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Is there an age cut off below you would not treat a keloid with radiation post surgical excision?

Assuming it has previously been treated with excision and steroid injections? Is it reasonable to treat a bothersome keloid in a pediatric patient after surgical excision or surgical re-excision with intralesional steroid injection? Do you worry about a risk of secondary malignancies?
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What is your age cut off for treating a keloid with radiotherapy?

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6 Answers
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Radiation Oncology · St Jude Children's Research Hospital
Answered on

While radiotherapy is considered an extremely useful modality in the treatment of recurrent keloids in the adult population, most would contend that the risks do not justify the application of adjuvant radiotherapy in the pediatric population (PMID: 10703484) for a benign condition when other modali...

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Radiation Oncology · University of Texas MD Anderson Cancer Center
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I have treated children as young as 13 years. I remember a case of a 13-year-old with a history of recurrent keloids s/p 3 surgeries, steroid injections, pressure earring. The recurrent keloid was like a small pear hanging and she has been bullied in school (calling her names, playing with her keloi...

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Radiation Oncology · Fox Chase Cancer Center
Answered on

I do not have a set age limit in my practice. However, having said that, I have seen younger patients, and especially those who have not tried other options, and I sent them to my plastic surgeon for steroids and re-resection before considering radiation. Fortunately, those patients have not yet rep...

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Radiation Oncology
Answered on

I tried diligently to not treat younger patients with keloids. However, I remember treating an 11-year-old with severe keloids to his arms and hands from hot grease. The keloids caused contractures of his thumbs to his distal arms so he had no appositional grasp. His plastic surgery to excise the ke...

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Radiation Oncology · Beaumont Hospital
Answered on

A great question. The literature reports on children as young as 2 being treated. Of course, the implied concern about SMN is very relevant. However, when we wrote our series and reviewed the literature regarding radiation induced second malignancies, we could only find a handful with a denominator ...

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Radiation Oncology · Physician Health Partners
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I agree.

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