Postoperative radiotherapy of keloids: a twenty-year experience.

In spite of several treatment modalities available, there is no method able to guarantee absolute success in the therapeutic approach to keloids. To evaluate the effectiveness and safety of postoperative radiotherapy we performed a retrospective study on 156 keloids, histologically ascertained, treated by means of orthovoltage radiotherapy in the last twenty years. The total doses administered ranged from 15 to 40 Gy. The radiotherapy started within 7 days from surgery in 127 lesions (81.4%), and within 3 weeks in the remaining 29 (18.6%). Surgical methods to minimize tension at wound sites were adopted. The follow-up ranged from 6 to 216 months. After irradiation a complete remission was obtained in 141 lesions (90.4%) and a partial response in 15 lesions (9.6%). The five-year relapse-free rate was 86.68%. Cosmetic results were evaluated as good or acceptable in 82.73% of the lesions. Afterwards, 17 lesions (10.89%) have relapsed. No stochastic or non stochastic effects have been observed.