いわゆるケロイドの電子線照射療法の治療成績

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  • Treatment Result of So-Called Keloid with Electron Beam Irradiation.

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Between September 1993 and February 1997, 28 sites of so-called keloid (14 true keloids and 14 hypertrophic scars) were treated with electron beam irradiation. Twenty-five of these sites were treated with surgical excision followed by radiotherapy, and the other 3 sites received radiotherapy only. Irradiation by 9 MeV electron beam was performed for all patients, with a total dose of 20 Gy (10 fractions for 2 weeks). The results were evaluated at 8-49 months (Ave. 28.4 months) after treatment. Three sites treated with radiation more than 60 days after exicion were excluded from evaluation of treatment response.<BR>Twenty-two of 25 sites showed complete response (CR) or partial response (PR). The control rate of total sites was 88.0%. The control rate was 92.9% in true keloids and 81.8% in hypertrophic scars. All keloid sites in the face, neck, shoulder, back and arm exhibited CR. One site of keloid in the head showed no response (NR). In 10 sites in the thoracic lesion, 8 were PR (80.0%) and 2 were NR (20.0%). In 8 sites in the abdominal lesion, 6 were CR (75.0%), 2 were PR (25.0%). All 3 non-operative sites exhibited PR. The control rate of sites treated with radiation within 14 days after keloid excision was 80.0% and that in sites treated more than 15 days after excision was 100.0%. Seven sites (7/28=25.0%) developed acute reaction, which were demonstrated erythema in the irradiated field, but this reaction was transient. Five sites (5/28=17.9%) showed hyperpigmentation indicating late reaction. The development of malignant tumor in or around the irradiated field was not shown.<BR>Postoperative electron beam irradiation was effective for so-called keloid. These data suggest that 10-fraction irradiation controls low grade of hyperpigmentation development, even though patients received a comparatively high total doseof radiotherapy.

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