Kal Henk B, Veen Ronald E, Jürgenliemk-Schulz Ina M
Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
Int J Radiat Oncol Biol Phys. 2009 May 1;74(1):245-51. doi: 10.1016/j.ijrobp.2008.12.066.
To show radiation dose-response relationships for recurrence of keloid and pterygium after radiotherapy following surgery.
Using PubMed, we performed a retrospective review of articles reporting incidences and/or dose-response relationships for recurrence of keloid and pterygium after radiotherapy following surgery. The irradiation regimens identified were normalized by use of the linear-quadratic model; biologically effective doses (BEDs) were calculated.
For keloid recurrence after radiotherapy following keloid removal, with either teletherapy or brachytherapy, the recurrence rate after having delivered a BED greater than 30 Gy is less than 10%. For pterygium recurrence after bare sclera surgery and (90)Sr beta-irradiation, a BED of about 30 Gy seems to be sufficient also to reduce the recurrence rate to less than 10%.
Most of the doses in the radiotherapy schemes used for prevention of keloid recurrence after surgery are too low. In contrast, the doses applied in most regimens to prevent pterygium recurrence are too high. A scheme with a BED of 30 to 40 Gy seems to be sufficient to prevent recurrences of keloid as well as pterygium.
展示手术后放疗后瘢痕疙瘩和翼状胬肉复发的辐射剂量-反应关系。
利用PubMed，我们对报告手术后放疗后瘢痕疙瘩和翼状胬肉复发的发生率和/或剂量-反应关系的文章进行了回顾性研究。通过线性二次模型对确定的照射方案进行归一化；计算生物等效剂量（BED）。
对于瘢痕疙瘩切除术后放疗后的瘢痕疙瘩复发，无论是远距离治疗还是近距离治疗，给予大于30 Gy的BED后的复发率均低于10%。对于单纯巩膜手术和（90）Srβ射线照射后的翼状胬肉复发，约30 Gy的BED似乎也足以将复发率降低至低于10%。
用于预防手术后瘢痕疙瘩复发的放疗方案中的大多数剂量过低。相比之下，大多数预防翼状胬肉复发的方案中应用的剂量过高。30至40 Gy的BED方案似乎足以预防瘢痕疙瘩和翼状胬肉的复发。
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