ABSTRACT
<p><b>OBJECTIVE</b>Radiation therapy combined with surgical excision was considered as one of the most effective treatment plans for keloid lesions. However, there was no unanimity found over present literatures regarding the issue on optimized treatment strategy for keloids. We here provide a comprehensive review over this issue and emphasize on the influencing factors.</p><p><b>DATA SOURCES</b>The data analyzed in this review were searched from articles included in PubMed and EMBASE databases.</p><p><b>STUDY SELECTION</b>The original articles and critical reviews discussing the application of radiation therapy in keloids treatment were selected for this review.</p><p><b>RESULTS</b>The application of radiation therapy has transitioned from simple superficial X-ray irradiation to brachytherapy. Furthermore, several factors including radiation type, dose, fraction, interval, and complications were reviewed, and the results revealed that these factors were significant toward clinical outcome at various levels.</p><p><b>CONCLUSIONS</b>Both past and present evidence support the idea that combination therapy of radiation and surgical therapy is safe and feasible. However, the optimization of treatment strategy was based on different radiation types and should take dose, fractions, interval, and complications into consideration, which will then decrease the rate of recurrence and increase the level of satisfaction.</p>