Tomotherapy as an Alternative Irradiative Treatment for Complicated Keloids.

Yu-Fang Lin,Tyng-Luen Roan,Hui-Ju Tien,An-Ta Kuo,Dun-Hao Chang,Chen-Hsi Hsieh,Pei-Wei Shueng,Yo-Shen Chen,Yen-Chen Yu,Che-Wei Chang,Hsiu-Wen Hsiao

doi:10.3390/jcm9113732

Abstract

The aim of this study was to investigate the treatment of complicated keloids with helical tomotherapy (HT) and electron beam radiotherapy. From July 2018 to September 2018, 11 patients with 23 keloid lesions treated with HT were enrolled. Additionally, 11 patients with 20 lesions treated with electron beam radiotherapy in the same period were enrolled. Patients in both groups were treated within 24 h after surgical excision of the keloid lesion with 13.5 Gy in three consecutive daily fractions. The median follow-up period was 15 months. The local control rate was 91.3% and 80% in the HT group and the electron beam group, respectively. No acute adverse effects were observed in either group, but most patients exhibited pigmentation. No radiation-induced cancer occurred in these patients up to the time of this report. Pain and pruritus improved for all patients and more obviously for three patients with complicated keloids treated with HT. The measured surface dose was 103.7–112.5% and 92.8–97.6% of the prescribed dose in the HT group and the electron beam group, respectively. HT can be considered an alternative in cases where it is not feasible to use multiple electron fields, due to encouraging clinical outcomes.

Highlights

Keloids are disfiguring fibroproliferative lesions that grow beyond the boundaries of the original wound scar and can significantly impair the quality of life of affected individuals [1]
One of the radiation-based modalities used for keloids is electron beam irradiation [10]
From July 2018 to September 2018, eleven patients with 23 keloids treated with helical tomotherapy (HT) and 11 patients with 20 lesions treated with electron beam radiotherapy (Elekta VERSA HD linac accelerator, Elekta Oncology Systems Ltd, Crawley, UK) were enrolled

Summary

Introduction

Keloids are disfiguring fibroproliferative lesions that grow beyond the boundaries of the original wound scar and can significantly impair the quality of life of affected individuals [1]. Affected patients may experience itching, pain, impaired range of motion, and interference with normal daily activities, and keloids can be complicated by ulceration, bleeding, and infection [2]. According to the international recommendations for scar management, postoperative radiotherapy is considered to be an effective method available for keloids to decrease the relapse rate to 20% [4,5,6,7,8,9]. One of the radiation-based modalities used for keloids is electron beam irradiation [10]. Electron beam irradiation exhibits an inhomogeneous dose distribution, especially when the treated area is irregular, has a large slope [11], or is in a junctional field [12]

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