- 作者：Ping Jiang ; MD&lowast ; ; ping.jiang@uksh.de" class="auth_mail" title="E-mail the corresponding author ; René ; Baumann ; MD&lowast ; ; Juergen Dunst ; MD&lowast ; ; &dagger ; ; Matthias Geenen ; MD&Dagger ; ; Frank-André ; Siebert ; PhD&lowast ; ; Peter Niehoff ; MD&lowast ; ; § ; ; ‖ ; Julia Bertolini ; MD¶ ; ; Daniel Druecke ; MD¶ ;
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2016
- 出版时间：1 March 2016
- 年：2016
- 卷：94
- 期：3
- 页码：532-536
- 全文大小：1424 K
Methods and Materials
From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immediate perioperative high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiation therapy and presented with recurrences in the pretreated areas. Two or more different treatment modalities had been tried in all patients and had failed to achieve remission. After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volume covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours after surgery, the other 2 fractions on the first postoperative day. Thus, a total dose of 18 Gy in 3 fractions was administered within 36 hours after the resection.
Results
The treatment was feasible in all patients. No procedure-related complications (eg, secondary infections) occurred. Nineteen patients had keloid-related symptoms before treatment like pain and pruritus; disappearance of symptoms was noticed in all patients after treatment. After a median follow-up of 29.4 months (range, 7.9-72.4 months), 2 keloid recurrences and 2 mildly hypertrophied scars were observed. The local control rate was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process.
Conclusions
The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest that brachytherapy may be advantageous in the management of high-risk keloids or as salvage treatment for failure after external beam therapy.