Excision and Radiotherapy

What Is It?

This method involves surgically removing the scar. Then, to prevent recurrence of the scar, radiotherapy is used hours or days following the surgery. Radiotherapy decreases the activity of cells present in the skin that normally produce collagen.

Non-recurrence rate

Strength of Evidence
Average 80% reduction in scarring
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  12. Berman, B. et al. A retrospective registry study evaluating the long-term efficacy and safety of superficial radiation therapy following excision of keloid scars. J Clin Aesthet Dermatol 13, 12–16 (2020).
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  16. 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).
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  22. 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).
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  25. 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).
  26. Qiao, X. F. & Li, X. Comparative study of surgical treatment combined with various methods for treatment of ear scar. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 31, 1341–1343 (2017).
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  28. 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).
  29. Hafkamp, C. J. H. et al. Postoperative single-dose interstitial high-dose-rate brachytherapy in therapy-resistant keloids. Brachytherapy 16, 415–420 (2017).
  30. 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).
  31. 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).
  32. 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).
  33. 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).
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  35. Wang, Q. et al. Effect of two dose fractionations on postoperative radiotherapy of keloid: an analysis of 107 patients. Beijing Da Xue Xue Bao Yi Xue Ban 46, 169–172 (2014).
  36. 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).
  37. 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).
  38. 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).
  39. 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).
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  42. 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).
  43. 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).
  44. 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).
  45. 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).
  46. 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).
  47. Sällström, K. O. et al. Treatment of keloids with surgical excision and postoperative X-ray radiation. Scand J Plast Reconstr Surg Hand Surg 23, 211–215 (1989).
  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. Enhamre, A. & Hammar, H. Treatment of keloids with excision and postoperative X-ray irradiation. Dermatologica 167, 90–93 (1983).
  50. King, G. D. & Salzman, F. A. Keloid scars. Analysis of 89 patients. Surg Clin North Am 50, 595–598 (1970).

Side Effects

High side effects and adverse reactions


1 Review