Radiotherapy in the management of keloids - Clinical experience with electron beam irradiation and comparison with X-ray therapy

Background: Aim of this study was to evaluate the advantages of electron beam irradiation compared to kilovoltage X-ray therapy in the treatment of keloids. Furthermore, the risk of developing malignancy following keloid radiotherapy was assessed. Patients and Methods: An automatic water phantom was used to evaluate the dose distribution in tissue, Furthermore, a series of measurements was done on the patients using thermoluminescence dosimeters (TLD) to estimate the doses absorbed by the organs at risk. We also report our clinical experience with electron beam radiation of 134 ketoids following surgical excision. Results: Electron beam irradiation offers a high control rate (84%) with minimal side effects for keloids. Electron irradiation provides better dose distribution in tissue, and therefore less radiation burden to the organs at risk, After a mean follow-up period of 7.2 years, no severe side effects or malignancies were observed after keloid radiotherapy. Conclusions: Electron radiation therapy is superior to kilovoltage irradiation for treating ketoids due to better dose distribution in tissue. In agreement with the literature, no cases of malignancy were observed after keloid irradiation.