Franzetti Jessica, Durante Stefano, Mastroleo Federico, Volpe Stefania, De Lorenzi Francesca, Rotondi Marco, Lorubbio Chiara, Vitullo Angelo, Frassoni Samuele, Bagnardi Vincenzo, Cambria Raffaella, Cattani Federica, Vavassori Andrea, Jereczek-Fossa Barbara Alicja
Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Via Ripamonti, 435, 20141, Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, 20122, Milan, Italy.
Radiol Med. 2024 Feb;129(2):328-334. doi: 10.1007/s11547-024-01756-4. Epub 2024 Jan 27.
To report the results involving post-operative interventional radiotherapy (POIRT) in a homogenous cohort of patients affected by keloid and treated at a single institution with the same fractionation schedule.
Inclusion criteria were: surgery with a histopathological diagnosis of keloid, subsequent high-dose rate interventional radiotherapy (HDR-IRT)-12 Gy in 4 fractions (3 Gy/fr) twice a day-and follow-up period ≥ 24 months.
One-hundred and two patients and a total of 135 keloids were eligible for the analyses. Median follow-up was 64 [IQR: 25-103] months. Thirty-six (26.7%) recurrences were observed, 12-months and 36-months cumulative incidence of recurrence were 20.7% (95% CI 12.2-28.5) and 23.8% (95% CI 14.9-31.7) respectively. History of spontaneous keloids (HR = 7.00, 95% CI 2.79-17.6, p < 0.001), spontaneous cheloid as keloid cause (HR = 6.97, 95% CI 2.05-23.7, p = 0.002) and sternal (HR = 10.6, 95% CI 3.08-36.8, p < 0.001), ear (HR = 6.03, 95% CI 1.71-21.3, p = 0.005) or limb (HR = 18.8, 95% CI 5.14-68.7, p < 0.001) keloid sites were significantly associated to a higher risk of recurrence.
The findings support the use of surgery and POIRT as an effective strategy for controlling keloid relapses. Further studies should focus on determining the optimal Biologically Effective Dose and on establishing a scoring system for patient selection.
报告在同一机构采用相同分割方案治疗的瘢痕疙瘩患者同质队列中术后介入放疗（POIRT）的结果。
纳入标准为：经组织病理学诊断为瘢痕疙瘩的手术患者，随后进行高剂量率介入放疗（HDR-IRT）——分4次给予12 Gy（每次3 Gy），每天2次——且随访期≥24个月。
102例患者及总共135个瘢痕疙瘩符合分析条件。中位随访时间为64 [四分位间距：25 - 103] 个月。观察到36例（26.7%）复发，12个月和36个月的累积复发率分别为20.7%（95%置信区间12.2 - 28.5）和23.8%（95%置信区间14.9 - 31.7）。自发性瘢痕疙瘩病史（风险比[HR]=7.00，95%置信区间2.79 - 17.6，p<0.001）、作为瘢痕疙瘩病因的自发性瘢痕瘤（HR=6.97，95%置信区间2.05 - 23.7，p=0.002）以及胸骨（HR=10.6，95%置信区间3.08 - 36.8，p<0.001）、耳部（HR=6.03，95%置信区间1.71 - 21.3，p=0.005）或肢体（HR=18.8，95%置信区间5.
