Superficial x-ray therapy in keloid management: a retrospective study of 24 cases and literature review.

Radiotherapy for the management of keloids was introduced in 1906. Eighty-eight years later there is no consensus among physicians who treat keloids that radiotherapy is safe, although it is generally accepted that radiotherapy is effective in reducing the recurrence of keloids following excision. This paper reports on a retrospective study of 24 patients whose keloid postexcisional sites were treated with superficial x-ray therapy. This paper compares the author's results with the results of 18 studies reported by other investigators. The objective of the paper was to determine the effectiveness and safety of superficial x-ray therapy. The paper concludes that superficial x-ray therapy does reduce the rate of postexcisional keloid recurrence. It stresses the need for better controls in reporting on superficial x-ray therapy in keloid management. A multi-institutional prospective study is proposed, and a suggested protocol is outlined. There has been only one case report of a carcinoma occurring subsequent to the treatment of a keloid postexcisional site with radiotherapy, and the causal relation was questionable. A system for long-term follow-up of patients who receive superficial x-ray therapy is proposed.