The efficacy of combined adjuvant radiotherapy with surgical excision in the treatment of keloids.

Keloid is a benign dermal condition that occurs due to excessive activation of fibroblasts, which leads to an abnormal accumulation of collagen. There are several treatment options, but none have been satisfactory or optimal. Often, combined treatments are used due to its high recurrence rate after surgical excision alone. The aim of this study is to evaluate the efficacy of adjuvant radiotherapy after surgical excision. A retrospective study was performed including patients with keloid scars who underwent surgical excision and adjuvant radiotherapy between May 2016 and March 2020. The data was collected from the radiotherapy and plastic surgery medical charts. There were 13 patients identified. The patient and observer scar assessment scale (POSAS) was performed in all 13 patients. The treatment used was surgical excision of the scar associated with 9 Gy radiotherapy dose within the first 24 hours after the surgery, plus another session after 7 days. 13 patients and 16 keloid scars were evaluated during a mean follow-up period of 13,5 months 95%CI (5,84; 21,16). There was no major adverse event from the treatment used. According to POSAS, the overall satisfaction rate was significantly good (mean of 2,29 on a scale from 1 to 10). Only one recurrence was observed (6.25%). Keloids are difficult to treat due to their high recurrence rate. There is no consent about the best treatment. This study showed that surgical excision combined with adjuvant radiotherapy is an excellent option, even for refractory keloids. The aesthetical result was satisfactory and the recurrence rate was low.