Surgical excision and postoperative radiotherapy for keloids

Area of Science:

• Dermatology
• Radiation Oncology

Background:

• Keloid recurrence after surgical excision is high (50%-80%).
• Postoperative radiotherapy is crucial for reducing keloid recurrence.
• Advancements in radiation technology enhance safety and efficacy.

Purpose of the Study:

• To refine and optimize a postoperative radiotherapy protocol for keloid excision wounds.
• To investigate the efficacy of electron beam (β-ray) irradiation in preventing keloid recurrence.
• To customize radiotherapy fractionation and dosage based on body site-specific recurrence risk.

Main Methods:

• Implementation of a multi-fraction electron beam radiotherapy protocol following keloid excision.
• Development and application of body site-customized radiation doses and fractionation schedules.
• Evolution of surgical techniques to complement the radiotherapy protocol.

Main Results:

• Optimized radiotherapy protocols significantly reduced keloid recurrence rates.
• Site-specific protocols include 18 Gy/3 fractions for high-risk areas, 8 Gy/1 fraction for earlobes, and 15 Gy/2 fractions for other sites.
• Overall keloid recurrence rate decreased to below 10%.

Conclusions:

• A tailored, multi-fraction electron beam radiotherapy protocol is highly effective in preventing keloid recurrence post-surgery.
• Optimized radiation doses and fractionation, customized by body site, are key to successful keloid management.
• The combination of optimized radiotherapy and surgical approaches dramatically improves outcomes for keloid patients.