Department of Radiation Oncology, the Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China.
Sci Rep. 2021 Feb 11;11(1):3598. doi: 10.1038/s41598-021-83255-4.
At present, the consensus on the best treatment for keloids is the combination of clinical and surgical therapies, if necessary, associated with adjuvant radiotherapy like brachytherapy. Whereas, the uniform scheme of radiotherapy in keloids is unclear. Here, we conducting a retrospective analysis to assess the efficacy and safety of a specific treatment regimen (20 Gy in 5 fractions) in keloid patients. We retrospectively analysed the medical records of keloid patients receiving auxiliary postoperative radiotherapy (PORT) treatment from 2009 to 2019. The patients were treated with the hypofractionation method of 20 Gy in 5 fractions. We compared the local control rate and complications, using the chi-square test and logistic regression analyses. After screening, we identified 100 keloid patients in this study, with a median follow-up of 59 months. In this study, the overall local control rate of keloid lesions was 84.8%. After multivariate analyses (primary keloid or not, family history, interval from surgery to irradiation and site), our research showed that primary keloid, site and interval from surgery to irradiation were significantly related to recurrence. Acute radiation injury and late radiation injury accounted for 3% (erythema) and 1% (skin sclerosis) of the total cases, respectively. Our results indicate that a postoperative hypofractionation with radiation dose of 20 Gy in 5 fractions may be effective, easy to accept and safe for keloid patients.
目前,对于瘢痕疙瘩的最佳治疗方法的共识是临床和手术治疗的联合,如果需要,可结合近距离放疗(如短程放疗)。然而,瘢痕疙瘩的放射治疗统一方案尚不清楚。在这里,我们进行了一项回顾性分析,以评估特定治疗方案(20Gy 分 5 次)在瘢痕疙瘩患者中的疗效和安全性。我们回顾性分析了 2009 年至 2019 年接受辅助术后放疗(PORT)治疗的瘢痕疙瘩患者的病历。患者采用 20Gy 分 5 次的分割放疗方法。我们使用卡方检验和逻辑回归分析比较了局部控制率和并发症。经过筛选,本研究纳入了 100 例瘢痕疙瘩患者,中位随访时间为 59 个月。在本研究中,瘢痕疙瘩病变的总体局部控制率为 84.8%。经过多变量分析(原发性瘢痕疙瘩或非原发性瘢痕疙瘩、家族史、手术至放疗的间隔时间和部位),我们的研究表明,原发性瘢痕疙瘩、部位和手术至放疗的间隔时间与复发显著相关。急性放射性损伤和晚期放射性损伤分别占总病例的 3%(红斑)和 1%(皮肤硬化)。我们的结果表明,术后分割放疗剂量为 20Gy 分 5 次可能对瘢痕疙瘩患者有效、易于接受且安全。