Assessing keloid recurrence following surgical excision and radiation
- Burns & Trauma Vol. 8, Issue 1, (2020)
- 作者机构：
1. Gold Skin Care Center
2. Center for Clinical and Cosmetic Research
3. Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine
4. Skin Laser & Surgery Specialists of NY/NJ
- 作者简介：
- 基金信息：
DOI：10.1093/burnst/tkaa031
CLC：Published：2020，
Published Online：14 November 2020，
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Michael H Gold, Mark S Nestor, Brian Berman, David Goldberg, Assessing keloid recurrence following surgical excision and radiation, Burns & Trauma, Volume 8, 2020, tkaa031, https://doi.org/10.1093/burnst/tkaa031
摘要
Abstract
Keloids are a fibroproliferative disorder that can result from a cutaneous injury to the reticular dermis. Recurrence rates as high as 100% have been reported following surgical excision alone. Consequently
a variety of post-surgical techniques have been employed to prevent keloid recurrence
including the use of radiation. Although numerous studies have shown post-excisional X-rays
electron beam
lasers and brachytherapy can reduce the rate of keloid recurrence
numerous inconsistencies
including a wide range of definitions for keloid recurrence
make it difficult to compare study outcomes. The review aims to examine the various means for defining keloid recurrence in clinical trials involving the use of radiation therapy.Searches of the Cochrane Library and PubMed were performed to identify the available information for post-surgical keloid recurrence following radiation therapy. Each identified study was reviewed for patient follow-up and criteria used to define keloid recurrence. The search results included clinical studies with external beam radiation
brachytherapy and superficial radiation therapy. Many studies did not include a definition of keloid recurrence
or defined recurrence only as the return of scar tissue. Other studies defined keloid recurrence based on patient self-assessment questionnaires
symptoms and scar elevation and changes in Kyoto Scar Scale
Japan Scar Workshop Scale and Vancouver Scar Scale scores.The results of this review indicate keloidectomy followed by radiation therapy provide satisfactory recurrence rates; however
clinical studies evaluating these treatments do not describe treatment outcomes or use different definitions of keloid recurrence. Consequently
recurrence rates vary widely
making comparisons across studies difficult. Keloid recurrence should be clearly defined using both objective and subjective measures.
关键词
Keywords
KeloidKeloid scarRecurrenceExternal beam radiationBrachytherapySuperficial radiation therapy
references
1.Brown JJ, Bayat A. Genetic susceptibility to raised dermal scarring. Br J Dermatol. 2009;161:8–18.
2.Ogawa R. Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis. Int J Mol Sci. 2017. doi: 10.3390/ijms18030606.
3.Jfri A, Rajeh N, Karkashan E. A case of multiple spontaneous keloid scars. Case Rep Dermatol. 2015;7:156–60.
4.Mari W, Alsabri SG, Tabal N, Younes S, Sherif A, Simman R. Novel insights on understanding of keloid scar: article review. J Am Coll Clin Wound Spec. 2016;7:1–7.
5.Bijlard E, Kouwenberg CA, Timman R, Hovius SE, Busschbach JJ, Mureau MA. Burden of keloid disease: a cross-sectional health-related quality of life assessment. Acta Derm Venereol. 2017;97:225–9.
6.Walliczek U, Engel S, Weiss C, Aderhold C. Clinical outcome and quality of life after a multimodal therapy approach to ear keloids. Arc Facial Plastic Surg. 2015;17:333–9.
7.Sclafani AP, Gordon L, Chadha M, Romo T III. Prevention of earlobe keloid recurrence with postoperative corticosteroid injections versus radiation therapy: a randomized, prospective study and review of the literature. Dermatol Surg. 1996;22:569–74.
8.Mustoe TA, Cooter RD, Gold MH, Hobbs FD, Ramelet AA, Shakespeare PG, et al. International clinical recommendations on scar management. Plast Reconstr Surg. 2002;110:560–71.
9.Berman B, Maderal A, Raphael B. Keloids and hypertrophic scars: pathophysiology, classification, and treatment. Dermatol Surg. 2017;43:S3–18.
10.Mamalis AD, Lev-Tov H, Nguyen DH, Jagdeo JR. Laser and light-based treatment of keloids--a review. J Eur Acad Dermatol Venereol. 2014;28:689–99.
11.Norris JE. Superficial x-ray therapy in keloid management: a retrospective study of 24 cases and literature review. Plast Reconstr Surg. 1995;95:1051–5.
