ArticleScars, burns & healing
Surgical excision and postoperative radiotherapy for keloids.
Article in Scars, burns & healing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The role of IL-17 and Th17 cells in keloid pathogenesis.Archives of dermatological research · 2024Pooled it
- Alternative treatment for recurrent keloids: initial clinical experience with Rhenium-188 using a specialized device.European journal of nuclear medicine and molecular imaging · 2025Trial
- Fibrinogen Immunostaining in a Single Case of an Earlobe Keloid: A Case Report and Literature Review.Plastic and reconstructive surgery. Global open · 2026Article
- Comparison of the biological effects of various radiation therapies for keloids by single-cell RNA sequencing reveals IRF1 as a novel target in keloid therapy.Fundamental research · 2026Article
- Modified Surgical Technique Combined with Radiation Therapy for Keloid Management.Aesthetic plastic surgery · 2026Article
- Assessment of keloids recurrence rate in patients treated by brachytherapy versus electron beam radiotherapy versus surgical excision.JPRAS open · 2026Article
- Proton Nuclear Magnetic Resonance With Time-Frequency Analysis: A Potential Diagnostic Approach for Keloids.International wound journal · 2026Article
- Comprehensive Update on Keloid Management.Archives of plastic surgery · 2026Article
- Ideal Surgical Incision Lines Minimizing Tension: A Proposal Based on Observations of Hypertrophic Scars and Keloids.Plastic and reconstructive surgery. Global open · 2025Article
- Ear Keloids Treated with Postoperative Electrons: A Case Series.South Asian journal of cancer · 2025Article
- Review
- Long-Term Outcome of Anterior Chest Keloid Excision Using Intercostal Artery Perforator Propeller Flaps.Aesthetic plastic surgery · 2025Article
- The efficacy of combined adjuvant radiotherapy with surgical excision in the treatment of keloids.Annals of burns and fire disasters · 2025Article
- Comprehensive Insights into Keloid Pathogenesis and Advanced Therapeutic Strategies.International journal of molecular sciences · 2024Review
- Treatment outcomes of surgery followed by short-course every other day radiotherapy in keloid.Radiation oncology (London, England) · 2024Article
- [Clinical study of ear keloids with surgical excision and intraoperative low-energy X-ray irradiation therapy].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2024Article
- Surgery and superficial x-ray radiotherapy for keloids of the preauricular and contralateral ear lobe: Case report.Clinical case reports · 2024Article
- Keloid Intralesional Excision Reduces Recurrence: A Meta-analytic Study of the Available Literature on 608 Keloids.Plastic and reconstructive surgery. Global open · 2024Article
- Postoperative Scar Management Protocol for Asian Patients.Aesthetic plastic surgery · 2024Review
- Post-Excision Soft X-Ray Radiotherapy for Keloids: Experience in a Tertiary Referral Center.Dermatology (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Keloids can be treated in a number of ways, including by surgery. Multiple studies now show that while surgical monotherapy associates with extremely high rates of recurrence (50%-80%), postoperative radiotherapy can significantly reduce these recurrence rates. Ongoing improvements in radiation technology have further increased the safety and efficacy of this combination protocol. Of the various radiotherapies that have been used in this setting, electron beam (β-ray) irradiation is currently the best due to its excellent dose distribution and safety. The maximal biologically effective dose (BED) for keloids is 30 Gy (using an estimated α / β ratio of 10); increasing the dose has no further benefits and elevates side effects. Over the last two decades, we have modified and then fine-tuned our radiotherapy protocol for keloid excision wounds. Thus, our early protocol was used for all body sites and consisted of 15 Gy/3 fr/3 days. We then customised the radiotherapy protocol so that body sites that are highly prone to recurrence (e.g. the anterior chest) receive higher doses while low recurrence sites like the earlobe receive a much smaller dose. More recently, we tweaked this body site-customised protocol so that fewer fractions are employed. Therefore, we currently apply 18 Gy/3 fr/3 days to high-recurrence sites, 8 Gy/1 fr/1 day to earlobes and 15 Gy/2 fr/2 days to other body sites. These radiotherapy protocol changes were accompanied by the evolution of body site-customised surgical approaches. As a result of these developments, our overall keloid recurrence rate is now below 10%.
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