Keloids treated with postoperative Iridium 192 brachytherapy: a retrospective study

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 23; no. 7; pp. 807 - 813
• Main Authors: Arnault, JP, Peiffert, D, Latarche, C, Chassagne, JF, Barbaud, A, Schmutz, JL
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-07-2009
• Subjects: Brachytherapy; Female; Humans; hypertrophic scar; iridium 192; Iridium Radioisotopes - therapeutic use; keloid; Keloid - radiotherapy; Male; Postoperative Care; Recurrence; Retrospective Studies
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2009.03190.x

Background  Post‐excisional brachytherapy with Iridium 192 is a treatment of keloids scars (KS). Its indications and its parameters are not subject to any consensus.
Objective  We wanted to assess the effectiveness and satisfaction of patients treated in our centre.
Patients and Methods  This was a retrospective study conducted from November 2006 to November 2007. Patients with clinically and histologically proven KS treated between 1990 and 2005, were convened in consultation between September and October 2007. Clinical data and parameters of the brachytherapy have been collected.
Results  Eighty‐seven patients (138 KS) were treated. Eighty‐two KS (46 patients) met the criteria for inclusion. Thirty‐two patients (55 KS) have been seen in consultation. The average time between the onset of KS and treatment was 63.5 months. The brachytherapy has begun after a maximum of 7 hours posterior to surgery for all KS. The average dose was 17.9 Gy calculated at 5 mm. We observed 23.6% of recurrence after treatment. Seventy‐nine per cent of itching and 87.5% of pain have totally disappeared. The phototypes 5 and 6 had an increased risk of reccurence.
Discussion  This is the most important series of KS treated with Post‐excisional brachytherapy presented so far. The technique is efficient in preventing keloid reccurence and in treating the functional signs, but at the expense of an unaesthetic result, of wich patient must be warned about. A follow‐up of at least two years after treatment is recommended.
Conflicts of interest
None declared