Papers of The 2nd Japan Scar Workshop

12. Postoperative irradiation of a giant keloid of the upper arm using a high-dose-rate brachytherapy mold

Shigehiko Kuribayashi, Tsuguhiro Miyashita
Department of Radiation Oncology, Nippon Medical School Hospital, Tokyo, Japan

Postoperative radiation for keloids with long dimensions or on a markedly curved surface is difficult because the radiation dose is distributed non-uniformly, which may cause keloid relapse. We reported on the use of postoperative radiotherapy using a high-dose-rate (HDL) brachytherapy mold for a huge keloid of the arm. An 18-year-old man with a keloid >25 cm on the right upper arm underwent surgical excision and postoperative irradiation using a HDR brachytherapy mold. A shell matching the shape of the arm was made and used as a bolus. The applicator tubes were put on the shell to conform to the operation wound lines. Dose evaluation points were established from the source axis, and 15 Gy was given in two fractions over two days. No relapse or side effects were observed in three months of irradiation. The HDR brachytherapy mold could be used for postoperative irradiation for patients with keloids under special conditions.
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