Antimitotic Drug Injections and Radiotherapy: A Review of the Effectiveness of Treatment for Hypertrophic Scars and Keloids

Wang, Xiqiao; Liu, Yingkai; Wang, Zhiyong; Wei, Jun; Jiang, Yuzhi; Qing, Chun; Lu, Shuliang

doi:10.1177/1534734608322099

Cited by 13 publications

(14 citation statements)

References 52 publications

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“…The results of the present study are consistent with those of previous ones, one of which reported that the effectiveness rate of 5-FU injection alone was 62.5%, whereas the effectiveness of combined 5-FU and glucocorticoids was significantly higher at 92% (21,22). Intralesional 5-FU is generally well tolerated.…”

Section: Discussionsupporting

confidence: 83%

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

Xiao-E

Liu

Jameel

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Keloids are benign tumors that originate from scar tissues, but they usually overgrow beyond the original wounds. In a three-month single-center clinical trial, 69 patients were randomly divided into three groups. Patients in group 1 were treated with intralesional injection of diprospan (2 mg betamethasone disodium phosphate and 5 mg betamethasone dipropionate in 1 ml) with one-month intervals for three months. Patients in groups 2 and 3 were injected with a combination of 0.5 ml 5-fluorouracil (5-FU; 25 mg/ml) and diprospan as above for three months also. Prior to each injection, the keloids of patients in group 3 were additionally irradiated by a 1,064-nm neodymium-yttrium-aluminum-ga rnet (Nd:YAG) laser with a single pulse at an energy density of 90-100 J/cm 2 and a pulse width of 12 msec. Clinical responses were evaluated by patient self-assessment and overall assessment by an observer according to the clinical signs of erythema, pruritus and pliability. A total of sixty-two patients completed the tests of the present study. At 2 and 3 months, the patients in all treatment groups showed an acceptable improvement in nearly all measurements. At the end of the study, the erythema and toughness score was significantly reduced and itch reduction was significantly greater in the diprospan + 5-FU + Nd:YAG group when compared to those in the other groups (P<0.05 for all indexes). The acceptable responses (good to excellent improvements) reported by blinded observers were as follows: 12% in the diprospan group, 48% in the diprospan + 5-FU group and 69% in the diprospan + 5-FU + Nd:YAG group. All of the results indicated that the combination of diprospan + 5-FU + Nd:YAG was the most efficacious therapy for keloid scars.

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Section: Discussionsupporting

confidence: 83%

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

Xiao-E

Liu

Jameel

et al. 2017

Experimental and Therapeutic Medicine

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“…It disrupts the interconversion of uridine into thymidine through inhibiting thymidylate synthase. 20 , 21 It was originally used in the 1980’s as an adjuvant to glaucoma filtering surgery and in recent years for the treatment of a variety of malignancies. 2 , 20 Both in vitro and in vivo experiments have shown that 5-FU can inhibit fibroblast proliferation.…”

Section: -Fluorouracilmentioning

confidence: 99%

“…Colchicine is an antimitotic agent commonly used for cancer therapy because of its ability to inhibit collagen synthesis, cause microtubular disruption and increase the activity of collagenase. 21 , 41 Peacock et al studied the effects of colchicine in 10 patients with scars and reported positive results. However, because of its narrow therapeutic window its application is restricted.…”

Section: Potential Therapiesmentioning

confidence: 99%

The use of chemotherapeutics for the treatment of keloid scars

et al. 2015

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Keloid scars are pathological scars, which develop as a result of exaggerated dermal tissue proliferation following cutaneous injury and often cause physical, psychological and cosmetic problems. Various theories regarding keloidogenesis exist, however the precise pathophysiological events remain unclear. Many different treatment modalities have been implicated in their management, but currently there is no entirely satisfactory method for treating all keloid lesions. We review a number of different chemotherapeutic agents which have been proposed for the treatment of keloid and hypertrophic scars while giving insight into some of the novel chemotherapeutic drugs which are currently being investigated. Non-randomized trials evaluating the influence of different chemotherapeutic agents, such as 5-fluorouracil (5-FU); mitomycin C; bleomycin and steroid injection, either alone or in combination with other chemotherapeutic agents or alternative treatment modalities, for the treatment of keloids were identified using a predefined PubMed search strategy. Twenty seven papers were identified. Scar improvement ≥50% was found in the majority of cases treated with 5-FU, with similar results found for mitomycin C, bleomycin and steroid injection. Combined intralesional 5-FU and steroid injection produced statistically significant improvements when compared to monotherapy. Monotherapy recurrence rates ranged from 0-47% for 5-FU, 0-15% for bleomycin and 0-50% for steroid injection. However, combined therapy in the form of surgical excision and adjuvant 5-FU or steroid injections demonstrated lower recurrence rates; 19% and 6% respectively. Currently, most of the literature supports the use of combination therapy (usually surgery and adjuvant chemotherapy) as the mainstay treatment of keloids, however further investigation is necessary to determine success rates over longer time frames. Furthermore, there is the potential for novel therapies, but further investigation is required to elucidate their true efficacy.

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“…Following this idea, probably the effect of the topical application of P144 may be enhanced in addition of a second agent, which can induce collagenolysis and cell apoptosis. Pulsed-dye laser [ 51 ], silicone-based products [ 52 ] and pressure dressings [ 53 ] can induce fibroblasts apoptosis and increase the collagen degradation. A combined drug therapy may yield greater efficacy and reduce side effects [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of P144® (Anti-TGF-β) in an “In Vivo” Human Hypertrophic Scar Model in Nude Mice

Qiu

Dotor²,

Hontanilla

2015

PLoS ONE

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BackgroundHypertrophic scars are one of the most important complications in surgery due to their cosmetic and functional impairments. Previous studies in tissue fibrotic disorders have shown promising results by inhibiting the biological activity effect of Transforming Growth Factor-beta 1 (TGF-β1). The aim of the current study was to determine the clinical effect of the inhibition of TGF-β1 signaling in human hypertrophic scars implanted in nude mice by topical application of an inhibitor of TGF-β1 (P144®).Material and MethodsA total of 30 human hypertrophic scars were implanted in 60 nude mice. The animals were divided in two groups, group A (placebo) and group B (treatment). Group C (basal) was considered as the preimplanted scar samples and they were not implanted in the nude mice. After the shedding period, topical application of a lipogel containing placebo (group A) or P144 (group B) was daily administered during two weeks. The animals were sacrificed upon completion of the study. Total area, thickness and collagen fibers area were measure and compared across all groups. Immunohistochemistry was also performed in order to quantify collagen type I and type III and elastic fiber expressions present in the dermis.ResultsSuccessful shedding was achieved in 83,3% of the xenografts. The mean time for shedding was 35±5.4 days. Statistically significant differences were found in the total area, collagen fibers area and thickness between the groups. Increased elastic fibers and decreased collagen I were found in the P144-treated group compared to the basal group.ConclusionTopical application of an inhibitor of TGF-β1 may promote scar maturation and clinical improvement of hypertrophic scar morphology features in an “in vivo” model in nude mice after two weeks of treatment.

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Antimitotic Drug Injections and Radiotherapy: A Review of the Effectiveness of Treatment for Hypertrophic Scars and Keloids

Cited by 13 publications

References 52 publications

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

The use of chemotherapeutics for the treatment of keloid scars

Effect of P144® (Anti-TGF-β) in an “In Vivo” Human Hypertrophic Scar Model in Nude Mice

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