Keloids treated with excision followed by radiation therapy

Background: In the treatment of keloids surgical excision followed by radiation therapy provides the highest reported control rates of 72% to 92%. Objective: We evaluated the effectiveness of excision followed by radiation therapy in the treatment of keloids and compared the efficacy of orthovoltage and electron beam radiation. Methods: One hundred twenty-six keloids were treated with radiation therapy after surgical excision. Median follow-up period was 12 years. Recurrence rate, side effects, and effectiveness of therapy were assessed, Data were analyzed with multivariate analysis for significant objective and subjective factors. Results: Higher posttreatment recurrence rates were noted with keloids forming at infected sites and in patients with a family history. No increased likelihood of recurrence was noted with respect to patient age, sex, or ethnicity; keloid size or location; individual keloid history; or prior therapy or radiation type used. Conclusion: Excision followed by radiation therapy is a useful and effective method of keloid eradication, particularly in cases in which lesions are disfiguring or refractory. Electron beam radiation offers no advantage over orthovoltage as a treatment.