What Is It?
First, a raised scar is surgically removed. Then, to prevent recurrence of the scar, radiotherapy is used hours or days following the surgery.
Even though excision + radiotherapy treatment completely removes the scar(s), in some cases, scar(s) may grow back after the treatment.
Non-recurrence rate
Strength of Evidence
1
2
3
4
5
Permanently reduces the scarring in 80% of cases
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- Son, Y. et al. Treatment of keloids with a single dose of low-energy superficial X-ray radiation to prevent recurrence after surgical excision: an in vitro and in vivo study. J Am Acad Dermatol 83, 1304–1314 (2020).
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- Daurade, M. et al. Efficacy of surgical excision and brachytherapy in the treatment of keloids: a retrospective cohort study. Adv Skin Wound Care 33, 1–6 (2020).
- Bradshaw, B. et al. Comparison of superficial radiation and HDR brachytherapy following surgical excision for keloid. International Journal of Radiation Oncology, Biology, Physics 108, e232 (2020).
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- Petrou, I. G. et al. Keloid treatment: what about adjuvant radiotherapy? Clin Cosmet Investig Dermatol 12, 295–301 (2019).
- Ogawa, R., Tosa, M., Dohi, T., Akaishi, S. & Kuribayashi, S. Surgical excision and postoperative radiotherapy for keloids. Scars Burn Heal 5, 2059513119891113 (2019).
- Liu, C.-L. & Yuan, Z.-Y. Retrospective study of immediate postoperative electron radiotherapy for therapy-resistant earlobe keloids. Arch Dermatol Res 311, 469–475 (2019).
- Jones, M. E., Ganzer, C. A., Bennett, D. & Finizio, A. Surgical excision of keloids followed by in-office superficial radiation therapy: prospective study examining clinical outcomes. Plast Reconstr Surg Glob Open 7, e2212 (2019).
- Hsueh, W.-T. et al. Adjuvant radiotherapy after keloid excision: preliminary experience in Taiwan. Ann Plast Surg 82, S39–S44 (2019).
- Sruthi, K., Chelakkot, P. G., Madhavan, R., Nair, R. R. & Dinesh, M. Single-fraction radiation: a promising adjuvant therapy to prevent keloid recurrence. J Cancer Res Ther 14, 1251–1255 (2018).
- Song, K.-X. et al. Hyperbaric oxygen therapy improves the effect of keloid surgery and radiotherapy by reducing the recurrence rate. J Zhejiang Univ Sci B 19, 853–862 (2018).
- Renz, P. et al. Dose effect in adjuvant radiation therapy for the treatment of resected keloids. Int J Radiat Oncol Biol Phys 102, 149–154 (2018).
- Khalid, F. A. et al. The efficacy of excision followed by intralesional 5-fluorouracil and triamcinolone acetonide versus excision followed by radiotherapy in the treatment of ear keloids: a randomized control trial. Burns 44, 1489–1495 (2018).
- Jiang, P. et al. Efficacy and the toxicity of the interstitial high-dose-rate brachytherapy in the management of recurrent keloids: 5-year outcomes. Brachytherapy 17, 597–600 (2018).
- Bijlard, E. et al. Intralesional cryotherapy versus excision with corticosteroid injections or brachytherapy for keloid treatment: randomised controlled trials. J Plast Reconstr Aesthet Surg 71, 847–856 (2018).
- Taheri, A., Molaei, H., Aghili, M., Rahmanpanah, N. & Mirmohseni, A. Outcomes of surgical excision and brachytherapy in intractable keloids. World J Plast Surg 6, 280–284 (2017).
- Mankowski, P., Kanevsky, J., Tomlinson, J., Dyachenko, A. & Luc, M. Optimizing radiotherapy for keloids: a meta-analysis systematic review comparing recurrence rates between different radiation modalities. Ann Plast Surg 78, 403–411 (2017).
- Hoang, D. et al. Surgical excision and adjuvant brachytherapy vs external beam radiation for the effective treatment of keloids: 10-year institutional retrospective analysis. Aesthet Surg J 37, 212–225 (2017).
