Descriptive study of patients receiving excision and radiotherapy for keloids.
OBJECTIVE
To review and describe our institution's outcomes in patients treated with external beam radiotherapy after keloid excision.


METHODS
This was a retrospective study. Patients who received radiotherapy between July 1994 and January 2004 after keloid excision were identified. A questionnaire was mailed regarding sociodemographic factors, early and late radiation toxicities, the need for additional therapy, and satisfaction level. All patients had received a total of 15 Gy in three daily 5-Gy fractions. Treatment started within 24 h after surgery and was delivered on a Siemens orthovoltage machine. The data were analyzed using the STATA statistical package.


RESULTS
A total of 234 patients were approached. The response rate was 41%, and 75% were female. The mean age was 36.5 years (range, 16-69 years). The patients were mainly of European (53.1%) or African (19.8%) descent. For early toxicity outcomes, 54.2% reported skin redness and 24% reported skin peeling. For late toxicity outcomes, 27% reported telangiectasia and 62% reported permanent skin color changes. No association was found with gender, skin color, or age for the late toxicity outcomes. Of the patients responding, 14.6% required adjuvant treatment. On a visual scale of 1-10 for the satisfaction level, 60% reported a satisfaction level of > or =8. Telangiectasia was the most significant predictor of a low satisfaction level (< or =3, p < 0.005).


CONCLUSIONS
The results of our study have shown that orthovoltage-based radiotherapy after surgical excision for keloids is a good method for the prevention of relapse. It is well tolerated, causes little toxicity, and leads to a high patient satisfaction level.
Speranza
Giovanna
G
Department of Medical Oncology, Jewish General Hospital, McGill University, 3755 rue de la Côte Ste. Catherine, Montreal, Quebec, Canada. giovanna.speranza@mail.mcgill.ca
Sultanem
Khalil
K
Muanza
Thierry
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007627:Keloid / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012880:Skin Pigmentation / Q000187:drug effects / Q000528:radiation effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome