Clavere P, Bedane C, Bonnetblanc J M, Bonnafoux-Clavere A, Rousseau J
Service de Radiothérapie, Hôpital Universitaire Dupuytren, Limoges, France.
Dermatology. 1997;195(4):349-52. doi: 10.1159/000245986.
Keloids are clinically vexacious scars characterized by a high recurrence rate after excision alone (50-100%). Many adjuvant techniques have been used with more or less convincing results.
The aim of this study is to show the efficiency of keloidectomy and postoperative interstitial radiotherapy by an iridium 192 wire.
During a 14-year period, 39 patients with keloids (46 keloids) were treated by this regimen. Seven patients had been previously treated by intralesional corticosteroids, surgery alone or postoperative interstitial radiotherapy, without improvement. A dose of 12 Gy (7 keloids) to 15 Gy (22 keloids) was delivered at a point 2.5 mm from the axis of the wire. For 17 keloids the dose schedule was 15 Gy at a point 5 mm to the wire. The median follow-up was 7 months.
The overall success rate is close to 63%. A recurrence occurred in 14 cases without relation to the method used, the age or the localization of the lesions. There were no side effects observed.
Postoperative interstitial radiotherapy represents an effective, unconstraining and safe treatment for keloids if the contraindications are respected.
瘢痕疙瘩是临床上棘手的瘢痕，其特征为单纯切除后复发率高（50%-100%）。已经使用了多种辅助技术，结果或多或少令人信服。
本研究的目的是展示铱192线间质放疗联合瘢痕疙瘩切除术的疗效。
在14年期间，39例瘢痕疙瘩患者（46个瘢痕疙瘩）接受了该治疗方案。7例患者先前曾接受病灶内皮质类固醇、单纯手术或术后间质放疗，但均未见改善。在距导线轴2.5毫米处给予12 Gy（7个瘢痕疙瘩）至15 Gy（22个瘢痕疙瘩）的剂量。对于17个瘢痕疙瘩，剂量方案为在距导线5毫米处给予15 Gy。中位随访时间为7个月。
总体成功率接近63%。14例出现复发，与所采用的方法、年龄或病变部位无关。未观察到副作用。
如果遵循禁忌证，术后间质放疗是一种有效、无限制且安全的瘢痕疙瘩治疗方法。