- Hafkamp, C. J. H. et al. Postoperative single-dose interstitial high-dose-rate brachytherapy in therapy-resistant keloids. Brachytherapy 16, 415–420 (2017).
- Bennett, K. G., Kung, T. A., Hayman, J. A. & Brown, D. L. Treatment of keloids with excision and adjuvant radiation: a single center experience and review of the literature. Ann Plast Surg 78, 157–161 (2017).
- Jiang, P. et al. Perioperative interstitial high-dose-rate brachytherapy for the treatment of recurrent keloids: feasibility and early results. Int J Radiat Oncol Biol Phys 94, 532–536 (2016).
- Shen, J. et al. Hypofractionated electron-beam radiation therapy for keloids: retrospective study of 568 cases with 834 lesions. J Radiat Res 56, 811–817 (2015).
- R, O. et al. Analysis of the surgical treatments of 63 keloids on the cartilaginous part of the auricle: effectiveness of the core excision method. Plastic and reconstructive surgery vol. 135 https://pubmed.ncbi.nlm.nih.gov/25719703/ (2015).
- Keeling, B. H., Whitsitt, J., Liu, A. & Dunnick, C. A. Keloid removal by shave excision with adjuvant external beam radiation therapy. Dermatol Surg 41, 989–992 (2015).
- Vila Capel, A., Vilar Palop, J., Pedro Olivé, A. & Sánchez-Reyes Fernández, A. Adjuvance in refractory keloids using electron beams with a spoiler: recent results. Rep Pract Oncol Radiother 20, 43–49 (2014).
- Van Leeuwen, M. C. E. et al. High-dose-rate brachytherapy for the treatment of recalcitrant keloids: a unique, effective treatment protocol. Plast Reconstr Surg 134, 527–534 (2014).
- Rong, L. et al. Long-term results of postoperative electronic irradiation for 53 patients with keloids. Zhonghua Zheng Xing Wai Ke Za Zhi 30, 270–274 (2014).
- Chen, Y. et al. Postoperative carbon ion radiotherapy for keloids: a preliminary report of 16 cases and review of the literature. Wounds 26, 264–272 (2014).
- Aluko-Olokun, B., Olaitan, A. A., Ladeinde, A. L. & Oginni, F. O. The facial keloid: a comparison of treatment outcome between intralesional steroid injection and excision combined with radiotherapy. Eur J Plast Surg 37, 361–366 (2014).
- Sakamoto, T., Oya, N., Shibuya, K., Nagata, Y. & Hiraoka, M. Dose-response relationship and dose optimization in radiotherapy of postoperative keloids. Radiother Oncol 91, 271–276 (2009).
- Bukvić-Mokos, Z., Lipozencić, J. & Marinović, B. Different therapeutic modalities in a patient with multiple spontaneously developed keloids--a case report. Coll Antropol 30, 941–944 (2006).
- Sclafani, A. P., Gordon, L., Chadha, M. & Romo, T. Prevention of earlobe keloid recurrence with postoperative corticosteroid injections versus radiation therapy: a randomized, prospective study and review of the literature. Dermatol Surg 22, 569–574 (1996).
- Norris, J. E. Superficial x-ray therapy in keloid management: a retrospective study of 24 cases and literature review. Plast Reconstr Surg 95, 1051–1055 (1995).
- Darzi, M. A., Chowdri, N. A., Kaul, S. K. & Khan, M. Evaluation of various methods of treating keloids and hypertrophic scars: a 10-year follow-up study. Br J Plast Surg 45, 374–379 (1992).
- Supe, S. S., Supe, S. J., Rao, S. M., Deka, A. C. & Deka, B. C. Treatment of keloids by 90Sr-90Y beta-rays. Strahlenther Onkol 167, 397–402 (1991).
- Kovalic, J. J. & Perez, C. A. Radiation therapy following keloidectomy: a 20-year experience. Int J Radiat Oncol Biol Phys 17, 77–80 (1989).
- King, G. D. & Salzman, F. A. Keloid scars. Analysis of 89 patients. Surg Clin North Am 50, 595–598 (1970).
Side Effects
High
High side effects and adverse reactions
Reviews
1.0
1 Review