12.Xu J, Yang E, Yu NZ, Long X. Radiation therapy in keloids treatment: history, strategy, effectiveness, and complication. Chin Med J (Engl). 2017;130:1715–21.
13.Pozzi M, Zoccali G, Drago MC, Mirri MA, Costantini M, De Vita R. Radiotherapy following surgery in keloid treatment: our protocol. G Ital Dermatol Venereol. 2016;151:492–8.
14.Ji J, Tian Y, Zhu YQ, Zhang LY, Ji SJ, Huan J, et al. Ionizing irradiation inhibits keloid fibroblast cell proliferation and induces premature cellular senescence. J Dermatol. 2015;42:56–63.
15.Tosa M, Ghazizadeh M, Shimizu H, Hirai T, Hyakusoku H, Kawanami O. Global gene expression analysis of keloid fibroblasts in response to electron beam irradiation reveals the involvement of interleukin-6 pathway. J Invest Dermatol. 2005;124:704–13.
16.McKeown SR, Hatfield P, Prestwich RJ, Shaffer RE, Taylor RE. Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation. Br J Radiol. 2015. doi: 10.1259/bjr.20150405.
17.Ogawa R, Yoshitatsu S, Yoshida K, Miyashita T. Is radiation therapy for keloids acceptable? The risk of radiation-induced carcinogenesis. Plast Reconstr Surg. 2009;124:1196–201.
18.Recalcati S, Caccialanza M, Piccinno R. Postoperative radiotherapy of auricular keloids: a 26-year experience. J Dermatolog Treat. 2011;22:38–42.
19.Leer JW, van Houtte P, Davelaar J. Indications and treatment schedules for irradiation of benign diseases: a survey. Radiother Oncol. 1998;48:249–57.
20.Mankowski P, Kanevsky J, Tomlinson J, Dyachenko A, Luc M. Optimizing radiotherapy for keloids: a meta-analysis systematic review comparing recurrence rates between different radiation modalities. Ann Plast Surg. 2017;78:403–11.
21.Kal HB, Veen RE. Biologically effective doses of postoperative radiotherapy in the prevention of keloids. Dose-effect relationship. Strahlenther Onkol. 2005;181:717–23.
22.Cheraghi N, Cognetta A, Jr, Goldberg D. Radiation therapy for the adjunctive treatment of surgically excised keloids: a review. J Clin Aesthet Dermatol. 2017;10:12–5.
23.Sruthi K, Chelakkot PG, Madhavan R, Nair RR, Dinesh M. Single-fraction radiation: a promising adjuvant therapy to prevent keloid recurrence. J Cancer Res Ther. 2018;14:1251–5.
24.Duan Q, Liu J, Luo Z, Hu C. Postoperative brachytherapy and electron beam irradiation for keloids: a single institution retrospective analysis. Mol Clin Oncol. 2015;3:550–4.
25.Ragoowansi R, Cornes PG, Moss AL, Glees JP. Treatment of keloids by surgical excision and immediate postoperative single-fraction radiotherapy. Plast Reconstr Surg. 2003;111:1853–9.
26.Flickinger JC. A radiobiological analysis of multicenter data for postoperative keloid radiotherapy. Int J Radiat Oncol Biol Phys. 2011;79:1164–70.
27.Carvajal CC, Ibarra CM, Arbulo DL, Russo MN, Solé CP. Postoperative radiotherapy in the management of keloids. Ecancermedicalscience. 2016;10:690.
28.de Oliveira B, Jr, Schellini SA, Lastória JC, de Carvalho LR, Stolf HO, de Oliveira ALP. Keloid treatment using postoperative radiotherapy with electron beams: a comparative randomized study of two methods. Surg Cosmet Dermatol. 2013;5:16–26.
29.Shen J, Lian X, Sun Y, Wang X, Hu K, Hou X, et al. Hypofractionated electron-beam radiation therapy for keloids: retrospective study of 568 cases with 834 lesions. J Radiat Res. 2015;56:811–7.
30.Guix B, Henríquez I, Andrés A, Finestres F, Tello JI, Martínez A. Treatment of keloids by high-dose-rate brachytherapy: a seven-year study. Int J Radiat Oncol Biol Phys. 2001;50:167–72.
31.Clavere P, Bedane C, Bonnetblanc JM, Bonnafoux-Clavere A, Rousseau J. Postoperative interstitial radiotherapy of keloids by iridium 192. Dermatology. 1997;195:349–52.
