Treatment of keloids by immediat post-operatoire interstitial brachytherapy

ABSTRACT

Clinically considered as a pathologic scar remaining beyond 12 to 18 months, the keloid is characterised by a high recurrance rate after excision alone [50% - 100%]. Many therapeutic methods were used [Corticotherapy, pressotherapy], with disappointing results. The aim of this paper is to identify that post operative interstitial radiotherapy by iridium 192 [low dose rate] is effective for improving local control of keloids and preventing recurrence. From 1995 to 1998, 14 patients [18 keloids] were treated at the National Institute of Oncology - Rabat - Morocco. The average age is 27 years. The keloid was located on ear lobes in half of the cases. All patients had previously a trauma [injured, surgery]. 3 patients had multiple keloids. 10 patients [70% of cases] had keloid relapse after surgical excision. The treatment consisted of surgical excision followed immediately by brachytherapy with iridium 192. After 41 months of follow-up, we had obtained a good esthetic results in 7 cases [8 keloids]. 4 patients [5 keloids] recurred after an average delay of 14 months. 4 patients [5 keloids] were lost to follow-up