Treatment of Earlobe Keloids Using the Cobalt 60 Teletherapy Unit

Abstract

The purpose of this study was to develop an easily accessible technique for the delivery of postoperative radiotherapy for the treatment of earlobe keloids. Forty-seven earlobe keloids were given postoperative radiation using the smallest achievable half field Telecobalt technique. Results showed 41 (87.2%) of treated patients' postoperative scars remained free from recurrent keloid formation. Acute reactions were minimal and patient compliance was excellent. In conclusion, the technique described in this study for the delivery of postoperative radiation to earlobe keloids should be readily available in areas of high prevalence. Results are comparable to previously used radiotherapy techniques.

Biologically Effective Doses of Postoperative Radiotherapy in the Prevention of Keloids

“…Results on recurrence rates at no stretch tense areas (Table 1) also indicate that the lowest recurrence rate was found for the shortest OTT or at the highest BED value [10,13,22,36,39,40,43]. However, the recurrence rate reported by Ragoowansi et al is an exception [43].…”

“…We therefore selected reports with results of keloids on earlobes, face and neck region (favorable sites, keloids in no stretch tension areas) [10,13,22,33,35,36,39,40,43] and reports with results of keloids mainly located in stretch tension areas as limbs and trunk (nonfavorable sites) [9, 12, 38-40, 43, 49]. The data points are shown in Figure 3 and were fitted with an exponential function as indicated.…”

Is Radiation Therapy for Keloids Acceptable? The Risk of Radiation-Induced Carcinogenesis

“…In addition, radiation therapy has been used as a monotherapy 11,23,29 or in combination with adjuvant therapy delivered preoperatively 33 or postoperatively. [1][2][3][4][5][6][7][8][9][10][12][13][14][15][16][17][18][19][20][21][23][24][25][26][27][28][29][30][31][32] However, it is generally believed that keloids are best treated by a combination of surgery and postoperative radiation therapy, although it should be noted that this notion has not yet been tested by randomized controlled trials. Although it is difficult to determine the effectiveness of irradiation for the treatment of keloids because of variations between studies in patient race, age, and sex; keloid area and size; radiation source and dose; result assessment strategies; and follow-up term, the reported postoperative radiation response rates (the rate of recurrences regardless of patient satisfaction) generally fall between 67 and 98 percent.…”

“…Although it is difficult to determine the effectiveness of irradiation for the treatment of keloids because of variations between studies in patient race, age, and sex; keloid area and size; radiation source and dose; result assessment strategies; and follow-up term, the reported postoperative radiation response rates (the rate of recurrences regardless of patient satisfaction) generally fall between 67 and 98 percent. [1][2][3][4][5][6][7][8][9][10][12][13][14][15][16][17][18][19][20][21][23][24][25][26][27][28][29][30][31][32] Thus, it is currently suggested that keloids can be treated effectively by a combination of surgery and radiation therapy. However, plastic surgeons tend to avoid radiation therapy for keloids for fear of inducing malignant tumors.…”

An overview of the pathogenesis, prevention and treatment of keloids

“…Some of these involved external irradiation using superficial [21][22][23][24] and orthovoltage [25][26][27] X-rays (photons) and b-rays (electron-beams) [28,29]. Others were brachytherapies employing b-rays (32P [30] or 90Sr/90Y [31,32]), and g-rays (60Co [33] or 192Ir [34,35]). In addition, radiation therapy has been employed as a monotherapy, or in combination with adjuvant therapy delivered on its own preoperatively or postoperatively.…”