Dose Effect in Adjuvant Radiation Therapy for the Treatment of Resected Keloids

Renz, Paul; Hasan, Shaakir; Gresswell, Steven; Hajjar, Raymond T.; Trombetta, Mark; Fontanesi, James

doi:10.1016/j.ijrobp.2018.05.027

Cited by 39 publications

(41 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 9 , 11 Various authors have reported a 1.6% to 18% recurrence rate with 20 Gy in 5 fractions, corresponding to a median biologically effective dose of 60 Gy 2 . 12 , 13 We observed a 9% (4 of 40) recurrence rate in our cohort treated with the same dose and fractionation schedule.…”

Section: Discussionsupporting

confidence: 61%

Single Institution Experience of Postoperative Electron Beam Radiation Therapy in the Treatment of Keloids

Rishi

Sarkar

Kesari

et al. 2021

Advances in Radiation Oncology

View full text Add to dashboard Cite

Purpose Surgical excision followed by postoperative radiation therapy is an accepted modality to prevent keloid recurrence. Our practice has been to use electron beam radiation postoperatively to prevent recurrence, and we share our experience with this method in this study. Methods and Materials Twenty-two patients with 40 keloids treated postoperatively with electron beam radiation at our institution from 2014 to 2019 were analyzed retrospectively. Electron beam radiation was used for treatment in all cases, and radiation was initiated within 24 hours of surgery. A dose of 20 Gy in 5 fractions was delivered to the postoperative scar in 95% of the sites, and 8 Gy to 10 Gy in a single fraction was delivered to the remaining 5%. The patients were followed up, and recurrences were documented. Results At a mean follow-up of 35 months (range, 7-66 months), local control and cosmesis were achieved in 90% (36 of 40) of the treated sites with electron beam radiation therapy delivered at a dose of 20 Gy in 5 fractions. All recurrent keloids were located on the anterior chest wall over the sternum. There was no difference in outcome based on age, sex, or keloid length. Conclusions Electron beam radiation therapy is a feasible, convenient, and safe modality for postoperative treatment of keloids. It achieves excellent local control with no grade 3 or higher toxicities.

show abstract

Section: Discussionsupporting

confidence: 61%

Single Institution Experience of Postoperative Electron Beam Radiation Therapy in the Treatment of Keloids

Rishi

Sarkar

Kesari

et al. 2021

Advances in Radiation Oncology

View full text Add to dashboard Cite

show abstract

“…28 However, moderately high doses are needed for keloids, regardless of the keloid site. 29 A large variety of radiation techniques have been devised to treat keloids. They vary in terms of the radiation source, total dose, fractionation, and schedule.…”

Section: Discussionmentioning

confidence: 99%

Z-plasty and Postoperative Radiotherapy for Anterior Chest Wall Keloids: An Analysis of 141 Patients

Arima

Dohi

Kuribayashi

et al. 2019

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: The therapies for anterior chest wall keloids include surgical excision, postoperative radiotherapy, silicone taping stabilization, and steroid plaster. However, to date, there is no universally accepted combination treatment strategy for anterior chest wall keloids. Methods: All consecutive patients with single or multiple anterior chest wall keloids who underwent keloid excision, tension-reducing suturing, z-plasty, and postoperative radiotherapy in 2013–2016 in Nippon Medical School were included in this case series study. Only keloids that arose from small injuries such as folliculitis or acne were selected. The surgery was followed by tension-reducing self-management of the wounds with silicone tape and steroid plaster. The postsurgical radiotherapy modality was 18 Gy administered in 3 fractions over 3 days. The primary study outcome was keloid recurrence during the 24-month follow-up period. Recurrence was defined as the development of stiff and red lesions in even a small part of the scar that did not respond to 6 months of steroid plaster therapy. Results: In total, 141 patients with 141 lesions were enrolled. Of the 141 lesions, 15 (10.6%) recurred. All recurrences were successfully treated by steroid plaster and steroid injection. The recurrence patients did not differ from the nonrecurrence patients in terms of the size of the original keloid or gender distribution. Conclusions: Anterior chest wall keloids can be successfully treated by customized plans that involve appropriate surgical modalities (including z-plasty) followed by postoperative radiotherapy (18 Gy in 3 fractions over 3 days) and scar self-management with silicone tape and steroid plaster.

show abstract

“…[38][39][40] Local control for resected keloids treated with radiation therapy may be dose-dependent, with higher radiation doses (e.g., biologically equivalent dose 2 > 60, such as 2,000 cGy in five fractions) resulting in lower rates of local recurrence than lower radiation doses. 41,42 Potential complications of radiation therapy are divided into acute (occurring during or shortly after completion of radiation) and late (developing months or years following completion of radiation) and are dose-dependent and generally mild. 43 The most prevalent acute side effect is transient desquamation, including erythema or pruritus.…”

Section: Radiation Therapymentioning

confidence: 99%

Management of Facial Scars

et al. 2019

View full text Add to dashboard Cite

Scarring is a natural process of healing after damage to the skin that extends to the reticular dermis. While some scars may be socially acceptable, even admirable, scars of the face can be viewed as disfiguring or ugly. Minimizing the appearance of facial scars and optimizing their cosmetic outcome ideally begin before surgery or, in the cause of trauma, at the initial reconstruction. Even when there has been poor initial healing, a scar's appearance can be improved. Herein, we review conservative, medical, and surgical therapies to improve the appearance of facial scars.

show abstract

Dose Effect in Adjuvant Radiation Therapy for the Treatment of Resected Keloids

Abstract: Surgical excision followed by immediate adjuvant radiation therapy for keloids provides excellent local control and cosmesis. Treatment with a biologically equivalent dose > 60 (20 Gy in 5 fractions) yielded superior local control over lower dose regimens.

Cited by 39 publications

References 25 publications

Single Institution Experience of Postoperative Electron Beam Radiation Therapy in the Treatment of Keloids

Single Institution Experience of Postoperative Electron Beam Radiation Therapy in the Treatment of Keloids

Z-plasty and Postoperative Radiotherapy for Anterior Chest Wall Keloids: An Analysis of 141 Patients

Management of Facial Scars

Contact Info

Product

Resources

About