Brian Berman1,2,3,4,5, Mark S Nestor1,2,3,4,5, Michael H Gold1,2,3,4,5, David J Goldberg1,2,3,4,5, Eduardo T Weiss1,2,3,4,5, Isabelle Raymond1,2,3,4,5. 1. Drs. Berman and Nestor are with the Center for Clinical and Cosmetic Research in Aventura, Florida. 2. Dr. Gold is with the Gold Skin Care Center in Nashville, Tennessee. 3. Dr. Goldberg is with the Skin Laser & Surgery Specialists of NY/NJ in New York City, New York. 4. Dr. Weiss is with the Memorial Health System in Hollywood, Florida. 5. Dr. Raymond is with Memorial Health System in Boca Raton, Florida.
Abstract
BACKGROUND: Surgical treatment of keloid scars is associated with an approximately 70% recurrence rate at the excision site. OBJECTIVE: We sought to assess keloid recurrence rates when superficial radiation therapy (SRT) was applied following surgical excision. METHODS: Medical records were reviewed of subjects treated for keloid scars followed by SRT (SRT-100™; Sensus Healthcare, Boca Raton, Florida) using a biologically effective dose (BED) of 30Gy and for whom the required retrospective data was available. Eligible subjects (N=61) were treated for 96 keloid scars with SRT. Subjects were male (48%) and female (52%) with a mean age of 38.87 years. Subjects were treated for ≥1 keloid scars following removal by sutured excision (93%) or tangential excision with secondary intention technique (7%). Almost all subjects (98%) received BED 30Gy with irradiation scheme of three 6Gy SRT treatments on Days 1, 2 and 3 following surgery. Mean energy of 100KV (73%) or 70KV (27%) were applied. RESULTS: Ten treated keloidectomy sites (10.4%) had recurrences (i.e., presence of any new tissue growth on the surgical scar) within 12 months increasing to 11 (12.7%) at 18 months. Kaplan-Meier survival probability cure rate was 85.6% from 24 months post-SRT treatment onwards. Transient hyperpigmentation was the most frequent adverse event and there were no malignancies in the treatment area during follow-up evaluations. CONCLUSIONS: SRT with a BED value of 30 Gy delivered to keloidectomy excision sites immediately following excision was well-tolerated and resulted in markedly fewer long-term recurrences than reported following keloidectomy alone. Most keloid scar recurrences occurred within one year. There were no malignancies during follow-up evaluations.
BACKGROUND: Surgical treatment of keloid scars is associated with an approximately 70% recurrence rate at the excision site. OBJECTIVE: We sought to assess keloid recurrence rates when superficial radiation therapy (SRT) was applied following surgical excision. METHODS: Medical records were reviewed of subjects treated for keloid scars followed by SRT (SRT-100™; Sensus Healthcare, Boca Raton, Florida) using a biologically effective dose (BED) of 30Gy and for whom the required retrospective data was available. Eligible subjects (N=61) were treated for 96 keloid scars with SRT. Subjects were male (48%) and female (52%) with a mean age of 38.87 years. Subjects were treated for ≥1 keloid scars following removal by sutured excision (93%) or tangential excision with secondary intention technique (7%). Almost all subjects (98%) received BED 30Gy with irradiation scheme of three 6Gy SRT treatments on Days 1, 2 and 3 following surgery. Mean energy of 100KV (73%) or 70KV (27%) were applied. RESULTS: Ten treated keloidectomy sites (10.4%) had recurrences (i.e., presence of any new tissue growth on the surgical scar) within 12 months increasing to 11 (12.7%) at 18 months. Kaplan-Meier survival probability cure rate was 85.6% from 24 months post-SRT treatment onwards. Transient hyperpigmentation was the most frequent adverse event and there were no malignancies in the treatment area during follow-up evaluations. CONCLUSIONS: SRT with a BED value of 30 Gy delivered to keloidectomy excision sites immediately following excision was well-tolerated and resulted in markedly fewer long-term recurrences than reported following keloidectomy alone. Most keloid scar recurrences occurred within one year. There were no malignancies during follow-up evaluations.
Authors: T van der Aa; S H W L Verhiel; M Erends; A A Piatkowski de Grzymala; E Van den Kerckhove; C Colla; R R W J van der Hulst Journal: J Plast Reconstr Aesthet Surg Date: 2015-07-16 Impact factor: 2.740
Authors: Marcello Pozzi; Giovanni Zoccali; Maria C Drago; Maria A Mirri; Maurizio Costantini; Roy DE Vita Journal: G Ital Dermatol Venereol Date: 2015-04-24 Impact factor: 2.011
Authors: Mark S Nestor; Brian Berman; David Goldberg; Armand B Cognetta; Michael Gold; William Roth; Clay J Cockerell; Brad Glick Journal: J Clin Aesthet Dermatol Date: 2019-02-01
Authors: S H W L Verhiel; A A Piatkowski de Grzymala; E Van den Kerckhove; C Colla; R R W J van der Hulst Journal: Skin Res Technol Date: 2016-06-10 Impact factor: 2.365