A Single-Institution Review of the Use of Radiation in the Adjuvant and Definitive Management of Keloids

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) 2024-06, Vol.36 (6), p.e163-e167
• Main Authors: Fernandes, J., Liao, D., Dasgupta, A., Tsao, M.N., Barnes, E.A.
• Format: Article
• Language: English
• Subjects: Keloid; radiation therapy
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1016/j.clon.2024.03.018

Many individuals suffer from keloids that are refractory to standard treatment modalities, including surgical excision alone. Radiation therapy can be used to reduce the risk of recurrent keloids post-operatively, as well as be used as primary treatment for keloids not amenable to surgical resection. The purpose of this study was to review our institutional experience of radiation therapy for keloid management. A retrospective review of patients treated with radiation therapy for keloids between 2014 and 2020 at our institution was performed. A total of 70 keloids in 41 patients were treated. For the 55 keloids treated with post-operative radiation therapy (16Gy delivered in 2 fractions), 82.5% (33/40) of evaluable lesions did not recur. Among the 15 keloids treated with definitive radiation therapy (24Gy delivered in 3 fractions), 78.6% (11/14) of evaluable keloids showed complete flattening, and 14.3% (2/14) had partial flattening. Both acute and late toxicities were mild, with only a single instance of grade 3 toxicity (dermatitis). Our study confirms that radiation therapy has a role in reducing the risk of keloid recurrence post-operatively, and plays an important role in the definitive management of unresectable keloids. •Single-institution review of treatment for 70 keloids among 41 patients with adjuvant or definitive radiation therapy.•We demonstrate a complete keloid flattening rate of 78.6% for keloids treated with definitive radiation therapy.•We describe our treatment protocol for the definitive treatment of keloids with radiation therapy.