Postoperative interstitial radiotherapy of keloids by iridium 192: A retrospective study of 46 treated scars

Background: Keloids are clinically veracious scars characterized by a high recurrence rate after excision alone (50-100%). Many adjuvant techniques have been used with more or less convincing results. Objective: The aim of this study is to show the efficiency of keloidectomy and postoperative interstitial radiotherapy by an iridium 192 wire. Methods: During a 14-year period, 39 patients with keloids (46 keloids) were treated by this regimen. Seven patients had been previously treated by intralesional corticosteroids, surgery alone or postoperative interstitial radiotherapy, without improvement. A dose of 12, Gy (7 keloids) to 15 Gy (22 keloids) was delivered at a point 2.5 mm from the axis of the wire. For 17 keloids the dose schedule was 15 Gy at a point 5 mm to the wire. The median follow-up was 7 months. Results: The overall success rate is close to 63%. A recurrence occurred in 14 cases without relation to the method used, the age or the localization of the lesions. There were no side effects observed. Conclusion: Postoperative interstitial radiotherapy represents an effective, unconstraining and safe treatment for keloids if the contraindications are respected.