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

Rishi, Karthik S; Sarkar, Nivedita; Kesari, Prashanta; Pathikonda, Muddappa; Ramachandra, Prakash; Donapati, Pradeep Kumar Reddy; Giri, G.V.; Srinath, B S

doi:10.1016/j.adro.2020.10.009

Cited by 5 publications

(3 citation statements)

References 24 publications

(29 reference statements)

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“…19 Many studies have found no difference in the ease of use, the side effects such as hyperemia or pigment changes, or the rates of recurrence between HDR brachytherapy and External beam therapy. [20][21][22] We have used both modalities as were available and suitable for each case. All the children in this study were given electron beam radiotherapy and they tolerated it well without panicking or fidgeting, maybe because it is painless.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years

Bhattacharya¹,

Bhattacharya²,

Chandran

2023

Indian J Plast Surg

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Background The treatment of keloidal scars with radiotherapy has been practiced for more than a century. Radiotherapy post-surgery has been deemed necessary and effective in preventing recurrence but still, no clear guidelines exist as to the best modality of radiotherapy, the ideal dose, and the time it should be given for keloidal scars. The purpose of this study is to confirm the effectiveness of this treatment and address these issues. Methods Since 2004, 120 patients presenting with keloidal scars were seen by the author. Out of them, 50 were managed with surgery followed by HDR brachytherapy/electron beam radiotherapy delivering 2000 rads to the scar within 24 hours of surgery. Patients were followed up for at least 18 months to assess the scar status and the recurrence of keloids. Recurrence was defined as the appearance of a nodule or an obvious return of the keloid within 1 year of treatment. Results Three patients developed a nodule in the scar, which was deemed a recurrence, making an incidence of 6%. There was no major problem after immediate postoperative radiotherapy. Five patients had delayed healing at 2 weeks and a hypertrophic scar was noted in five patients at 4 weeks that settled with conservative measures. Conclusion Treating the vexing problem of keloids with surgery and immediate postoperative radiotherapy is safe and effective. We recommend that this be adopted as the standard treatment in keloid management.

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Section: Discussionmentioning

confidence: 99%

Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years

Bhattacharya¹,

Bhattacharya²,

Chandran

2023

Indian J Plast Surg

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“…Postoperative RT has been proven to be the most effective treatment compared with other local treatments, and recurrence rates have been reported to vary from less than 10% to 20% or more. 3,[12][13][14] There is a continued lack of consensus among physicians regarding the dose protocols in keloid treatment. 1,15,16 Furthermore, owing to the location propensity of these keloids, the recurrence rate may differ depending on the keloid's location, and the proportion of the sites in the previous studies may have also contributed to the overall recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of CT-Based Conformal Electron Beam Radiation Therapy After Keloid Excision

Hwang

Lee

Chae

et al. 2022

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BACKGROUND Adjuvant computed tomography-based conformal electron beam radiation therapy (RT) for patients with keloids enables radiation oncologists to customize the target volume with precision and deliver the maximal prescription dose while sparing normal surrounding tissues. OBJECTIVE To report treatment and cosmetic outcomes by the patient's self-assessment survey. METHODS Medical records of patients with keloids, who were treated with postoperative electron beam RT between January 2015 and December 2020, were reviewed. A total of 85 consecutive patients with 136 keloids were included in this study. Subjective cosmetic outcomes were scored by each patient using a 5-point Likert scale survey. RESULTS The median follow-up time was 29.0 months (range, 12.1-77.9 months), and local recurrence was observed in 10 lesions (7.4%). The recurrence rate of keloids occurring in the ear was 5.4%, whereas the recurrence rate of keloids occurring at other body sites was 11.4%. Among the patients who responded to the questionnaire about the cosmetic outcome, 70.2% of patients declared being either very satisfied (44.7%) or satisfied (25.5%). CONCLUSION Surgical excision, followed by CT-based conformal electron beam RT, for patients with keloids ensures a high degree of local control resulting in good cosmetic outcomes.

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“…16 While surgical excision followed by RT is widely accepted as an effective modality to treat keloids, optimum fractionation schedule is still elusive. Doses have ranged from prolonged schedules of 20 Gy in five fractions 19,20 to upcoming single-fraction schedules of 10Gy in one fraction. 21 Ogawa et al from Tokyo, Japan, have published their experience with different fractionation schedules through the years ranging from 20Gy in four fractions to 8 Gy in single fraction.…”

Section: Discussionmentioning

confidence: 99%

Ear Keloids Treated with Postoperative Electrons: A Case Series

Vats

Sarin

Mukundan

et al. 2022

South Asian J Cancer

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Introduction Multiple modalities exist for treating keloids ranging from surgical, medical, chemotherapeutic, and radiation therapy. Different techniques of radiation therapy have been used to treat keloids as an adjuvant to surgical excision. With this case series, we report our experience of using electron beam radiation therapy in this setting. Materials and Methods We retrospectively analyzed 16 ear keloids treated in 10 patients from January 2013 to October 2015 with surgical excision followed by electron beam to a dose of 10 Gy in two fractions over two consecutive days in immediate postoperative period. Patients were evaluated for recurrent lesions, cosmesis, and adverse effects. Results With a median follow-up of 78 months (range: 67–100 months), recurrent lesion was seen in five cases; a local control rate of 68.75% was seen. Median recurrence-free period was 67 months (range: 12–100 months). Acceptable cosmesis was seen in all cases and no acute or chronic adverse effects were seen. Conclusion The large follow-up period in our series establishes the role of electron beam radiation therapy in attaining long-term control in keloid patients. The lower total dose with higher dose per fraction used in our patients has acceptable control along with good cosmesis and absent adverse effects.

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

Cited by 5 publications

References 24 publications

Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years

Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years

The Efficacy of CT-Based Conformal Electron Beam Radiation Therapy After Keloid Excision

Ear Keloids Treated with Postoperative Electrons: A Case Series

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