Radiotherapy for the management of
keloids was introduced in 1906. Eighty-eight years later there is no consensus among physicians who treat
keloids that
radiotherapy is safe, although it is generally accepted that
radiotherapy is effective in reducing the recurrence of
keloids following excision. This paper reports on a retrospective study of 24 patients whose
keloid postexcisional sites were treated with superficial
x-ray therapy. This paper compares the author's results with the results of 18 studies reported by other investigators. The objective of the paper was to determine the effectiveness and safety of superficial
x-ray therapy. The paper concludes that superficial
x-ray therapy does reduce the rate of postexcisional
keloid recurrence. It stresses the need for better controls in reporting on superficial
x-ray therapy in
keloid management. A multi-institutional prospective study is proposed, and a suggested protocol is outlined. There has been only one case report of a
carcinoma occurring subsequent to the treatment of a
keloid postexcisional site with
radiotherapy, and the causal relation was questionable. A system for long-term follow-up of patients who receive superficial
x-ray therapy is proposed.