32.Garg MK, Weiss P, Sharma AK, Gorla GR, Jaggernauth W, Yaparpalvi R, et al. Adjuvant high dose rate brachytherapy (Ir-192) in the management of keloids, which have recurred after surgical excision and external radiation. Radiother Oncol. 2004;73:233–6.
33.Veen RE, Kal HB. Postoperative high dose rate brachytherapy in the prevention of keloids. Int J Radiat Oncol Biol Phys. 2007;69:1205–8.
34.DeLorenzi F, Tielemans HJ, van der Hulst RR, Rhemrev R, Nieman FH, Lutgens LC, et al. Is the treatment of keloid scars still a challenge in 2006? Ann Plast Surg. 2007;58:186–92.
35.Arneja JS, Singh GB, Dolynchuk KN, Murray KA, Rozzelle AA, Jones KD. Treatment of recurrent earlobe keloids with surgery and high dose rate brachytherapy. Plast Reconstr Surg. 2008;121:95–9.
36.Wagner W, Alfrink M, Micke O, Schäfer U, Schüller P, Willich N. Results of prophylactic irradiation in patients with resected keloids. Acta Oncol. 2000;39:217–20.
37.Malaker K, Ellis F, Paine CH. Keloid scars: a new method of treatment combining surgery with interstitial radiotherapy. Clin Radiol. 1976;27:179–83.
38.Arnault JP, Peiffert D, Latarche C, Chassagne JF, Barbaud A, Schmutz JL. Keloids treated with postoperative iridium 192 brachytherapy treatment: a retrospective study. J Eur Acad Dermatol Venereol. 2009;23:807–13.
39.Fraunholz IB, Gerstenhauer A, Boettcher HD. Results of postoperative 90Sr radiotherapy of keloids in view of patients’subjective assessment. Strahlenther Onkol. 2005;181:724–9.
40.Narkwong L, Thirakhupt P. Postoperative radiation with high dose rate iridium 192 mould for prevention of earlobe keloids. J Med Assoc Thai. 2006;89:428–33.
41.Viani GA, Stefano EJ, Afonso SL, De Fendi LI. Postoperative strontium-90 brachytherapy in the prevention of keloids. Results and prognostic factors. Int J Radiat Oncol Biol Phys. 2009;73:1510–6.
42.Van Leeuwen MCE, Stokmans SC, Bulstra AE, Meijer OW, van Leeuwen PA, Niessen FB. High-dose rate brachytherapy for the treatment of recalcitrant keloids: a unique, effective treatment protocol. Plast Reconstr Surg. 2014;134:527–34.
43.Jiang P, Baumann R, Dunst J, Geenen M, Siebert FA, Niehoff P, et al. Perioperative interstitial high dose rate brachytherapy for the treatment of recurrent keloids. Int J Radiat Oncol Biol Phys. 2016;94:532–6.
44.Jiang P, Geenen M, Siebert FA, Bertolini J, Poppe B, Luetzen U, et al. Efficacy and the toxicity of the interstitial high-dose-rate brachytherapy in the management of recurrent keloids: 5-year outcomes. Brachytherapy. 2018;17:597–600.
45.Hafkamp CJH, Lapid O, Dávila Fajardo R, van de Kar AL, Koedooder C, Stalpers LJ, et al. Postoperative single-dose interstitial high-dose-rate brachytherapy in therapy-resistant keloids. Brachytherapy. 2017;16:415–20.
46.Escarmant P, Zimmermann S, Amar A, Ratoanina JL, Moris A, Azaloux H, et al. The treatment of 783 keloid scars by iridium 192 interstitial irradiation after surgical excision. Int J Radiat Oncol Biol Phys. 1993;26:245–51.
47.Kuribayashi S, Miyashita T, Ozawa Y, Iwano M, Ogawa R, Akaishi S, et al. Post-keloidectomy irradiation using high-dose-rate superficial brachytherapy. J Radiat Res. 2011;52:365–8.
48.Hoang D, Reznik R, Orgel M, Li Q, Mirhadi A, Kulber DA, et al. Surgical excision and adjuvant brachytherapy vs external beam radiation for the effective treatment of keloids: 10-year institutional retrospective analysis. Aesthet Surg J. 2017;37:212–25.
49.Pampena R, Palmieri T, Kyrgidis A, Ramundo D, Iotti C, Lallas A, et al. Orthovoltage radiotherapy for nonmelanoma skin cancer (NMSC): comparison between 2 different schedules. J Am Acad Dermatol. 2016;74:341–7.
