Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2019
Surface brachytherapy in the treatment of keloid scars in Mexico.
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Bautista Hernandez Yicel, Villavicencio Queijero Michelle Aline, Quezada Bautista Abril Antonia, Vazquez Tinajero Azcary
Аннотация
OBJECTIVE: To demonstrate that superficial high-dose-rate (HDR) brachytherapy by means of Leipzig applicators or moulds with catheters is an adjuvant treatment with impact on local control and low toxicity.
BACKGROUND: Keloid scars occur in 5-15 % of cases, secondary to an uncontrolled proliferation of fibroblasts and reduction in the inhibition of growth factors.
MATERIAL AND METHODS: Retrospective, longitudinal and descriptive study in patients with keloid scars who were treated with superficial HDR brachytherapy in the General Hospital of Mexico between November 2009 and December 2013.
RESULTS: Eighty patients were evaluated, and the mean follow-up was 22.18 months (range 8-48). The anatomic site treated was the ear in 72 patients (90.0 %), anterior thorax in 5 patients, retroauricular region in 2, and abdomen region in 1 patient. The application was performed 24 h after surgery; the dose for 79 patients (99 %) was 1500 cGy/3 fractions, and 1 received 500 cGy in 1 fraction. Adequate healing occurred in 76 patients (95 %), and the local failure was 5 % (95 % CI). Acute toxicity occurred in 15 % (12 patients) with grade 1 radioepithelitis. Chronic toxicity occurred in 22 patients (27.5 %) with grade 1 hypopigmentation and 18 patients (22.5 %) with grade 1 fibrosis. The cosmetic result was good in 72 patients (90 %). During follow-up, 2 patients presented recurrence, and 2 patients persisted.
CONCLUSIONS: Treatment with superficial brachytherapy in keloid scars using a mould with catheters or a Leipzig applicator is a therapeutic option that results in 95 % local control and low toxicity.
BACKGROUND: Keloid scars occur in 5-15 % of cases, secondary to an uncontrolled proliferation of fibroblasts and reduction in the inhibition of growth factors.
MATERIAL AND METHODS: Retrospective, longitudinal and descriptive study in patients with keloid scars who were treated with superficial HDR brachytherapy in the General Hospital of Mexico between November 2009 and December 2013.
RESULTS: Eighty patients were evaluated, and the mean follow-up was 22.18 months (range 8-48). The anatomic site treated was the ear in 72 patients (90.0 %), anterior thorax in 5 patients, retroauricular region in 2, and abdomen region in 1 patient. The application was performed 24 h after surgery; the dose for 79 patients (99 %) was 1500 cGy/3 fractions, and 1 received 500 cGy in 1 fraction. Adequate healing occurred in 76 patients (95 %), and the local failure was 5 % (95 % CI). Acute toxicity occurred in 15 % (12 patients) with grade 1 radioepithelitis. Chronic toxicity occurred in 22 patients (27.5 %) with grade 1 hypopigmentation and 18 patients (22.5 %) with grade 1 fibrosis. The cosmetic result was good in 72 patients (90 %). During follow-up, 2 patients presented recurrence, and 2 patients persisted.
CONCLUSIONS: Treatment with superficial brachytherapy in keloid scars using a mould with catheters or a Leipzig applicator is a therapeutic option that results in 95 % local control and low toxicity.