PO-0760: Adjuvant treatment of keloid scars: brachytherapy or electrontherapy?

Yossi, S.; Krhili, S.; Gustin, P.; Alouani, C. El; Rousseau, D.; Nebout, N.; Petit, Sylvie; Tuchais, C.; Cellier, P.; Paumier, A.

doi:10.1016/s0167-8140(15)33066-8

Cited by 5 publications

(9 citation statements)

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“…Adjuvant radiation therapy can be delivered by kilovoltage x-ray, electrons, or brachytherapy, but there is no consensus on the ideal modality. [14][15][16] In agreement with Ogawa et al, 17 we believe that electron-beam radiation is the most effective modality for preventing postoperative keloid recurrence. Various dose and fractionation schedules have been used for the treatment of keloids.…”

Section: Discussionsupporting

confidence: 89%

“…Studies in the literature report that high dose rate brachytherapy for keloids allows good local control. [14][15][16]20 Yossi et al 16 compared postoperative electron treatment with brachytherapy and observed no statistically significant difference in local control between the 2 modalities. Moreover, brachytherapy cannot be offered to all patients for technical and logistic reasons.…”

Section: Discussionmentioning

confidence: 99%

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

Rishi

Sarkar

Kesari

et al. 2021

Advances in Radiation Oncology

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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

Rishi

Sarkar

Kesari

et al. 2021

Advances in Radiation Oncology

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“…Recently, several studies have supported the use of brachytherapy or electron irradiation [ 27 , 37 , 38 , 39 , 40 ]. However, these studies are limited by their retrospective designs, indirect comparison of radiation modalities, or old techniques that use kilovoltage X-rays.…”

Section: Radiation Techniquementioning

confidence: 99%

Adjuvant Radiotherapy after Surgical Excision in Keloids

Lee

Seol

2021

Medicina

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Keloids are a benign fibroproliferative disease with a high tendency of recurrence. Keloids cause functional impairment, disfigurement, pruritus, and low quality of life. Many therapeutic options have been used for keloids. However, the high recurrence rates have led to the use of adjuvant therapy after surgical keloid excision. There are different radiotherapy regimens available, and the advantages and disadvantages of each are still unclear. The aim of this review is to explain the appropriate radiotherapy regimen for keloids as well as discuss the recent reports on keloid management with radiotherapy. Adjuvant radiotherapy after surgical excision for keloids yields excellent local control with tolerable side effects. Hypofractionated radiotherapy with a BED of more than 28 Gy (α/β value of 10) after excision is recommended in the light of its biologic background.

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“…The transition to a formal treatment regime develops when a true hypertrophic scar or keloid, and not an immature hypertrophic scar, has been diagnosed. Conventional treatment of both hypertrophic scars and keloids commonly involves massage, [15][16][17][18] pressure therapy, [19][20][21][22][23] hydrating occlusive silicone dressings, [24][25][26][27][28][29] corticosteroid injection, [30][31][32] surgical excision [33][34][35] and radiotherapy, [36][37][38][39] alone or in combination. 30,31 Only hydrating occlusive silicone dressing and corticosteroid injection have been demonstrated effective in randomised controlled trials.…”

Section: Prophylaxis Of Hypertrophic and Keloid Scarsmentioning

confidence: 99%

“…39 Radiation acts to inhibit fibroblast proliferation and collagen synthesis, inducing apoptosis of proliferating cells at doses of 15–30 Gy over six sessions with precise dosimetry with appropriate shielding in the immediate postoperative period. 31,36,37,82 Radiotherapy is restricted to older adults given the small but theoretical risk of carcinogenesis 38,39 but is efficacious. Success rates in the literature are in the range of 25–88%, 83,84 but this is complicated by the retrospective nature of studies with variable follow-up periods and poorly defined clinical assessment.…”

Section: Hypertrophic Scars and Keloidsmentioning

confidence: 99%

Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars

McGoldrick

Theodorakopoulou

Azzopardi

et al. 2017

Scars, Burns & Healing

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The formation of a wide range of excessive scars following various skin injuries is a natural consequence of healing. Scars resulting from surgery or trauma affect approximately 100 million people per annum in the developed world and can have profound physical, aesthetic, psychological and social consequences. Thus, scar treatment is a priority for patient and physician alike. Laser treatment plays an important role in scar management with additional support from ancillary modalities. Subsequent to part 1: Burns scars, part 2 focuses on our strategies and literature review of treatment of keloid, hypertrophic, pigmented and acne scars where lasers are used in conjunction with other measures, and illustrated with case studies.

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PO-0760: Adjuvant treatment of keloid scars: brachytherapy or electrontherapy?

Cited by 5 publications

References 0 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

Adjuvant Radiotherapy after Surgical Excision in Keloids

Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars

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