open access

Vol 20, No 1 (2015)
Original research articles
Published online: 2015-01-01
Submitted: 2013-11-26
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Adjuvance in refractory keloids using electron beams with a spoiler: Recent results

Antoni Vila Capel, Jorge Vilar Palop, Agustí Pedro Olivé, Alberto Sánchez-Reyes Fernández
DOI: 10.1016/j.rpor.2014.08.005
·
Rep Pract Oncol Radiother 2015;20(1):43-49.

open access

Vol 20, No 1 (2015)
Original research articles
Published online: 2015-01-01
Submitted: 2013-11-26

Abstract

Aim

To present clinical results of adjuvant irradiation of excised refractory keloid wounds using a novel bolus-free technique developed within our group to irradiate the skin surface with a linear accelerator.

Background

The use of a bolus to increase surface dose over a newly excised keloid presents several problems. Previous solutions are unsatisfactory. Our technique is promising but needs to be evaluated in practice.

Materials and methods

Twenty refractory skin keloids in 19 patients were excised and irradiated in Hospital Plató (Barcelona, Spain) using a 6[[ce:hsp sp="0.25"/]]MeV electron beam with a 4-mm aluminium spoiler. 15[[ce:hsp sp="0.25"/]]Gy in fractions of 3[[ce:hsp sp="0.25"/]]Gy were delivered to the excision site plus a safety margin. All patients were examined during the follow-up (median: 40 months, interval: 12–68 months) and toxicities were recovered.

Results

At the end of the follow-up period, 76% of the cases had not recurred, while the complete response rate amounted to 53%. Residual hypertrophic scars were classified as partial responses. After therapy, itching and pain were observed in 30% of the patients, as well as one telangiectasia and two hyperchromatic scars.

Conclusion

Our technique avoids using a bolus while combining the benefits of electron beam therapy in keloids (fewer secondary effects, and fewer and shorter treatments) with a dose deposition adequate for skin surface treatments. Our results are in line with the most successful therapies evaluated in the literature, as secondary effects are acceptable and recurrence rates are low.

Abstract

Aim

To present clinical results of adjuvant irradiation of excised refractory keloid wounds using a novel bolus-free technique developed within our group to irradiate the skin surface with a linear accelerator.

Background

The use of a bolus to increase surface dose over a newly excised keloid presents several problems. Previous solutions are unsatisfactory. Our technique is promising but needs to be evaluated in practice.

Materials and methods

Twenty refractory skin keloids in 19 patients were excised and irradiated in Hospital Plató (Barcelona, Spain) using a 6[[ce:hsp sp="0.25"/]]MeV electron beam with a 4-mm aluminium spoiler. 15[[ce:hsp sp="0.25"/]]Gy in fractions of 3[[ce:hsp sp="0.25"/]]Gy were delivered to the excision site plus a safety margin. All patients were examined during the follow-up (median: 40 months, interval: 12–68 months) and toxicities were recovered.

Results

At the end of the follow-up period, 76% of the cases had not recurred, while the complete response rate amounted to 53%. Residual hypertrophic scars were classified as partial responses. After therapy, itching and pain were observed in 30% of the patients, as well as one telangiectasia and two hyperchromatic scars.

Conclusion

Our technique avoids using a bolus while combining the benefits of electron beam therapy in keloids (fewer secondary effects, and fewer and shorter treatments) with a dose deposition adequate for skin surface treatments. Our results are in line with the most successful therapies evaluated in the literature, as secondary effects are acceptable and recurrence rates are low.

Get Citation

Keywords

Keloids; Spoiler; Superficial treatment; Electron therapy

About this article
Title

Adjuvance in refractory keloids using electron beams with a spoiler: Recent results

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 20, No 1 (2015)

Pages

43-49

Published online

2015-01-01

DOI

10.1016/j.rpor.2014.08.005

Bibliographic record

Rep Pract Oncol Radiother 2015;20(1):43-49.

Keywords

Keloids
Spoiler
Superficial treatment
Electron therapy

Authors

Antoni Vila Capel
Jorge Vilar Palop
Agustí Pedro Olivé
Alberto Sánchez-Reyes Fernández

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