Efficacy and the toxicity of the interstitial high-dose-rate brachytherapy in the management of recurrent keloids: 5-year outcomes
| Autor: | Ulf Luetzen, Juergen Dunst, Ping Jiang, Daniel Druecke, Frank-André Siebert, Matthias Geenen, Julia Bertolini, Bjoern Poppe |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Brachytherapy Scars 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Keloid Recurrence Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies External beam radiotherapy Prospective cohort study Aged Aged 80 and over business.industry Radiotherapy Dosage Perioperative Middle Aged medicine.disease Survival Analysis High-Dose Rate Brachytherapy Surgery Radiation therapy Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Radiotherapy Adjuvant medicine.symptom business Follow-Up Studies |
| Zdroj: | Brachytherapy. 17:597-600 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2017.12.002 |
| Popis: | Purpose Recurring keloids are a clinical challenge. Interdisciplinary treatments are required in most cases. Owing to the wide variety of concepts, the optimal treatment regime remains unclear. Our clinic established a protocol of perioperative interstitial high-dose-rate brachytherapy with three fractions of 6 Gy and achieved an excellent 2-year local control rate of 94% (In search of the optimal treatment of keloids: Report of a series and a review of the literature). This report is an update on our long-term results of prospective study. Twenty-nine patients were included with a median followup of 5 years. Methods and Materials From 2009 to 2015, 29 patients with 37 recurrent keloids were treated with perioperative interstitial high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiotherapy and presented with recurrences in the pretreated area. Brachytherapy was given in three fractions with a single dose of 6 Gy in 5-mm tissue depth and covered the scar in total length. Followup visits were scheduled at 6 weeks, 3 months, 6 months, 1 year, and annually thereafter. Therapeutic outcome was assessed in terms of recurrence, acute and late complications, and cosmetic results. Results No procedure-related complications occurred. Improvement of keloid-related symptoms was noticed in all patients after treatment. After a median followup of 49.7 months (range: 7.9–91.9 months), three keloid recurrences and two hypertrophied scars were observed. Conclusions Our results suggest that brachytherapy may be advantageous in the management of high-risk keloids, even after failure of external beam radiotherapy and other treatment procedures. Our three-fraction treatment schedule reduces the treatment period to 2 days and is therefore convenient for the patients. |
| Databáze: | OpenAIRE |
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