Excision and Radiotherapy

Compare To Other Treatments

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
▸ Based on These Clinical Studies & Trials
▾ Based on These Clinical Studies & Trials
  1. Liu, Z., Zhang, J. & Guo, X. Clinical effects of pulsed dye laser dynamically combined with triamcinolone acetonide in the treatment of postoperative recurrence keloids. Indian J Dermatol 68, 486 (2023).
  2. Dong, W., Xiao, X., Yang, X. & Zhao, Z. Efficacy and safety of surgical excision and reconstruction combined with radiotherapy for huge keloids: A 13‐year experience. J of Cosmetic Dermatology jocd.16060 (2023) doi:10.1111/jocd.16060.
  3. Mohamed, R. et al. The outcome of postoperative radiation therapy following plastic surgical resection of recurrent ear keloid: A single institution experience. J Egypt Natl Canc Inst 34, 4 (2022).
  4. Li, Y., Zhang, D., Hang, B. & Wang, H. The efficacy of combination therapy involving excision followed by intralesional 5-fluorouracil and betamethasone, and radiotherapy in the treatment of keloids: A randomized controlled trial. Clin Cosmet Investig Dermatol 15, 2845–2854 (2022).
  5. Chen, F. et al. Lesion site is the key prognostic factor for keloid patients receiving surgery with adjuvant radiotherapy. Ann Plast Surg 89, 626–630 (2022).
  6. Wen, P., Wang, T., Zhou, Y., Yu, Y. & Wu, C. A retrospective study of hypofractionated radiotherapy for keloids in 100 cases. Sci Rep 11, 3598 (2021).
  7. Rishi, K. S. et al. Single institution experience of postoperative electron beam radiation therapy in the treatment of keloids. Adv Radiat Oncol 6, 100596 (2021).
  8. Fuenmayor, P., Quiñonez, H., Salas, R. & Pujadas, Z. Outcomes of surgical excision and high-dose-rate brachytherapy for earlobe keloids. World J Plast Surg 10, 78–84 (2021).
  9. Wang, Y., Ma, J., Zhang, Z. & Shen, H. Combined surgical excision and electron external beam radiation improves the treatment of keloids: a descriptive study. Dermatol Ther 33, e13494 (2020).
  10. 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).
  11. Moura Filho, F. R., Assis, G. D. R. R., Pereira, L. S., Buffo, T. H. & Stolf, H. O. Radioterapia com feixe de elétrons adjuvante à cirurgia de queloide gigante recalcitrante na orelha. S&CD 12, (2020).
  12. Liu, Q. et al. Multi-stage surgery combined with radiotherapy for treatment of giant anterior chest wall keloid: a case report. Medicine (Baltimore) 99, e18886 (2020).
  13. Gomes, S. F. N. The efficacy of combined adjuvant radiotherapy with surgical excision in the treatment of keloids. (2020).
  14. 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).
  15. 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).
  16. Yang, X. et al. A novel radiotherapy approach for keloids with Intrabeam. Biomed Res Int 2019, 4693528 (2019).
  17. Petrou, I. G. et al. Keloid treatment: what about adjuvant radiotherapy? Clin Cosmet Investig Dermatol 12, 295–301 (2019).
  18. Ogawa, R., Tosa, M., Dohi, T., Akaishi, S. & Kuribayashi, S. Surgical excision and postoperative radiotherapy for keloids. Scars Burn Heal 5, 2059513119891113 (2019).
  19. 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).
  20. 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).
  21. Hsueh, W.-T. et al. Adjuvant radiotherapy after keloid excision: preliminary experience in Taiwan. Ann Plast Surg 82, S39–S44 (2019).
  22. 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).
  23. 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).
  24. 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).
  25. 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).
  26. 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).
  27. 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).
  28. 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).
  29. 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).
  30. 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).
  31. Hafkamp, C. J. H. et al. Postoperative single-dose interstitial high-dose-rate brachytherapy in therapy-resistant keloids. Brachytherapy 16, 415–420 (2017).
  32. 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).
  33. 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).
  34. 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).
  35. 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).
  36. 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).
  37. 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).
  38. 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).
  39. 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).
  40. 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).
  41. 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).
  42. 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).
  43. 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).
  44. 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).
  45. 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).
  46. 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).
  47. 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).
  48. Kovalic, J. J. & Perez, C. A. Radiation therapy following keloidectomy: a 20-year experience. Int J Radiat Oncol Biol Phys 17, 77–80 (1989).
  49. 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

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1 Review

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