Subscribe to RSS
DOI: 10.5999/aps.2015.42.5.588
Radiation Therapy Following Total Keloidectomy: A Retrospective Study over 11 Years
Background Radiotherapy treatment after keloidectomy is known to be an effective method for reducing the rate of recurrence. However, to date, the appropriate total radiation dose and fractionation have not yet been confirmed. The authors performed a retrospective analysis to identify the appropriate radiation dose and fractionation in post-keloidectomy radiotherapy.
Methods From May 2000 to February 2011, postoperative radiotherapy was performed on 39 lesions in 28 patients after total keloidectomy. The keloid lesions were confined to the ear lobes. Between May 2000 and May 2004, 14 keloids were treated with surgical excision, followed by a total radiation dose of 1,200 cGy in three fractions over four to five days (group 1). Between June 2004 to February 2011, 25 keloids were treated with surgical excision, followed by a total radiation dose of 1,500 cGy in three fractions over four to five days (group 2). Patients were given a survey asking them to report their experiences regarding reoperation, recurrence of symptoms, recurrence of the lesion, and satisfaction with the operation.
Results Of the 28 patients who were treated, 20 underwent follow-up. Group 2 had more cases showing elevation with erythematous changes, whereas group 1 had more cases showing progressive stages of elevation than group 2. These differences were statistically significant. Moreover, a correlation was observed between the level of keloid elevation and the extent of symptoms.
Conclusions We suggest 1,500 cGy of radiation in three fractions following keloidectomy for ear lobe keloids. A further randomized study is needed to assess the recurrence of keloids after radiotherapy.
This article was presented at the 71st Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 1-3, 2013 in Seoul, Korea.
Publication History
Received: 23 April 2015
Accepted: 19 June 2015
Article published online:
05 May 2022
© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Berman B, Bieley HC. Adjunct therapies to surgical management of keloids. Dermatol Surg 1996; 22: 126-130
- 2 Stahl S, Barnea Y, Weiss J. et al. Treatment of earlobe keloids by extralesional excision combined with preoperative and postoperative "sandwich" radiotherapy. Plast Reconstr Surg 2010; 125: 135-141
- 3 Botwood N, Lewanski C, Lowdell C. The risks of treating keloids with radiotherapy. Br J Radiol 1999; 72: 1222-1224
- 4 Wang Y, Qi Z, Wang X. Dermis reconstruction and dermis fat graft through an intraoral incision: a new method to correct the furrowed philtral column deformity in lesser-form cleft lip. Cleft Palate Craniofac J 2014; 51: 184-188
- 5 Son D, Lee HG, Han KH. et al. Radiation therapy following total keloidectomy; a preliminary report. J Korean Soc Plast Reconstr Surg 2005; 32: 717-722
- 6 Ogawa R, Miyashita T, Hyakusoku H. et al. Postoperative radiation protocol for keloids and hypertrophic scars: statistical analysis of 370 sites followed for over 18 months. Ann Plast Surg 2007; 59: 688-691
- 7 Ogawa R, Mitsuhashi K, Hyakusoku H. et al. Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstr Surg 2003; 111: 547-553
- 8 Niessen FB, Spauwen PH, Schalkwijk J. et al. On the nature of hypertrophic scars and keloids: a review. Plast Reconstr Surg 1999; 104: 1435-1458
- 9 Ogawa R, Huang C, Akaishi S. et al. Analysis of surgical treatments for earlobe keloids: analysis of 174 lesions in 145 patients. Plast Reconstr Surg 2013; 132: 818e-825e
- 10 Ragoowansi R, Cornes PG, Moss AL. et al. Treatment of keloids by surgical excision and immediate postoperative single-fraction radiotherapy. Plast Reconstr Surg 2003; 111: 1853-1859
- 11 Lo TC, Seckel BR, Salzman FA. et al. Single-dose electron beam irradiation in treatment and prevention of keloids and hypertrophic scars. Radiother Oncol 1990; 19: 267-272
- 12 Dinh Q, Veness M, Richards S. Role of adjuvant radiotherapy in recurrent earlobe keloids. Australas J Dermatol 2004; 45: 162-166
- 13 Kovalic JJ, Perez CA. Radiation therapy following keloidectomy: a 20-year experience. Int J Radiat Oncol Biol Phys 1989; 17: 77-80
- 14 Levy DS, Salter MM, Roth RE. Postoperative irradiation in the prevention of keloids. AJR Am J Roentgenol 1976; 127: 509-510
- 15 Veen RE, Kal HB. Postoperative high-dose-rate brachytherapy in the prevention of keloids. Int J Radiat Oncol Biol Phys 2007; 69: 1205-1208
- 16 Kal HB, Veen RE, Jurgenliemk-Schulz IM. Dose-effect relationships for recurrence of keloid and pterygium after surgery and radiotherapy. Int J Radiat Oncol Biol Phys 2009; 74: 245-251
- 17 Hoffman S. Radiotherapy for keloids. Ann Plast Surg 1982; 9: 265
- 18 Ogawa R, Yoshitatsu S, Yoshida K. et al. Is radiation therapy for keloids acceptable? The risk of radiation-induced carcinogenesis. Plast Reconstr Surg 2009; 124: 1196-1201