Abstract
There are two main options for radiotherapy after keloidectomy : external radiotherapy (ERT) using electron-beam and high-dose-rate interstitial brachytherapy (HDR-ISBT).
In our institute, we determine the method according to the conditions of each keloid. We usually apply radiotherapy only for keloids on the anterior chest wall, shoulder, and pubic area. We apply radiotherapy for spontaneously formed keloids, recurrent keloids, and when the patient strongly wants radiotherapy. ERT is most suitable for flat areas with bone just beneath the surface and areas reconstructed with flaps or skin grafts. HDR-ISBT is suitable for keloids on curved surfaces, keloids that recur after radiotherapy, and when the patient prefers a shorter period of radiotherapy.
We treated 51 patients (64 keloids) with surgery and followed them for more than one year. Adjuvant radiotherapy was administered to 13 patients (19 keloids). The total dose of ERT was 15 Gy (3 fractions), and that of HDR-ISBT was 12 to 24 Gy (2 to 4 fractions). Only two of 19 keloids recurred after radiotherapy (10.5%), and in both cases, the patients had multiple spontaneously formed keloids and they were treated with only 12 Gy (2 fractions) of HDR-ISBT.
In conclusion, our study demonstrated the effectiveness of radiotherapy after keloidectomy.