50.Jones ME, McLane J, Adenegan R, Lee J, Ganzer CA. Advancing keloid treatment: a novel multimodal approach to ear keloids. Dermatol Surg. 2017;43:1164–9.
51.Song C, Wu HG, Chang H, Kim IH, Ha SW. Adjuvant single-fraction radiotherapy is safe and effective for intractable keloids. J Radiat Res. 2014;55:912–6.
52.Jones ME, Hardy CJ, Ridgway JM. Head and neck keloid management: a retrospective early review on a new approach using surgical excision, platelet rich plasma and in-office superficial photon X-ray radiation. Edorium J Otolaryngol. 2015;2:14–9.
53.Jones ME, Hardy C, Ridgway J. Keloid management: a retrospective case review on a new approach using surgical excision, platelet-rich plasma, and in-office superficial photon X-ray radiation therapy. Adv Skin Wound Care. 2016;29:303–7.
54.Kim LSH. Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period. Radiat Oncol J. 2012;30:49–52.
55.Yamawaki S, Naitoh M, Yoshikawa K, Ishiko T, Suzuki S. Kyoto scar scale for assessment of keloids following surgery and irradiation. J-Stage. 2011;2:112–7.
56.Yamawaki S, Naitoh M, Ishiko T, Muneuchi G, Suzuki S. Keloids can be forced into remission with surgical excision and radiation, followed by adjuvant therapy. Ann Plast Surg. 2011;67:402–6.
57.Hsueh WT, Hung KS, Chen YC, Huang YT, Hsu CK, Ogawa R, et al. Adjuvant radiotherapy after keloid excision: preliminary experience in Taiwan. Ann Plast Surg. 2019;82:S39–44.
58.Ogawa R, Akita S, Akaishi S, Aramaki-Hattori N, Dohi T, Hayashi T, et al. Diagnosis and treatment of keloids and hypertrophic scars-Japan scar workshop consensus document 2018. Burns Trauma. 2019;7:39.
59.Baryza MJ, Baryza GA. The Vancouver scar scale: an administration tool and the interrater reliability. J Care Rehab. 1995;16:535–8.
60.Mohammadi AA, Mohammadian Panah M, Pakyari MR, Tavakol R, Ahrary I, Seyed Jafari SM, et al. Surgical excision followed by low dose rate radiotherapy in the management of resistant keloids. World J Plast Surg. 2013;2:81–6.
61.Salameh F, Koren A, Sprecher E, Artzi O. Novel stereoscopic optical system for objectively measuring above-surface scar volume-first-time quantification of responses to various treatment modalities. Dermatol Surg. 2018;44:848–54.
62.Verhiel SH, Piatkowski de Grzymala AA, Van den Kerckhove E, Colla C, van der Hulst RR. Three-dimensional imaging for volume measurement of hypertrophic and keloid scars, reliability of a previously validated simplified technique in clinical setting. Skin Res Technol. 2016;22:513–8.
63.Berman B, Young VL, McAndrews J. Objective assessment of the precision, accuracy, and reliability of a measurement method for keloid scar volume (PARKS study). Dermatol Surg. 2015;41:1274–82.
64.van der Aa T, Verhiel SH, Erends M, Piatkowski de Grzymala AA, Van den Kerckhove E, Colla C, et al. A simplified three-dimensional volume measurement technique in keloid scars: validity and reliability. J Plast Reconstr Aesthet Surg. 2015;68:1574–80.
65.Schwaiger H, Reinholz M, Poetschke J, Ruzicka T, Gauglitz G. Evaluating the therapeutic success of keloids treated with cryotherapy and intralesional corticosteroids using noninvasive objective measures. Dermatol Surg. 2018;44:635–44.
66.Kim K, Son D, Kim J. Radiation therapy following total keloidectomy: a retrospective study over 11 years. Arch Plast Surg. 2015;42:588–95.
67.Bennett KG, Kung TA, Hayman JA, Brown DL. Treatment of keloids with excision and adjuvant radiation: a single center experience and review of the literature. Ann Plast Surg. 2017;78:157–61.
68.Emad M, Omidvari S, Dastgheib L, Mortazavi A, Ghaem H. Surgical excision and immediate postoperative radiotherapy versus cryotherapy and intralesional steroids in the management of keloids: a prospective clinical trial. Med Princ Pract. 2010;19:402–5.
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