Keloids treated with excision followed by radiation therapy.
BACKGROUND
In the treatment of keloids surgical excision followed by radiation therapy provides the highest reported control rates of 72% to 92%.


OBJECTIVE
We evaluated the effectiveness of excision followed by radiation therapy in the treatment of keloids and compared the efficacy of orthovoltage and electron beam radiation.


METHODS
One hundred twenty-six keloids were treated with radiation therapy after surgical excision. Median follow-up period was 12 years. Recurrence rate, side effects, and effectiveness of therapy were assessed. Data were analyzed with multivariate analysis for significant objective and subjective factors.


RESULTS
Higher posttreatment recurrence rates were noted with keloids forming at infected sites and in patients with a family history. No increased likelihood of recurrence was noted with respect to patient age, sex, or ethnicity; keloid size or location; individual keloid history; or prior therapy or radiation type used.


CONCLUSIONS
Excision followed by radiation therapy is a useful and effective method of keloid eradication, particularly in cases in which lesions are disfiguring or refractory. Electron beam radiation offers no advantage over orthovoltage as a treatment.
Division of Dermatology, Duke University Medical Center, Durham, NC 27710.
D I
DI
Klumpar
J C
JC
Murray
M
M
Anscher
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome