 fractions, depending on lesion location.

Main Results:

• A low local recurrence rate of 9.7% was observed, with a median time to failure of 12 months.
• All recurrences occurred in anterior chest wall lesions.
• Acceptable cosmetic results were achieved in non-recurrent cases, with minimal acute side effects.

Conclusions:

• Postoperative HDR-SB is an effective and safe method for preventing keloid recurrence after keloidectomy.
• HDR-SB offers a promising therapeutic option for managing keloid scars, particularly in high-risk areas.
• Further research may explore optimal fractionation and dose strategies for specific anatomical locations.