Clin Oncol (R Coll Radiol) 2004-06-01
Retrospective analysis of treatment of unresectable keloids with primary radiation over 25 years.
Abstract
Aims
The purpose of the study was to review retrospectively the role of primary radiotherapy for unresectable keloids.
Materials and methods
Kilovoltage X-rays and mega-voltage electron beams were used to irradiate large bulky unresectable keloids. A total of 3750 cGy was given in five once-weekly fractions, over a period of 5 weeks. Eighty-six keloids in 64 patients were treated between 1977 and 2002.
Results
Ninety-seven per cent of this cohort had significant regression, and 3% had partial regression 18 months after completing radiotherapy. Both acute and long-term reactions were acceptable, and so far none of the patients have been reported as having cancer of any sort. Sixty-three per cent of the patients surveyed were very happy with the outcome of their treatment.
Conclusion
Unresectable bulky symptomatic keloids can be satisfactorily treated with hypo-fractionated radiotherapy primarily using either kilovoltage X-rays or electron beams without significant short- or long-term side-effects.
Related Questions
Would you offer upfront radiation for a large painful keloid of the chest that has arisen from an irritated pyoderma gangrenosum lesion?
Radiation therapy is actually used (rarely) for pyoderma gangrenosum that has been unresponsive to medical management via immunosuppression [1]. Single fraction doses of 400 to 800 cGy have been used with slow regression of the lesions. In the case report cited, the lesion started fading after 3 mon...
What is your regimen for treating a keloid with radiation alone?
Our institutional experience (Hoang, Aesthet Surg J 2017) has largely been with post-excisional RT, although at our institution we have on occasion treated definitively with RT alone. We do not have a standardized regimen for primary RT at our institution and the Malaker et al article is the only pu...