Eveline Bijlard1, Gerda M Verduijn2, J X Harmeling3, Homan Dehnad4, Frank B Niessen5, Otto W M Meijer6, Marc A M Mureau3. 1. Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: e.bijlard@erasmusmc.nl. 2. Department of Radiation Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. 3. Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. 4. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. 5. Department of Plastic and Reconstructive Surgery, VU Medical Center, Amsterdam, The Netherlands. 6. Department of Radiation Oncology, VU Medical Center, Amsterdam, The Netherlands.
Abstract
PURPOSE: To determine the optimal brachytherapy dose and fractionation scheme for keloid treatment. METHODS AND MATERIALS: Patient cohorts from 3 centers treated with keloid excision followed by 2 × 9 Gy, 3 × 6 Gy, or 2 × 6 Gy high-dose-rate brachytherapy were retrospectively compared regarding recurrence (after at least 12 months' follow-up) and complications (after at least 1 month's follow-up), using logistic regression analyses. RESULTS: A total of 238 keloids were treated. An overall full recurrence rate of 8.3% was found. After correction for confounders (sex, skin color, keloid location, keloid duration) no statistically significant differences in recurrence rates could be discerned between fractionation schemes. There were 12.8% major and 45.6% minor complication rates. Lower radiation dose resulted in significantly fewer complications (odds ratio 0.35, P=.015). CONCLUSIONS: After excision of resistant keloids, high-dose-rate brachytherapy with a biological equivalent dose of approximately 20 Gy is recommended, on the basis of low recurrence and complication rates.
PURPOSE: To determine the optimal brachytherapy dose and fractionation scheme for keloid treatment. METHODS AND MATERIALS: Patient cohorts from 3 centers treated with keloid excision followed by 2 × 9 Gy, 3 × 6 Gy, or 2 × 6 Gy high-dose-rate brachytherapy were retrospectively compared regarding recurrence (after at least 12 months' follow-up) and complications (after at least 1 month's follow-up), using logistic regression analyses. RESULTS: A total of 238 keloids were treated. An overall full recurrence rate of 8.3% was found. After correction for confounders (sex, skin color, keloid location, keloid duration) no statistically significant differences in recurrence rates could be discerned between fractionation schemes. There were 12.8% major and 45.6% minor complication rates. Lower radiation dose resulted in significantly fewer complications (odds ratio 0.35, P=.015). CONCLUSIONS: After excision of resistant keloids, high-dose-rate brachytherapy with a biological equivalent dose of approximately 20 Gy is recommended, on the basis of low recurrence and complication rates.
Authors: Jaclyn B Anderson; Aaron Foglio; Alex B Harrant; Christene A Huang; C Scott Hultman; David W Mathes; Tae W Chong Journal: Plast Reconstr Surg Glob Open Date: 2021-03-22
Authors: Victoria Vera Barragán; Ana Isabel Alonso García; José Fernández García; Marta De Juan Marín; Johanna Del Carmen Peña Vivas; Germán Juan Rijo Journal: J Contemp Brachytherapy Date: 2022-02-18