Liao Yixiang, Dorafshar Amir H, Bernard Damian, Kim Thomas, Camden Nathaniel B, Wang Dian
Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA.
Division of Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL, USA.
Med Dosim. 2022;47(2):158-160. doi: 10.1016/j.meddos.2022.01.003. Epub 2022 Mar 7.
Postoperative external beam radiation therapy (EBRT) with superficial X-rays or electrons and high-dose-rate brachytherapy (HDR BT) are both viable options for managing keloid scars. However, complex keloid scars are especially challenging to manage. We aim to compare the benefit and challenges between interstitial HDR BT and electron EBRT in treating the complex keloids. Three patients with 7 complex keloids: 3 jaw lines, 1 postauricular, 1 posterior neck, and 2 chest walls are included in this study. All patients are treated to 6 Gy x 3 fractions with HDR BT using the flexible interstitial catheters, and electron EBRT plans were created retrospectively for dosimetric comparison. The average D is 21.8 ± 8.3 Gy (1 SD) (121%) and 16.9 ± 1.9 Gy (1SD) (94%) in HDR and EBRT plans, respectively. The average treatment time was 7 minutes per patient (range: 6 - 8.5 minutes) for the HDR BT. Dosimetric comparison reveals that HDR plans provide superior coverage to the keloid scars than the EBRT plans. Clinical workflow is streamlined with HDR procedures. The cosmetic outcome with the interstitial HDR BT is satisfactory.
术后使用浅层X射线或电子束进行外照射放疗（EBRT）以及高剂量率近距离放疗（HDR BT）都是治疗瘢痕疙瘩的可行选择。然而，复杂的瘢痕疙瘩尤其难以处理。我们旨在比较组织间HDR BT和电子束EBRT在治疗复杂瘢痕疙瘩方面的益处和挑战。本研究纳入了3例患有7处复杂瘢痕疙瘩的患者，其中3处位于颌面部、1处位于耳后、1处位于颈后部、2处位于胸壁。所有患者均使用可弯曲的组织间导管接受HDR BT治疗，剂量为6 Gy×3分次，同时回顾性制定电子束EBRT计划以进行剂量学比较。在HDR和EBRT计划中，平均D值分别为21.8±8.3 Gy（1个标准差）（121%）和16.9±1.9 Gy（1个标准差）（94%）。HDR BT每位患者的平均治疗时间为7分钟（范围：6 - 8.5分钟）。剂量学比较显示，HDR计划比EBRT计划能更好地覆盖瘢痕疙瘩。HDR治疗简化了临床工作流程。组织间HDR BT的美容效果令人满意。
