Abstract
Keloid resection followed by adjuvant radiotherapy is the most efficacious treatment for keloids. However, for earlobe keloids, an optimal protocol for the total dose and fractions of adjuvant radiation has not yet been established. We retrospectively analyzed the efficacy and safety of immediate three-fraction electron radiotherapy after operation for resistant earlobe keloids. From 2011 to 2017, three-fraction electron radiotherapy with single dose of 5 Gy was given postoperatively to 23 patients with 30 keloids in our hospital. The first fraction of adjuvant radiotherapy was administered within 2 h of surgery, and the other two sessions were completed within the next day or two. Five (16.7%) primary keloids and 25 (83.3%) recurrent keloids were examined in this study. The primary endpoint was the local control rate, which was 86.7% after a median follow-up of 26 months (14–93 months). Secondary endpoints were acute and late procedure-related complications, and no severe complications were observed after combination therapy. Our results suggest that three-fraction electron radiotherapy after excision within 2 days of surgery is a safe and effective protocol for the prevention of earlobe keloid recurrence that can also improve patient compliance and comfort.
Highlights
Keloids are a benign fibro-proliferative disease that spread beyond the original borders of a wound in response to an injury or trauma
We retrospectively evaluated the results of surgical excision combined with immediate adjuvant radiotherapy in patients with therapyresistant keloids
From January 2011 to July 2017, clinical data on 23 patients (8 males and 15 females) with 30 keloids of the earlobe were retrospectively reviewed, and these 23 patients were treated with surgical excision followed by immediate adjuvant electron radiotherapy
Summary
Keloids are a benign fibro-proliferative disease that spread beyond the original borders of a wound in response to an injury or trauma. Earlobe has been mentioned as the most common location for keloids after any injury, most commonly cosmetic piercing [1], and due to the unique characteristics of the earlobe, such as its free edge, arc-like shape, and lack of cartilage. The incidence of earlobe keloids after ear piercing has been estimated at 2.5% [25]. It often causes pain, pruritus, and tenderness, and can cause cosmetic disfigurement, impairing the quality of life.
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