title: Hypofractionated electron-beam radiation therapy for keloids: retrospective study of 568 cases with 834 lesions.
abstract: We aimed to analyze the outcomes of hypofractionated high-energy electron beam radiotherapy for the treatment of keloids. From February 1998 to January 2012, 568 patients with a total of 834 keloids underwent radiotherapy: 826 lesions with postoperative radiotherapy, and 36 with skin-grafting. Lesion size was >5 cm in 335 keloids. An electron-beam of 6 or 7 MeV was used, with a total dose of 18 Gy (two fractions with a 1-week interval) covering the lesion with a 1-cm margin. The time between surgery and radiotherapy was 24-48 h. Skin-grafted patients underwent radiotherapy 10-15 days after the operation. The median follow-up was 40 months (range: 12-160 months). The local control rate was 88.25% (736/834). The relapse rate was 9.59% (80/834), and the time to relapse was 6-28 months (median: 12 months). Univariate analyses showed that gender, age, keloid size, keloid site, skin grafting, and operation-to-irradiation interval influenced the local control rate. Multivariate analysis showed that the relapse rate was correlated with gender (P = 0.048), age (P < 0.01), operation-to-irradiation interval (P < 0.01), keloid site (P < 0.01), surgical method (P = 0.04) and keloid size (P < 0.02). Adverse effects were observed in 9.83% (82/834). No radiation-induced cancers were observed. Hypofractionated high-energy electron beam radiotherapy for keloids yielded excellent outcomes, especially in cases without skin grafting. Early postoperative radiotherapy with limited hypofractionation could be a good choice for keloid treatment.
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Lian
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Yuliang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Hu
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Hou
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Junfang
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Lang
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Xiansong
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Xinhai
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Guan
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China.
authors.forename: Tingtian
authors.initials: T
authors.lastname: Pang
authors.affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Bei Jing, 100000, China zhangfuquan3@sina.com.
authors.forename: Fuquan
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019583:Dose Fractionation, Radiation; D004583:Electrons; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D011878:Radiotherapy / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: assessment; electron beam; keloids; prognosis; radiotherapy