Papers of The 1st Japan Scar Workshop

9. Postoperative Radiation Therapy for Keloids -Investigation of the Optimal Dose of Electron-beam Irradiation

Ogawa R1, Akaishi S1, Kuribayashi S2, Tateno A2, Miyashita T2, Hyak/usoku H1

BACKGROUND: In our department, we have treated keloids with postoperative electron-beam irradiation. Up to 2002, we treated all regions with 15Gy/3fractions/3days, but since 2003, we have used 20Gy/4fractions/4days for the anterior chest, scapular and suprapubic regions; 10Gy/2fractions/2days for the earlobe; and 15Gy/3fractions/3days for all other regions. The purpose of this study was to investigate the optimal dose of postoperative irradiation. METHODS: Cases that had been followed up for over eighteen months were selected, and their therapeutic outcomes evaluated. Statistical analysis was performed using Fisher’s exact probability test or Chi-square test. RESULTS: 249 regions treated before 2002, and 109 regions treated since 2003 were selected for this study. The total recurrence rate was 28.9% (pre-2002) and 12.8% (post-2003). The rates for the anterior chest were significantly lower post-2003, but for the earlobe, there was no difference between the 15Gy (pre-2002) and 10Gy (post-2003) groups. CONCLUSIONS: The results suggest that keloid sites with a high risk of recurrence should be treated with 20Gy/4fractions/4days. Moreover, that the earlobe can be treated with 10Gy/2fractions/2days.
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