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瘢痕疙瘩的围手术期组织间高剂量率近距离放射治疗

Perioperative interstitial high-dose-rate brachytherapy for keloids scar.

作者信息

Barragán Victoria Vera, García Ana Isabel Alonso, García José Fernández, Marín Marta De Juan, Vivas Johanna Del Carmen Peña, Rijo Germán Juan

机构信息

Hospital Universitario Badajoz, Badajoz, Spain.

Hospital Universitario Central de Asturias, Oviedo, Spain.

出版信息

J Contemp Brachytherapy. 2022 Feb;14(1):29-34. doi: 10.5114/jcb.2022.113547. Epub 2022 Feb 18.

Abstract

PURPOSE

To evaluate the results of keloids treated with perioperative interstitial high-dose-rate brachytherapy (HDR-BT).

MATERIAL AND METHODS

A retrospective review of 61 keloids in 51 patients treated with perioperative interstitial HDR-BT was performed. Keloid lesions were treated with 12 Gy in 4 fractions within 48 hours. Time between surgery and brachytherapy was less than 90 minutes. Local failure was defined as recurrence of apparent keloid or symptoms in the same place. Median age of patients was 46 years (range, 20-89 years). Keloid scars were located on the chest (41%), ear lobe (21%), back (1.6%), extremities (11.5%), and mean keloid size was 6.3 cm.

RESULTS

With a median follow-up of 47.95 months (range, 1-96 months), the recurrence rate was 4.9%, all located on the chest. The multivariate analysis showed no statistically significant relationship between location, scar size, and previously treated lesions with the recurrence rate.

CONCLUSIONS

The treatment of keloid scars with perioperative interstitial high-dose-rate brachytherapy achieved excellent results, with a recurrence rate of only 4.9% and excellent cosmetic outcomes, suggesting that this technique might be one of the best options for treating keloids.

摘要

目的

评估围手术期组织间高剂量率近距离放射治疗(HDR-BT)治疗瘢痕疙瘩的效果。

材料与方法

对51例患者的61个瘢痕疙瘩进行围手术期组织间HDR-BT治疗的回顾性研究。瘢痕疙瘩病灶在48小时内分4次给予12 Gy照射。手术与近距离放射治疗的时间间隔小于90分钟。局部失败定义为同一部位明显瘢痕疙瘩或症状复发。患者的中位年龄为46岁(范围20-89岁)。瘢痕疙瘩位于胸部(41%)、耳垂(21%)、背部(1.6%)、四肢(11.5%),瘢痕疙瘩平均大小为6.3 cm。

结果

中位随访47.95个月(范围1-96个月),复发率为4.9%,均位于胸部。多因素分析显示,部位、瘢痕大小和既往治疗的病灶与复发率之间无统计学显著关系。

结论

围手术期组织间高剂量率近距离放射治疗瘢痕疙瘩取得了良好效果,复发率仅为4.9%,美容效果良好,提示该技术可能是治疗瘢痕疙瘩的最佳选择之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/065b/8867237/9b5a99d863a4/JCB-14-46410-g001.jpg

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