Post-operative KEloids iRradiation (POKER): does the surgery/high-dose interventional radiotherapy association make a winning hand?
Radiol Med
; 129(2): 328-334, 2024 Feb.
Article
in En
| MEDLINE
| ID: mdl-38280971
ABSTRACT
PURPOSE:
To report the results involving post-operative interventional radiotherapy (POIRT) in a homogenous cohort of patients affected by keloid and treated at a single institution with the same fractionation schedule. PATIENTS ANDMETHODS:
Inclusion criteria were surgery with a histopathological diagnosis of keloid, subsequent high-dose rate interventional radiotherapy (HDR-IRT)-12 Gy in 4 fractions (3 Gy/fr) twice a day-and follow-up period ≥ 24 months.RESULTS:
One-hundred and two patients and a total of 135 keloids were eligible for the analyses. Median follow-up was 64 [IQR 25-103] months. Thirty-six (26.7%) recurrences were observed, 12-months and 36-months cumulative incidence of recurrence were 20.7% (95% CI 12.2-28.5) and 23.8% (95% CI 14.9-31.7) respectively. History of spontaneous keloids (HR = 7.00, 95% CI 2.79-17.6, p < 0.001), spontaneous cheloid as keloid cause (HR = 6.97, 95% CI 2.05-23.7, p = 0.002) and sternal (HR = 10.6, 95% CI 3.08-36.8, p < 0.001), ear (HR = 6.03, 95% CI 1.71-21.3, p = 0.005) or limb (HR = 18.8, 95% CI 5.14-68.7, p < 0.001) keloid sites were significantly associated to a higher risk of recurrence.CONCLUSIONS:
The findings support the use of surgery and POIRT as an effective strategy for controlling keloid relapses. Further studies should focus on determining the optimal Biologically Effective Dose and on establishing a scoring system for patient selection.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Brachytherapy
/
Radiosurgery
/
Keloid
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Year:
2024
Type:
Article