Treatment Results of Combined Surgery and Brachytherapy, and the Rate of Recurrence in Patients with Recurrent Keloid Scars

Several options are described to treat keloid scars, none of them being 100% successful. Radiotherapy is suggested to have the most significant effect on recurrence rate. The aim of the study is to evaluate the effectiveness of High-dose brachytherapy combined with surgery and to evaluate patient satisfaction.
Methods and Material: We retrospectively enrolled 5 patients with 10 keloids, treated by surgical excision and high-dose-rate (HDR) brachytherapy. Total dose was 12 Gy in 3 fractions.
The median size of the lesions before brachytherapy was 153.48 mm2. The improvement of scars of scoring POSAS by observer and patient were 17.1±3.2 (11-32) and 20.8±11.5 (5-51), respectively. Mean of recurrent time was 26.3±0.9 months. With a median follow-up of 60 months, the overall recurrence-free response rate for all keloids was 20%. Except for one patient, in other patients seen no complications.
It seems that keloid excision followed by HDR brachytherapy is effective in the eradication of keloids in treatment. It also resulted in a good cosmetic rate and relief of symptoms.