The efficacy of combined adjuvant radiotherapy with surgical excision in the treatment of keloids

• Autor(a) principal: Sara Fátima Nunes Gomes
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/128691
• topic: Ciências médicas e da saúde; Medical and Health sciences

Purpose: Keloid scar is a benign dermal condition that occurs due to excessive activation of fibroblast, which leads to an abnormal accumulation of collagen. As a result of its high recurrence rate it is performed nowadays combined treatments. This study aims to evaluate, in real-life patients, the efficacy of adjuvant radiotherapy when used associated with surgical excision. Methods: We conducted a retrospective study on patients with keloid scars who underwent surgical excision and adjuvant radiotherapy, between May 2016 and March 2020. The data was collected from the radiology and plastic surgery medical charts. The patient and observer scar assessment scale (POSAS) was performed in all 13 patients. The treatment used was surgical removal of the scar associated with 9 Gy radiotherapy dose within the first 24 hours after the surgery, plus another session after 7 days. Results: 13 patients and 16 keloid scars were evaluated during a mean follow-up period of 13,5 months 95%CI (5,84; 21,16). There was no major adverse event from the treatment used. According to POSAS, the overall satisfaction rate was significantly good (mean of 2,29 on a scale from 1 to 10). Only one recurrence was observed (6,25%). Conclusion: Keloid scars are difficult to treat due to their high recurrence rate. There is no consent about which treatment is the best. This study showed that surgical excision combined with adjuvant radiotherapy is an excellent option, even for refractory keloids. The aesthetical result was satisfactory, and the recurrence rate was low.