Surgical treatment of keloid scars is associated with an approximately 70% recurrence rate at the excision site. 

 

A new study published in The Journal of Clinical and Aesthetic Dermatology aimed to assess keloid recurrence rates when superficial radiation therapy (SRT) was applied following surgical excision. 

 

This was a retrospective registry study wherein medical records of subjects treated for keloid scars, followed by SRT, using a biologically effective dose (BED) of 30Gy, were reviewed. Overall, 61 eligible subjects – 48% males and female 52% females with a mean age of 38.87 years, were treated for 96 keloid scars with SRT. Subjects were treated for ≥1 keloid scar, following removal by sutured excision (93%) or tangential excision with secondary intention technique (7%). Almost all subjects (98%) received BED 30Gy with irradiation scheme of three 6Gy SRT treatments on Days 1, 2 and 3 postsurgery. Mean energy of 100KV (73%) or 70KV (27%) were applied.

 

The results showed that ten treated keloidectomy sites (10.4%) had recurrences within 12 months, which increased to 11 (12.7%) at 18 months. While Kaplan-Meier survival probability cure rate was 85.6% from 24 months post-SRT treatment onwards. Transient hyperpigmentation was the most frequent adverse event and there were no malignancies in the treatment area during follow-up evaluations. 

 

It was concluded that SRT with a BED value of 30 Gy delivered to keloidectomy excision sites immediately following excision was well-tolerated and resulted in markedly fewer long-term recurrences than reported following keloidectomy alone. Most keloid scar recurrences occurred within one year. There were no malignancies during follow-up evaluations. These findings are consistent with recent consensus recommendations on the treatment of keloidectomy sites with superficial radiation.

 

Source: The Journal of Clinical and Aesthetic Dermatology. 2020 Oct;13(10):12-16.