Ping Jiang1, Matthias Geenen2, Frank-André Siebert3, Julia Bertolini4, Bjoern Poppe5, Ulf Luetzen6, Juergen Dunst7, Daniel Druecke4. 1. Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany. Electronic address: fraujiang@hotmail.com. 2. Department of Reconstructive Surgery, Lubinus Clinic Kiel, Kiel, Germany. 3. Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany. 4. Department of Reconstructive Surgery, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany. 5. University Clinic for Medical Radiation Physics, Medical Campus Pius-Hospital, Carl von Ossietzky University, Oldenburg, Germany. 6. Department of Nuclear Medicine, University Clinic Schleswig-Holstein, Campus Kiel, Germany. 7. Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Radiation Oncology, University of Copenhagen, Denmark.
Abstract
PURPOSE: Recurring keloids are a clinical challenge. Interdisciplinary treatments are required in most cases. Owing to the wide variety of concepts, the optimal treatment regime remains unclear. Our clinic established a protocol of perioperative interstitial high-dose-rate brachytherapy with three fractions of 6 Gy and achieved an excellent 2-year local control rate of 94% (In search of the optimal treatment of keloids: Report of a series and a review of the literature). This report is an update on our long-term results of prospective study. Twenty-nine patients were included with a median followup of 5 years. METHODS AND MATERIALS: From 2009 to 2015, 29 patients with 37 recurrent keloids were treated with perioperative interstitial high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiotherapy and presented with recurrences in the pretreated area. Brachytherapy was given in three fractions with a single dose of 6 Gy in 5-mm tissue depth and covered the scar in total length. Followup visits were scheduled at 6 weeks, 3 months, 6 months, 1 year, and annually thereafter. Therapeutic outcome was assessed in terms of recurrence, acute and late complications, and cosmetic results. RESULTS: No procedure-related complications occurred. Improvement of keloid-related symptoms was noticed in all patients after treatment. After a median followup of 49.7 months (range: 7.9-91.9 months), three keloid recurrences and two hypertrophied scars were observed. CONCLUSIONS: Our results suggest that brachytherapy may be advantageous in the management of high-risk keloids, even after failure of external beam radiotherapy and other treatment procedures. Our three-fraction treatment schedule reduces the treatment period to 2 days and is therefore convenient for the patients.
PURPOSE: Recurring keloids are a clinical challenge. Interdisciplinary treatments are required in most cases. Owing to the wide variety of concepts, the optimal treatment regime remains unclear. Our clinic established a protocol of perioperative interstitial high-dose-rate brachytherapy with three fractions of 6 Gy and achieved an excellent 2-year local control rate of 94% (In search of the optimal treatment of keloids: Report of a series and a review of the literature). This report is an update on our long-term results of prospective study. Twenty-nine patients were included with a median followup of 5 years. METHODS AND MATERIALS: From 2009 to 2015, 29 patients with 37 recurrent keloids were treated with perioperative interstitial high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiotherapy and presented with recurrences in the pretreated area. Brachytherapy was given in three fractions with a single dose of 6 Gy in 5-mm tissue depth and covered the scar in total length. Followup visits were scheduled at 6 weeks, 3 months, 6 months, 1 year, and annually thereafter. Therapeutic outcome was assessed in terms of recurrence, acute and late complications, and cosmetic results. RESULTS: No procedure-related complications occurred. Improvement of keloid-related symptoms was noticed in all patients after treatment. After a median followup of 49.7 months (range: 7.9-91.9 months), three keloid recurrences and two hypertrophied scars were observed. CONCLUSIONS: Our results suggest that brachytherapy may be advantageous in the management of high-risk keloids, even after failure of external beam radiotherapy and other treatment procedures. Our three-fraction treatment schedule reduces the treatment period to 2 days and is therefore convenient for the patients.
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
Authors: Kwanza T Warren; Andrew Boucher; David P Bray; Sean Dresser; Jim Zhong; Hiu-Kuo Shu; Jeffrey Olson; Kimberly Hoang Journal: Cureus Date: 2021-11-20