Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Radiother Oncol. 2022 Aug;173:146-153. doi: 10.1016/j.radonc.2022.06.003. Epub 2022 Jun 7.
Adjuvant electron beam radiation therapy after keloid excision has been proven as highly effective in reducing local recurrence. We performed a meta-analysis of studies on hypofractionated electron beam radiation therapy after keloid excision based on accurate radiation dose information to provide a more precise estimate of the effect of the biologically effective dose (BED) on recurrence rate.
A literature search was performed in PubMed, Embase, and the Cochrane Library for the period from 1990 to December 2021. Studies that provided information on the recurrence rate for the exact prescription dose were selected for analysis. The recurrence rate with respect to the BED was evaluated using forest plots and the best-fit lines on scatter plots.
From the 28 studies that were included for analysis, a total of 37 radiation dose datasets were extracted and 3128 excised keloids were identified. The recurrence rate for all sites and for the ear was 0.16 (95% confidence interval, 0.12-0.21; P < 0.01) and 0.11 (95% confidence interval, 0.06-0.20; P < 0.01), respectively. The estimated recurrence rate for all sites and the ear was calculated as "-1.992 + 1018.226/BED" or "2.982 + 330.51/BED" and "-16.8 + 1597.84/BED" or "-14.65 + 656.58/BED," respectively.
Postoperative radiation therapy with higher BED resulted in lower recurrence rates. As expected, ear keloids had lower estimated recurrence rates than all keloids at all sites. We derived a model for estimating the recurrence rate using the dose fractionation scheme.
在切除瘢痕疙瘩后，辅助电子束放射治疗已被证明能有效降低局部复发率。我们对基于准确放射剂量信息的瘢痕疙瘩切除后分割电子束放射治疗的研究进行了荟萃分析，以便更精确地评估生物有效剂量（BED）对复发率的影响。
在 PubMed、Embase 和 Cochrane Library 中进行了 1990 年至 2021 年 12 月的文献检索。选择提供确切处方剂量复发率信息的研究进行分析。使用森林图和散点图上的最佳拟合线评估 BED 与复发率的关系。
从纳入分析的 28 项研究中，共提取了 37 个放射剂量数据集，确定了 3128 个切除的瘢痕疙瘩。所有部位和耳部的复发率分别为 0.16（95%置信区间，0.12-0.21；P<0.01）和 0.11（95%置信区间，0.06-0.20；P<0.01）。所有部位和耳部的估计复发率分别计算为“-1.992+1018.226/BED”或“2.982+330.51/BED”和“-16.8+1597.84/BED”或“-14.65+656.58/BED”。
较高 BED 的术后放射治疗可降低复发率。正如预期的那样，耳部瘢痕疙瘩的估计复发率低于所有部位的所有瘢痕疙瘩。我们使用剂量分割方案为复发率估计建立了模型。
