Kim Juree, Lee Sang Hoon
Department of Radiation Oncology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2012 Jun;30(2):49-52. doi: 10.3857/roj.2012.30.2.49. Epub 2012 Jun 30.
To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section.
A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the final Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus.
In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%.
When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.
评估剖宫产术后立即进行放射治疗对瘢痕疙瘩的有效性和安全性。
共有26例因既往剖宫产导致确诊瘢痕疙瘩的产后患者接受了12或15 Gy的放射治疗。放射治疗分为三个6 MeV电子束分次，在最后一次剖宫产术后的产后期进行。为评估卵巢安全性，使用固体平板模体和电离室，在计算出的卵巢深度处估计指定的辐射剂量，该电离室具有与用于治疗剖宫产手术瘢痕相同的铅挡块和组织等效填充物。
总体而言，控制率为77%（20例患者），而6例（23%）在原腹部瘢痕中部出现局部隆起的瘢痕疙瘩（长度为0.5至2 cm）。5例患者出现轻度色素沉着。尽管如此，大多数患者（96%）对治疗结果满意。到达计算出的卵巢深度的应用辐射剂量估计百分比范围为0.0033%至0.0062%。
在产后立即进行时，对重复剖宫产瘢痕进行术后电子束放射治疗通常是安全的，并且能产生良好的美容效果，毒性最小。
