Analysis of efficacy of high-dose fractionated radiotherapy after keloid surgery
DONG Xiangli
PANG Cui
Abstract：Objective To assess the efficacy and safety of high-dose fractionated radiotherapy for the postoperative treatment of keloids.Methods A retrospective analysis was performed on 32 patients(48 lesions)with keloids who received treatment at our institution from January 2020 to June 2023.All patients received radiotherapy using 6 MV energy within 24 h after surgical exci-sion,with a source-to-skin distance of 100 cm.Based on different fractionation regimens,patients were divided into two groups:the high-dose group[16 patients with 24 lesions received a total dose of 20 Gy,delivered as 5 Gy per fraction over 4 fractions(20Gy/5Gy/4F)]and the conven-tional-dose group[16 patients with 24 lesions received a total dose of 20 Gy,delivered as 2 Gy per fraction over 10 fractions(20Gy/2Gy/10F)].Treatment outcomes were evaluated using the Darzi keloid efficacy criteria and classified into effective and ineffective categories.The treatment efficacy,adverse reactions,and recurrence rates were compared between the two groups.Results All patients completed the treatment as planned.At the 12-month follow-up,the response rate of the high-dose group was significantly higher than that of the conventional-dose group(91.67％vs.66.67％,x2=4.55,P=0.033).In contrast,the recurrence rate was lower in the high-dose group than in the standard-dose group(8.33％vs.33.33％,P=0.033).There was no signifi-cant difference between the two groups in the incidence of acute radiation reactions(P＞0.05).Additionally,no late adverse effects such as skin atrophy or fibrosis were observed in either group during the follow-up period.Conclusions The high-dose fractionation regimen of 20Gy/5Gy/4 fractions offers superior local control compared to the conventional dose fractionation regimen of 20Gy/2Gy/10 fractions,without increasing the incidence of adverse reactions.Therefore,it may be considered a preferred treatment option in clinical practice.
Keywords：keloidradiation therapy after surgeryconventional dose-fractionated therapyhigh-dose fractionated radiotherapy
Publication Date：2025-08-28
Online Publishing Date：2025-09-23(First online date of this platform, not the publication date of the document)
Pages：7( 560-566 )