Mokoala Kgomotso M G, Nonjola Linda, Moeng Thabiso, Corbett Cecilia, Magwaza Martin, Dahlhoff Gerhard, Brown Shannon, Vetter Nicholas, Vorster Mariza, Sathekge Mike Machaba
Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa.
Nuclear Medicine Research Infrastructure (NuMeRI), Pretoria, South Africa.
Eur J Nucl Med Mol Imaging. 2025 Mar 12. doi: 10.1007/s00259-025-07184-4.
Keloids have proved challenging to manage with various therapies providing variable success rates and recurrences. Alternative therapies or a multimodal approach is often necessary to ensure complete eradication and prevent recurrence. The use of radioactive creams or patches embedded with Holmium-166, Phosphorus-32 for superficial skin lesions has been documented to be safe and effective. The use of Rhenium-188 has proved effective in non-melanoma skin cancers. We report on the initial experience with Rhenium-188 SCT in the treatment of recurrent keloid lesions.
Patients with recurrent keloid lesions were recruited for therapy with Rhenium-188. These patients had failed most forms of therapy including surgery, intralesional steroids and radiation therapy. Treatment with Re via a specialized unit (Rhenium SCT -Oncobeta) was applied onto the keloid lesion. A personalized treatment time was calculated for every patient. Topical Rhenium delivered as a jelly like matrix containing an insoluble dirhenium-heptasulfide was applied to every target lesion in a single session. The goal is to deliver 30 Gy to the deepest part of the lesion per session (3 mm). Patients were followed up at 2 weeks, 1, 3, 6 and 12 months for side effects as well as clinical and cosmetic outcomes.
A total of 58 lesions were treated. Majority of the lesions were in the head and neck region. The smallest area for treatment was 0.25cm and the largest area treated was 46.25cm. With the exception of four patients (2 sessions to the same lesion), all the other patients received a single session of therapy. The mean activity administered was 256,7MBq (range: 35MBq- 663,50MBq). The treatment time averaged 350.89 min (range: 85-1304 min). There was complete response in 72% of the lesions. Hypopigmentation was the commonest expected long term side effect. After a median follow-up period of 37 months (range: 7-53), there was a 7% recurrence rate.
Treatment with Re is a great alternative in patients with keloids that have had minimal success with other therapies. The use of the specialized applicator system provides great flexibility, reduced morbidity and great results that are comparable to other therapies.
Not applicable.
瘢痕疙瘩的治疗颇具挑战性，各种疗法的成功率和复发率各不相同。通常需要采用替代疗法或多模式方法来确保彻底根除并防止复发。已证明，使用含钬 - 166、磷 - 32的放射性乳膏或贴片治疗浅表皮肤病变是安全有效的。已证明铼 - 188在治疗非黑色素瘤皮肤癌方面有效。我们报告了铼 - 188皮肤表面敷贴治疗复发性瘢痕疙瘩病变的初步经验。
招募复发性瘢痕疙瘩病变患者接受铼 - 188治疗。这些患者对包括手术、病灶内注射类固醇和放射治疗在内的大多数治疗方法均无效。通过一个专门的设备（铼皮肤表面敷贴 - Oncobeta）将铼应用于瘢痕疙瘩病变。为每位患者计算个性化的治疗时间。将以含有不溶性七硫化二铼的凝胶状基质形式提供的局部铼在单个疗程中应用于每个目标病变。目标是每个疗程（3毫米）向病变最深部位给予30戈瑞的剂量。对患者进行为期2周、1个月、3个月、6个月和12个月的随访，观察副作用以及临床和美容效果。
共治疗了58个病变。大多数病变位于头颈部区域。最小治疗面积为0.25平方厘米，最大治疗面积为46.25平方厘米。除4名患者（同一病变接受2个疗程治疗）外，所有其他患者均接受了单个疗程的治疗。平均给予的活度为256.7兆贝可（范围：35兆贝可 - 663.50兆贝可）。治疗时间平均为350.89分钟（范围：85 - 1304分钟）。72%的病变完全缓解。色素减退是最常见的预期长期副作用。在中位随访期37个月（范围：7 - 53个月）后，复发率为7%。
对于其他治疗方法效果不佳的瘢痕疙瘩患者，铼治疗是一种很好的替代方法。使用专门的敷贴系统具有很大的灵活性，可降低发病率，且效果与其他疗法相当。
不适用。
