Radiotherapy for Keloids: A Comprehensive Narrative Review

Keloids cause uncomfortable symptoms that disrupt daily life. The outcomes of monotherapy are often unsatisfactory. However, surgical excision followed by adjuvant radiotherapy has been shown to reduce recurrence rates. Radiotherapy for keloid treatment can be administered using various radiation modalities and sources. Each radiation modality and source has unique treatment properties and requires careful setup considerations. Treatment parameters and variability in clinical outcomes and adverse effects have been reported across studies. This literature review aimed to provide a narrative overview of the differences and defining characteristics of each radiation modality used in keloid management and to summarize the clinical evidence supporting their treatment efficacy. Radiation treatment regimens, recurrence rates, and adverse effects were summarized according to modality. The factors affecting treatment efficacy were analyzed. A comprehensive understanding of each radiation modality's properties enables the development of institution-specific treatment strategies, tailored to available resources and supported by multidisciplinary collaboration. Cautious planning and delivery of radiotherapy, combined with surgery, can result in favorable clinical outcomes for patients with keloids.