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Radiation therapy following keloidectomy: a 20-year experience
1Radiation Oncology Center, Mallinckrodt Institute of Radiology, St. Louis, MO 63110.
Summary
Post-excision radiation therapy for keloids significantly reduces recurrence. This study found a 73% control rate, with no benefit to early treatment, but identified factors like size and prior therapy as recurrence indicators.
Area of Science:
- Dermatology
- Radiation Oncology
Background:
- Keloids are benign fibrous growths that can be challenging to treat.
- Recurrence rates after surgical excision alone can be high.
- Adjuvant therapies are explored to improve outcomes after keloid removal.
Purpose of the Study:
- To evaluate the efficacy and safety of adjuvant radiation therapy following surgical excision of keloids.
- To identify factors associated with keloid recurrence after treatment.
Main Methods:
- A retrospective study of 75 patients with 113 keloids treated with radiation therapy post-excision.
- Superficial X-ray therapy was the primary modality used, with a common dose of 12 Gy in three fractions.
- Patient data, including keloid characteristics and follow-up duration (mean 9.75 years), were analyzed.
Main Results:
- An overall keloid control rate of 73% was achieved.
- No significant benefit was observed in initiating radiation therapy within 1 day of surgery.
- Factors predicting recurrence included keloid size (>2 cm), prior treatment history, and male gender.
- Mean time to recurrence was 12.8 months.
- No complications were reported with the low-dose treatment regimen.
Conclusions:
- Adjuvant radiation therapy following keloid excision is an effective and safe treatment modality.
- The findings support the use of radiotherapy as an adjunct to surgery for keloid management.
- Understanding recurrence predictors can help tailor treatment strategies.