RESUMO
OBJECTIVE: To investigate the clinical efficacy of self-made 32P applicator for treating different kinds of keloid. others were treated with surgical excision combined with self-made 32P applicator. The 32P applicator was shaped according to the size and shape of the diseased region and the application time was calculated according to the dose rate and the decay correction. 4.0-5.0 Gy was applied in every diseased region in each of the four days (one course), and 4-6 courses in total was required, with 4 weeks of intervals following each course. For children, dose was reduced to 4 Gy or less once a day in every diseased region. Patients in the operation combined with application group were performed keloids excision first. Then 32P applicators were applied to the wound without any exudation in the same way as above. RESULTS: Of all the 39 patients (lesion thickness≤0.3 cm, 32P applicator therapy only), 32 ones was cured (82.1%), with the total effective rate of 98%. For patients with lesion thickness > 0.3 cm, the total effective rate of 32P applicator therapy and surgical excision combined with self-made 32P applicator were 55.6% and 93.3% respectively, and the difference was ofsignificance (P < 0.01 ). Among these patients, those with disease course less than 9 months had the effective rates of 25.0% and75.0% corresponding to 32P applicator therapy only and surgical excision combined with self-made 32p applicator respectively.For those with long course of disease, the effective rates were 13% and 77% respectively. A total of 26 patients experienced local buming and slight pain during the 32P applicator treatment, and all the symptoms were relieved by using calamine lotion; 5 patients and 2 patients expedencad grade Ⅰ and Ⅱ radio dermatitis respectively, which were relieved by using Mupirocin Ointment. No radio dermatitis of grade Ⅲ or above occurred to any patient. In addition, pigmentation or color changing occurred at local skins of cured patients.CONCLUSION: 32P applicator therapy is safe and effective for treating keloid. For patients with short disease course and lesion thickness ≤0.3 cm, 32P applicator therapy only is enough. Otherwise, patients are suggested to use 32P applicator after operation.