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Title: Postoperative Strontium-90 Brachytherapy in the Prevention of Keloids: Results and Prognostic Factors

Abstract

Purpose: The aim of this study was to evaluate the results of keloidectomy and strontium 90 brachytherapy in the prevention of keloid recurrence following excision and to identify outcome and the prognostic factors that predict keloid recurrence after irradiation. Methods and Materials: Data of 612 patients with 892 keloids treated between 1992 and 2006 were evaluated retrospectively. Brachytherapy was performed using a Sr-90Y surface applicator. Total dose was 20 Gy in 10 fractions. Results: With a median follow-up of 61 months, the overall recurrence-free response rate for all keloids was 87.6%. Multivariate analysis revealed the following prognostic factors for recurrence: keloid size > 5 cm (p < 0.0001), burn scars as the keloid etiology (p < 0.0001), and previous treatment (p < 0.0001). Outcome was not found to be significantly related to the interval between surgery and radiotherapy, sex, or age. Pruritus and skin reddening were the most common symptoms of keloids, but all signs and symptoms abated with time after treatment. Cosmetic results from the keloid treatment were considered good or excellent in 70.6% of the patients. Conclusion: Our study findings show that excision plus Sr-90 brachytherapy is effective in the eradication of keloids. Sr-90 radiotherapy (20 Gy inmore » 10 fractions) achieved a similar local control rate, as have higher doses per fraction in other series. It also resulted in a good cosmetic rate and relief of symptoms. Our data further suggest that the initiation of postoperative irradiation within hours of surgical excision is not important to therapeutic outcome.« less

Authors:
 [1]; ;  [2];  [3]
  1. Department of Radiation Oncology, Marilia Medicine School, Sao Paulo (Brazil), E-mail: gusviani@gmail.com
  2. Department of Radiation Oncology, Marilia Medicine School, Sao Paulo (Brazil)
  3. Department of Ophthalmology, Marilia Medicine School, Sao Paulo (Brazil)
Publication Date:
OSTI Identifier:
21276751
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 73; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2008.07.065; PII: S0360-3016(08)03517-7; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; MULTIVARIATE ANALYSIS; PATIENTS; RADIATION DOSES; SKIN; STRONTIUM 90; SURGERY; SYMPTOMS; YTTRIUM 90

Citation Formats

Viani, Gustavo A., Stefano, Eduardo J., Afonso, Sergio L., and De Fendi, Ligia I. Postoperative Strontium-90 Brachytherapy in the Prevention of Keloids: Results and Prognostic Factors. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.07.065.
Viani, Gustavo A., Stefano, Eduardo J., Afonso, Sergio L., & De Fendi, Ligia I. Postoperative Strontium-90 Brachytherapy in the Prevention of Keloids: Results and Prognostic Factors. United States. doi:10.1016/j.ijrobp.2008.07.065.
Viani, Gustavo A., Stefano, Eduardo J., Afonso, Sergio L., and De Fendi, Ligia I. Wed . "Postoperative Strontium-90 Brachytherapy in the Prevention of Keloids: Results and Prognostic Factors". United States. doi:10.1016/j.ijrobp.2008.07.065.
@article{osti_21276751,
title = {Postoperative Strontium-90 Brachytherapy in the Prevention of Keloids: Results and Prognostic Factors},
author = {Viani, Gustavo A. and Stefano, Eduardo J. and Afonso, Sergio L. and De Fendi, Ligia I.},
abstractNote = {Purpose: The aim of this study was to evaluate the results of keloidectomy and strontium 90 brachytherapy in the prevention of keloid recurrence following excision and to identify outcome and the prognostic factors that predict keloid recurrence after irradiation. Methods and Materials: Data of 612 patients with 892 keloids treated between 1992 and 2006 were evaluated retrospectively. Brachytherapy was performed using a Sr-90Y surface applicator. Total dose was 20 Gy in 10 fractions. Results: With a median follow-up of 61 months, the overall recurrence-free response rate for all keloids was 87.6%. Multivariate analysis revealed the following prognostic factors for recurrence: keloid size > 5 cm (p < 0.0001), burn scars as the keloid etiology (p < 0.0001), and previous treatment (p < 0.0001). Outcome was not found to be significantly related to the interval between surgery and radiotherapy, sex, or age. Pruritus and skin reddening were the most common symptoms of keloids, but all signs and symptoms abated with time after treatment. Cosmetic results from the keloid treatment were considered good or excellent in 70.6% of the patients. Conclusion: Our study findings show that excision plus Sr-90 brachytherapy is effective in the eradication of keloids. Sr-90 radiotherapy (20 Gy in 10 fractions) achieved a similar local control rate, as have higher doses per fraction in other series. It also resulted in a good cosmetic rate and relief of symptoms. Our data further suggest that the initiation of postoperative irradiation within hours of surgical excision is not important to therapeutic outcome.},
doi = {10.1016/j.ijrobp.2008.07.065},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 73,
place = {United States},
year = {2009},
month = {4}
}