Postoperative Electron Beam Radiotherapy for Keloids: Treatment Outcome and Factors Associated with Occurrence and Recurrence
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Background: In the treatment of keloids, the recurrence aftersurgical excision is relatively high. Various types of adjuvanttherapy such as radiotherapy and corticosteroid injectionhave been used to reduce the recurrence. Objective: The aimof this study was to determine the appropriate time forinitiating postoperative radiotherapy and to analyze factorsassociated with the occurrence and recurrence of keloids. Methods: Of these 37 lesions, 22 were located in the earlobe, 6 in the helix of the auricle, 4 on the shoulder, 3 on thechest wall, and 2 on the abdomen. Causative factors werepiercings (n=24), trauma (n=5), previous surgical lesions orbacillus Calmette-Guerin vaccination lesions (n=3) andacne (n=2). Radiation therapy was initiated within 24 h in 24lesions, between 24 and 72 h in 6 lesions, and after more than72 h in 7 lesions. Results: Seven lesions recurred, including5 recurrences in high stretch-tension regions (p=0.010). Initial treatments were administered within 24 h in 1 lesionand more than 72 h after surgical excision in 6 lesions (p＜0.0001). In the 19 patients with family histories, maternaland paternal genetic predispositions were present in 14 and5 patients, respectively (p=0.033). Conclusion: Radiotherapyshould be initiated within 72 h of surgical excision. Location in a high stretch-tension region was significantlyassociated with recurrence. Patients with a family historyshowed a significant tendency toward maternal geneticpredisposition. Therefore, combination therapy should beconsidered to reduce the occurrence and recurrence ofkeloids, and careful observation is required.
Abstract
Background: In the treatment of keloids, the recurrence aftersurgical excision is relatively high. Various types of adjuvanttherapy such as radiotherapy and corticosteroid injectionhave been used to reduce the recurrence. Objective: The aimof this study was to determine the appropriate time forinitiating postoperative radiotherapy and to analyze factorsassociated with the occurrence and recurrence of keloids. Methods: Of these 37 lesions, 22 were located in the earlobe, 6 in the helix of the auricle, 4 on the shoulder, 3 on thechest wall, and 2 on the abdomen. Causative factors werepiercings (n=24), trauma (n=5), previous surgical lesions orbacillus Calmette-Guerin vaccination lesions (n=3) andacne (n=2). Radiation therapy was initiated within 24 h in 24lesions, between 24 and 72 h in 6 lesions, and after more than72 h in 7 lesions. Results: Seven lesions recurred, including5 recurrences in high stretch-tension regions (p=0.010). Initial treatments were administered within 24 h in 1 lesionand more than 72 h after surgical excision in 6 lesions (p＜0.0001). In the 19 patients with family histories, maternaland paternal genetic predispositions were present in 14 and5 patients, respectively (p=0.033). Conclusion: Radiotherapyshould be initiated within 72 h of surgical excision. Location in a high stretch-tension region was significantlyassociated with recurrence. Patients with a family historyshowed a significant tendency toward maternal geneticpredisposition. Therefore, combination therapy should beconsidered to reduce the occurrence and recurrence ofkeloids, and careful observation is required.
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