Purpose: To evaluate the results of keloids treated with perioperative interstitial high-dose-rate brachytherapy (HDR-BT).Material and methods: A retrospective review of 61 keloids in 51 patients treated with perioperative interstitial HDR-BT was performed. Keloid lesions were treated with 12 Gy in 4 fractions within 48 hours. Time between surgery and brachytherapy was less than 90 minutes. Local failure was defined as recurrence of apparent keloid or symptoms in the same place. Median age of patients was 46 years (range, 20-89 years). Keloid scars were located on the chest (41%), ear lobe (21%), back (1.6%), extremities (11.5%), and mean keloid size was 6.3 cm.Results: With a median follow-up of 47.95 months (range, 1-96 months), the recurrence rate was 4.9%, all located on the chest. The multivariate analysis showed no statistically significant relationship between location, scar size, and previously treated lesions with the recurrence rate.Conclusions: The treatment of keloid scars with perioperative interstitial high-dose-rate brachytherapy achieved excellent results, with a recurrence rate of only 4.9% and excellent cosmetic outcomes, suggesting that this technique might be one of the best options for treating keloids.

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The good results of local control, disease-free survival and few complications that the external radiotherapy combined with HDR brachytherapy have shown suggest that the method should be considered as first-choice in the treatment of prostate tumours of high- and intermediate-risk.

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