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Postoperative radiotherapy in the management of keloids

BACKGROUND: The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. OBJECTIVE: This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. METHODS: Retrospective analysis of resected keloids in patients referr...

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Autores principales: Carvajal, Claudia C, Ibarra, Carla M, Arbulo, Douglas L, Russo, Moisés N, Solé, Claudio P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cancer Intelligence 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130331/
https://www.ncbi.nlm.nih.gov/pubmed/27994646
http://dx.doi.org/10.3332/ecancer.2016.690
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author Carvajal, Claudia C
Ibarra, Carla M
Arbulo, Douglas L
Russo, Moisés N
Solé, Claudio P
author_facet Carvajal, Claudia C
Ibarra, Carla M
Arbulo, Douglas L
Russo, Moisés N
Solé, Claudio P
author_sort Carvajal, Claudia C
collection PubMed
description BACKGROUND: The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. OBJECTIVE: This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. METHODS: Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin. RESULTS: Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months. CONCLUSIONS: The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes.
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spelling pubmed-51303312016-12-19 Postoperative radiotherapy in the management of keloids Carvajal, Claudia C Ibarra, Carla M Arbulo, Douglas L Russo, Moisés N Solé, Claudio P Ecancermedicalscience Research BACKGROUND: The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. OBJECTIVE: This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. METHODS: Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin. RESULTS: Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months. CONCLUSIONS: The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes. Cancer Intelligence 2016-11-08 /pmc/articles/PMC5130331/ /pubmed/27994646 http://dx.doi.org/10.3332/ecancer.2016.690 Text en © the authors; licensee ecancermedicalscience. http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Carvajal, Claudia C
Ibarra, Carla M
Arbulo, Douglas L
Russo, Moisés N
Solé, Claudio P
Postoperative radiotherapy in the management of keloids
title Postoperative radiotherapy in the management of keloids
title_full Postoperative radiotherapy in the management of keloids
title_fullStr Postoperative radiotherapy in the management of keloids
title_full_unstemmed Postoperative radiotherapy in the management of keloids
title_short Postoperative radiotherapy in the management of keloids
title_sort postoperative radiotherapy in the management of keloids
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130331/
https://www.ncbi.nlm.nih.gov/pubmed/27994646
http://dx.doi.org/10.3332/ecancer.2016.690
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