Wu Beiyi, Zhang Bohan, Xiao Haitao, Xu Xuewen
Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan, People's Republic of China.
Aesthetic Plast Surg. 2025 May 27. doi: 10.1007/s00266-025-04927-4.
Keloid management has been debated for decades due to unsatisfactory outcomes and high recurrence rates. Intralesional injection and radiotherapy are prominent nonsurgical interventions for keloids. However, monotherapies for keloids usually yield poor efficacy and cause patient burden due to additional treatment sessions and side effects, affecting adherence. The study aimed to evaluate the safety and efficacy of combining intralesional triamcinolone acetonide (TAC) + 5-fluorouracil (5-FU) injection with electron beam radiotherapy or brachytherapy compared to intralesional TAC+5-FU injection alone.
We retrospectively reviewed patients who were initially treated between 2019 and 2022 and followed for more than 12 months. The baseline condition, the Vancouver Scar Scale (VSS), recurrence, symptoms, follow-up period, and patient self-assessment were recorded.
The study included a cohort of 100 eligible patients with a total of 111 keloids. Seventy-one of patients received the combined therapy and 29 received TAC+5-FU injection only. The results revealed that combining injection with radiotherapy reduced the recurrence rate and improved symptoms such as pruritus and pain while posing minimal extra risk of side effects. Moreover, patients receiving combined therapy assessed treatment outcomes more positively than those solely receiving injection therapy. Other factors that related to increased risk of recurrence included a higher VSS score at the end of treatment and the presence of keloid family history.
The combined schedule of intralesional TAC+5-FU injection with radiotherapy could effectively reduce the recurrence rate and alleviate symptoms of keloids.
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由于治疗效果不尽人意且复发率高，瘢痕疙瘩的治疗方法已争论了数十年。病灶内注射和放射治疗是瘢痕疙瘩突出的非手术干预措施。然而，瘢痕疙瘩的单一疗法通常疗效不佳，且由于额外的治疗疗程和副作用会给患者带来负担，影响依从性。本研究旨在评估病灶内注射曲安奈德（TAC）+5-氟尿嘧啶（5-FU）联合电子束放疗或近距离放疗与单纯病灶内注射TAC+5-FU相比的安全性和疗效。
我们回顾性分析了2019年至2022年期间首次接受治疗并随访超过12个月的患者。记录基线情况、温哥华瘢痕量表（VSS）、复发情况、症状、随访期和患者自我评估。
该研究纳入了100例符合条件的患者，共有111个瘢痕疙瘩。71例患者接受了联合治疗，29例仅接受了TAC+5-FU注射。结果显示，注射联合放疗可降低复发率，改善瘙痒和疼痛等症状，同时带来的额外副作用风险最小。此外，接受联合治疗的患者对治疗结果的评价比单纯接受注射治疗的患者更积极。与复发风险增加相关的其他因素包括治疗结束时较高的VSS评分和瘢痕疙瘩家族史的存在。
病灶内TAC+5-FU注射联合放疗方案可有效降低瘢痕疙瘩的复发率并缓解症状。
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