The authors report the outcomes of patients with
keloid scars treated with a protocol of extralesional excision and immediate single-fraction
adjuvant radiotherapy. The design of the study was a retrospective analysis with up to 5-year outcome data. The setting was a single treatment team, University Teaching Hospital in London, United Kingdom. Participants (n = 80) were treated for 80
keloid scars (59 percent female patients, 76 percent nonwhite), and 44 percent of
keloids were located on earlobes. For all patients, prior treatment without
radiotherapy had failed. The
salvage treatment reported in this article is combined extralesional excision and immediate postoperative external-beam
radiotherapy. A 10-Gy dose of superficial 60-kV or 100-kV photon irradiation was given within 24 hours of the operation. The main outcome measure was freedom from recurrence of
keloid scars. Results were that all
keloid scars were controlled at 4-week follow-up. Probability of relapse at 1 year was 9 percent; at 5 years, probability of relapse was 16 percent. The earlobe showed no greater chance of relapse than other sites on the body. The authors' report shows that extralesional excision of
keloid followed by early, single-fraction, postoperative
radiotherapy is both simple and effective in preventing recurrence at excision sites.