Speranza Giovanna, Sultanem Khalil, Muanza Thierry
Department of Medical Oncology, Jewish General Hospital, McGill University, 3755 rue de la Côte Ste. Catherine, Montreal, Quebec, Canada.
Int J Radiat Oncol Biol Phys. 2008 Aug 1;71(5):1465-9. doi: 10.1016/j.ijrobp.2007.12.015. Epub 2008 Feb 4.
To review and describe our institution's outcomes in patients treated with external beam radiotherapy after keloid excision.
This was a retrospective study. Patients who received radiotherapy between July 1994 and January 2004 after keloid excision were identified. A questionnaire was mailed regarding sociodemographic factors, early and late radiation toxicities, the need for additional therapy, and satisfaction level. All patients had received a total of 15 Gy in three daily 5-Gy fractions. Treatment started within 24 h after surgery and was delivered on a Siemens orthovoltage machine. The data were analyzed using the STATA statistical package.
A total of 234 patients were approached. The response rate was 41%, and 75% were female. The mean age was 36.5 years (range, 16-69 years). The patients were mainly of European (53.1%) or African (19.8%) descent. For early toxicity outcomes, 54.2% reported skin redness and 24% reported skin peeling. For late toxicity outcomes, 27% reported telangiectasia and 62% reported permanent skin color changes. No association was found with gender, skin color, or age for the late toxicity outcomes. Of the patients responding, 14.6% required adjuvant treatment. On a visual scale of 1-10 for the satisfaction level, 60% reported a satisfaction level of > or =8. Telangiectasia was the most significant predictor of a low satisfaction level (< or =3, p < 0.005).
The results of our study have shown that orthovoltage-based radiotherapy after surgical excision for keloids is a good method for the prevention of relapse. It is well tolerated, causes little toxicity, and leads to a high patient satisfaction level.
回顾并描述我院在瘢痕疙瘩切除术后接受外照射放疗患者的治疗结果。
这是一项回顾性研究。确定了1994年7月至2004年1月间瘢痕疙瘩切除术后接受放疗的患者。通过邮寄问卷了解社会人口统计学因素、早期和晚期放射毒性、是否需要额外治疗以及满意度。所有患者均接受总量15 Gy的放疗，分3次，每次5 Gy，每日1次。治疗在术后24小时内开始，使用西门子正交电压放疗机进行。使用STATA统计软件包对数据进行分析。
共联系了234例患者。回复率为41%，75%为女性。平均年龄为36.5岁（范围16 - 69岁）。患者主要为欧洲裔（53.1%）或非洲裔（19.8%）。关于早期毒性结果，54.2%报告有皮肤发红，24%报告有皮肤脱皮。关于晚期毒性结果，27%报告有毛细血管扩张，62%报告有永久性皮肤颜色改变。晚期毒性结果与性别、肤色或年龄均无关联。在回复的患者中，14.6%需要辅助治疗。在1 - 10的视觉满意度量表上，60%报告满意度≥8。毛细血管扩张是低满意度（≤3，p < 0.005）的最显著预测因素。
我们的研究结果表明，瘢痕疙瘩手术切除后基于正交电压的放疗是预防复发的一种好方法。耐受性良好，毒性小，患者满意度高。
