Yicel Bautista Hernandez1, Michelle Aline Villavicencio Queijero2,3, Abril Antonia Quezada Bautista4,5, Azcary Vazquez Tinajero1. 1. Hospital General de México "Dr. Eduardo Liceaga", 148 Balmis Street, Doctores Colony, Mexico City 06720, Mexico. 2. Centro Médico Nacional 20 de Noviembre, Issste (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado), 540 Felix Cuevas Street, del Valle Sur Colony, Mexico City 03100, Mexico. 3. ISSSTE and ABC Medical Center, 136 116 South, Las Americas, Alvaro Obregon, 01120, Mexico City, Mexico. 4. Fucam (Fundación de Cáncer de Mama), 100 El Bordo Avenue, El Vergel de Coyoacán Colony, México City 04980, Mexico. 5. Fucam and Hospital Juarez de Mexico, 5160 Politecnico Nacional Avenue, Magdalena de las Salinas Colony, Mexico City 07760, Mexico.
Abstract
OBJECTIVE: To demonstrate that superficial high-dose-rate (HDR) brachytherapy by means of Leipzig applicators or moulds with catheters is an adjuvant treatment with impact on local control and low toxicity. BACKGROUND: Keloid scars occur in 5-15 % of cases, secondary to an uncontrolled proliferation of fibroblasts and reduction in the inhibition of growth factors. MATERIAL AND METHODS: Retrospective, longitudinal and descriptive study in patients with keloid scars who were treated with superficial HDR brachytherapy in the General Hospital of Mexico between November 2009 and December 2013. RESULTS: Eighty patients were evaluated, and the mean follow-up was 22.18 months (range 8-48). The anatomic site treated was the ear in 72 patients (90.0 %), anterior thorax in 5 patients, retroauricular region in 2, and abdomen region in 1 patient. The application was performed 24 h after surgery; the dose for 79 patients (99 %) was 1500 cGy/3 fractions, and 1 received 500 cGy in 1 fraction. Adequate healing occurred in 76 patients (95 %), and the local failure was 5 % (95 % CI). Acute toxicity occurred in 15 % (12 patients) with grade 1 radioepithelitis. Chronic toxicity occurred in 22 patients (27.5 %) with grade 1 hypopigmentation and 18 patients (22.5 %) with grade 1 fibrosis. The cosmetic result was good in 72 patients (90 %). During follow-up, 2 patients presented recurrence, and 2 patients persisted. CONCLUSIONS: Treatment with superficial brachytherapy in keloid scars using a mould with catheters or a Leipzig applicator is a therapeutic option that results in 95 % local control and low toxicity.
OBJECTIVE: To demonstrate that superficial high-dose-rate (HDR) brachytherapy by means of Leipzig applicators or moulds with catheters is an adjuvant treatment with impact on local control and low toxicity. BACKGROUND: Keloid scars occur in 5-15 % of cases, secondary to an uncontrolled proliferation of fibroblasts and reduction in the inhibition of growth factors. MATERIAL AND METHODS: Retrospective, longitudinal and descriptive study in patients with keloid scars who were treated with superficial HDR brachytherapy in the General Hospital of Mexico between November 2009 and December 2013. RESULTS: Eighty patients were evaluated, and the mean follow-up was 22.18 months (range 8-48). The anatomic site treated was the ear in 72 patients (90.0 %), anterior thorax in 5 patients, retroauricular region in 2, and abdomen region in 1 patient. The application was performed 24 h after surgery; the dose for 79 patients (99 %) was 1500 cGy/3 fractions, and 1 received 500 cGy in 1 fraction. Adequate healing occurred in 76 patients (95 %), and the local failure was 5 % (95 % CI). Acute toxicity occurred in 15 % (12 patients) with grade 1 radioepithelitis. Chronic toxicity occurred in 22 patients (27.5 %) with grade 1 hypopigmentation and 18 patients (22.5 %) with grade 1 fibrosis. The cosmetic result was good in 72 patients (90 %). During follow-up, 2 patients presented recurrence, and 2 patients persisted. CONCLUSIONS: Treatment with superficial brachytherapy in keloid scars using a mould with catheters or a Leipzig applicator is a therapeutic option that results in 95 % local control and low toxicity.
Authors: C J H Hafkamp; O Lapid; R Dávila Fajardo; A L van de Kar; C Koedooder; L J Stalpers; B R Pieters Journal: Brachytherapy Date: 2017-01-27 Impact factor: 2.362