[Radiotherapy in scar-induced keloid]

In a retrospective study, the results of the excision of keloids in combination with postoperative irradiation were investigated with respect to the cosmetic effect and the recurrence rate.

Between 1978 and 1990, 20 patients aged between 15 and 64 years who, together, had a total of 23 localized keloids, were submitted to prophylactic irradiation following excision of the latter.

Radiotherapy was applied, fractionated, using low-energy (soft) X-rays, the strontium 90 Dermaplatte, or with electrons produced by a linear accelerator. The mean total surface dose applied was 20 Gy.

Eighteen patients with 21 keloids were followed-up for a period of between 2 months and 12 years (mean: 33 months). The cosmetic result was good or very good in 17, and unsatisfactory in four of the 21 keloids. Prior to treatment, 18 of the keloids were associated with local complaints; 15 of these cases were symptom-free after treatment.

With the combination of excision and postoperative irradiation, the results of keloid treatment can be improved, and recurrence largely avoided.