Postoperative management of keloids: Low-dose-rate and high-dose-rate brachytherapy

Cicco, Luigi De; Vischioni, Barbara; Vavassori, Andrea; Gherardi, F.; Jereczek‐Fossa, Barbara Alicja; Lazzari, Roberta; Cattani, Federica; Comi, S.; Lorenzi, Francesca De; Martella, Stefano; Orecchia, Roberto

doi:10.1016/j.brachy.2014.01.005

Cited by 33 publications

(18 citation statements)

References 23 publications

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“…They reported a recurrence rate of 12%. In contrast, a high recurrence rate of 38% was observed after treatment with 4 Â 3 Gy (13). It should be noted that the sample sizes were small in all those studies, and the selection of patients with regard to risk factors varied in the studies.…”

Section: Discussionmentioning

confidence: 59%

Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

Jiang

Baumann

Dunst

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 59%

Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

Jiang

Baumann

Dunst

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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“…Several studies show that radiotherapy effectively prevents and treats keloids [20,21]. While it is reported that radiotherapy primarily acts by suppressing fibroblast activity, it should be noted that endothelial cells are more sensitive to radiation than fibroblasts.…”

Section: Treatment Of Keloids and Hypertrophic Scarsmentioning

confidence: 99%

Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

Ogawa

2017

IJMS

668

616

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Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection. Notably, superficial injuries that do not reach the reticular dermis never cause keloidal and hypertrophic scarring. This suggests that these pathological scars are due to injury to this skin layer and the subsequent aberrant wound healing therein. The latter is characterized by continuous and histologically localized inflammation. As a result, the reticular layer of keloids and hypertrophic scars contains inflammatory cells, increased numbers of fibroblasts, newly formed blood vessels, and collagen deposits. Moreover, proinflammatory factors, such as interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor-α are upregulated in keloid tissues, which suggests that, in patients with keloids, proinflammatory genes in the skin are sensitive to trauma. This may promote chronic inflammation, which in turn may cause the invasive growth of keloids. In addition, the upregulation of proinflammatory factors in pathological scars suggests that, rather than being skin tumors, keloids and hypertrophic scars are inflammatory disorders of skin, specifically inflammatory disorders of the reticular dermis. Various external and internal post-wounding stimuli may promote reticular inflammation. The nature of these stimuli most likely shapes the characteristics, quantity, and course of keloids and hypertrophic scars. Specifically, it is likely that the intensity, frequency, and duration of these stimuli determine how quickly the scars appear, the direction and speed of growth, and the intensity of symptoms. These proinflammatory stimuli include a variety of local, systemic, and genetic factors. These observations together suggest that the clinical differences between keloids and hypertrophic scars merely reflect differences in the intensity, frequency, and duration of the inflammation of the reticular dermis. At present, physicians cannot (or at least find it very difficult to) control systemic and genetic risk factors of keloids and hypertrophic scars. However, they can use a number of treatment modalities that all, interestingly, act by reducing inflammation. They include corticosteroid injection/tape/ointment, radiotherapy, cryotherapy, compression therapy, stabilization therapy, 5-fluorouracil (5-FU) therapy, and surgical methods that reduce skin tension.

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“…The other advantages of HDR BT are the ease of optimization of the dose distribution by varying dwell times at various locations within individual catheters (29,30,33,34), and the possibility of remote afterloading, with absence of radiation exposure of the staff (31,46). Comparison of outcomes from the different studies, including HDR and LDR BT, can be seen in Tables 7 and 8.…”

Section: Discussionmentioning

confidence: 98%

Interstitial high-dose-rate brachytherapy in eyelid cancer

Mareco¹,

Bujor²,

Abrunhosa-Branquinho³

et al. 2015

Brachytherapy

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Postoperative management of keloids: Low-dose-rate and high-dose-rate brachytherapy

Cited by 33 publications

References 23 publications

Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

Interstitial high-dose-rate brachytherapy in eyelid cancer

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