FLORENCE, ITALY Complete remission of nearly 90% of keloids followed surgery and postoperative radiation, according to a report at the 13th Congress of the European Academy of Dermatology and Venereology.
With her colleagues, Monica Bellinvia, M.D., of the Institute of Dermatological Sciences of the University of Milan's Ospedale Maggiore, retrospectively analyzed the charts of 152 patients with 187 keloids treated with surgery and orthovoltage radiotherapy over the past 22 years (follow-up: 6 months to 18 years).
Complete remission occured in 166 lesions (89%), with a partial response in 21 lesions (11%). Relapses occurred in 17 lesions from 1 month to 6 years' post treatment, but the 5-year relapse-free rate was 85%, she said.
Excisional surgery was performed on all patients, with care taken to minimize tension at the wound site. Radiation followed within 48 hours in 48 lesions, within 37 days in 108 lesions, and within 823 days in 31 lesions. Surrounding tissues were protected from radiation.
Total radiation administered ranged from 15 Gy to 40 Gy, although a subanalysis of the data determined that the most therapeutic and cosmetically effective dose was between 25 Gy and 30 Gy.