Wagner W, Alfrink M, Micke O, Schäfer U, Schüller P, Willich N
Paracelsus-Strahlenklinik, Osnabrück, Germany.
Acta Oncol. 2000;39(2):217-20. doi: 10.1080/028418600430806.
The data of 139 patients with 166 keloids treated postoperatively between 1962 and 1996 were evaluated for prognostic factors and outcomes. Treatment commenced within 48 h after surgery. Radiotherapy was carried out as brachytherapy, using an integrated radionuclide 90 Sr-90Y surface applicator. The median dose delivered to the subcutis amounted to 14 Gy (range 7.5-28.5 Gy). The overall recurrence-free response rate was calculated to be 80% for all keloids. Response rates differed significantly (p < 0.001) between the different anatomical regions. The recurrence rate was lowest (2%) with keloids of the face and neck and highest with keloids of the thorax (49%). Outcome also differed significantly, depending on the etiology. Keloids following burns had a poorer success rate than those developing after surgery or mechanical trauma (p < 0.001). We were unable to demonstrate any significance in outcome related to gender, age or size. No direct correlation was found between total doses and response rates. In our patients there were no signs of secondary malignancies in the irradiation area within a median follow-up period of 12 years. Two new prognostic factors have been identified: keloid etiology and localization of the disorder.
对1962年至1996年间术后治疗的139例患者的166个瘢痕疙瘩数据进行了预后因素和结果评估。治疗在术后48小时内开始。放射治疗采用近距离放疗，使用集成放射性核素90 Sr-90Y表面敷贴器。皮下组织的中位剂量为14 Gy（范围7.5-28.5 Gy）。所有瘢痕疙瘩的总体无复发生存率计算为80%。不同解剖区域之间的反应率差异显著（p<0.001）。面部和颈部瘢痕疙瘩的复发率最低（2%），胸部瘢痕疙瘩的复发率最高（49%）。结果也因病因不同而有显著差异。烧伤后形成的瘢痕疙瘩成功率低于手术或机械创伤后形成的瘢痕疙瘩（p<0.001）.我们未能证明与性别、年龄或大小相关的结果有任何显著性。未发现总剂量与反应率之间有直接相关性。在中位随访期12年的患者中，照射区域未出现继发性恶性肿瘤迹象。已确定两个新的预后因素：瘢痕疙瘩病因和疾病部位。
