Radiation Therapy in Keloids Treatment

Xu, Jing; Yang, Elan; Yu, Nanze; Long, Xiao

doi:10.4103/0366-6999.209896

Cited by 46 publications

(32 citation statements)

References 70 publications

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“… 77 Radioactive skin patches have also been used in combination with other treatment modalities for keloids. 78 , 79 Radiotherapy is most commonly used 24–48 h after surgical excision 74 , 80 and acts by suppressing angiogenesis and inhibiting ﬁbroblast activity. 1 Decreased fibroblast proliferation, induced cell senescence and apoptosis, leading to reduction in collagen production and suppression of keloid development have also been reported.…”

Section: Current Treatmentsmentioning

confidence: 99%

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Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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Keloids are pathological scars that grow over time and extend beyond the initial site of injury after impaired wound healing. These scars frequently recur and rarely regress. They are aesthetically disfiguring, can cause pain, itching, discomfort as well as psychological stress, often affecting quality of life. Many treatment modalities, including surgical and non-surgical, have been explored and have been reported to be beneficial; however, none have been absolutely satisfactory or optimal for the treatment of all keloid subtypes to date. This poses a major challenge to clinicians. Often, a combinational therapeutic approach appears to offer the best results with higher patient satisfaction compared to monotherapy. The aetiopathogenesis of keloids is not fully elucidated; however, with recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and hence new therapeutic and management options for keloids. In this paper, we explore the literature and summarise the general concepts surrounding keloid development and review both current (corticosteroids, surgical excision, silicone-based products, pressure therapy, radiotherapy, cryotherapy, laser therapy, imiquimod and 5-fluorouracil) and emerging (stem cell therapy, mitomycin C, verapamil, interferons, bleomycin, botulinum toxin type A and angiotensin-converting enzyme inhibitors) treatments. Increased knowledge and understanding in this area may potentially lead to the discovery and development of novel therapeutic options that are more efficacious for all keloid types. Lay Summary [Formula: see text] Keloids are problematic scars that are difficult to treat and manage. The aetiopathogenesis of keloids is not clear; however, recent advances in molecular biology and genetics are beginning to shed light on the underlying mechanisms implicated in keloid scar formation which will hopefully lead to the development of treatment options for all keloid types. This review summarises current and emerging therapies.

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Section: Current Treatmentsmentioning

confidence: 99%

“…19 A recommended radiation dose > 30 Gy over several sessions can also minimise adverse effects. 19 , 80 Radiotherapy carries a risk of malignancy. 85 , 86 Therefore, caution should be used in radiation-vulnerable sites such as the head, neck, thyroid and breast, and in patients aged < 18 years.…”

Section: Current Treatmentsmentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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“…For large and refractory keloids, surgical resection combined with radiotherapy is a very effective and reliable method of treatment. 15 – 18 Shen et al. 19 retrospectively analyzed 834 cases of keloid lesions in 568 patients and reported that large-segment electron-beam radiation (18 Gy/2 fr, 1 week apart) postoperatively (within 48 hours) can reduce the recurrence rate of keloids to 11.75%.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous symmetrical giant keloids at the bilateral labia majora: a case report

et al. 2019

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Keloids are caused by an imbalance between collagen matrix decomposition and production during wound repair. Spontaneous keloids are a rare type of keloid that arise without a significant history of trauma or surgery. We herein report a case involving a 59-year-old woman with symmetric neoplasms at the bilateral labia majora that had persisted for about 3 years and a >10-year history of pruritus and pain at the bilateral labia majora with folliculitis. The bilateral labia majora gradually swelled and lost their normal physiological morphology. The patient was diagnosed with keloids. Under general anesthesia, the keloids were resected. The right incision was sutured directly and the left was closed using an inguinal flap. Adjuvant radiotherapy was administered after the surgery. No recurrence of the keloids was observed at the 1-year follow-up, and the patient was satisfied with the appearance of the vulvar region. This is the first report of spontaneous symmetrical giant keloids at the bilateral labia majora, and it emphasizes the importance of the effect of abnormal inflammation on keloid formation. Repairing genital defects using an inguinal flap has only a minor effect on the patient’s postoperative movement, and an ideal vulvar appearance can be achieved.

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“…The most common side effects are hyperpigmentation and hypopigmentation [ 4 ]. The theoretical risk of malignancy as a side effect from radiation therapy has been discussed ever since the implementation of this treatment, however, a 2019 comprehensive review of radiation therapy for keloids suggests that this risk remains negligible [ 8 ]. The current consensus regarding radiation therapy for keloids is that it is safe and effective for treating keloid scars with minimal long-term risk.…”

Section: Reviewmentioning

confidence: 99%

Keloid Scars: An Updated Review of Combination Therapies

Thornton

García

Hoyer

et al. 2021

Cureus

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Keloid scars are a common yet poorly understood complication of wound healing that can cause a diminished quality of life. Currently, there is little agreement amongst the medical community regarding the best treatment modality for keloids. For this reason, we have created an updated review of the most successful combination therapies for keloid scars and compared their efficacy based on rates of recurrence following treatment. Additionally, these combination therapies have been compared with intralesional triamcinolone acetonide corticosteroid (TAC), which is considered the mainstay monotherapy for keloids. All combination therapies included in our review were shown to produce superior outcomes than TAC monotherapy. We have also found that certain combination therapies are known to produce superior results when used in specific anatomic locations. Intralesional TAC plus intralesional cryotherapy appeared to have the most promising results for non-auricular keloids, and the authors suggest considering this as a first-line treatment. Additionally, the use of surgical excision plus compression therapy achieved superior results for auricular keloids and should be considered first-line for keloids in these locations.

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Radiation Therapy in Keloids Treatment

Cited by 46 publications

References 70 publications

Keloids: Current and emerging therapies

Keloids: Current and emerging therapies

Spontaneous symmetrical giant keloids at the bilateral labia majora: a case report

Keloid Scars: An Updated Review of Combination Therapies

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