title: Post-keloidectomy irradiation using high-dose-rate superficial brachytherapy.
abstract: A study was conducted to evaluate the early results of high-dose-rate superficial brachytherapy (HDR-SB) after keloidectomy. Between April 2008 and April 2009, 21 patients with 36 histologically confirmed keloids were treated with postoperative HDR-SB. The tube applicator was placed on the skin to match the area of the surgical wound, and a spacer 5 mm thick was placed between the skin and the applicator. A dose evaluation point was established below 2 mm from skin surface, and 20 Gy was delivered in 4 daily fractions to keloidectomy scars on the anterior chest wall, scapular region, lower jaw and suprapubic region. A dose of 15 Gy was delivered in 3 daily fractions to lesions in other areas. The median follow-up period was 18 months (range, 9 to 29 months). Therapeutic outcome was judged in terms of recurrence, control, or acute side effects. Three keloids (9.7%) in two patients showed local recurrence, with a median time to failure after HDR-SB of 12 months. All recurrences affected the anterior chest wall. Dysraphia occurred in only one patient with an anterior chest wall lesion. Excluding the cases of recurrence, acceptable cosmetic results were achieved. Our results indicate that HDR-SB is effective and safe for preventing recurrence of keloids.
authors.affiliation: Department of Radiology, Nippon Medical School, Tokyo. s5043@nms.ac.jp
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Kuribayashi
authors.forename: Tsuguhiro
authors.initials: T
authors.lastname: Miyashita
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Ozawa
authors.forename: Marie
authors.initials: M
authors.lastname: Iwano
authors.forename: Rei
authors.initials: R
authors.lastname: Ogawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Akaishi
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Dohi
authors.forename: Hiko
authors.initials: H
authors.lastname: Hyakusoku
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kumita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007627:Keloid / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome; D055815:Young Adult