strontium-radioisotopes and Keloid

The use of radiations for the treatment of keloids was the topic of debate for years. Because of the benign nature of the keloids, surgery (keloidectomy) was treatment of choice. However, the use of surgery alone for arresting the keloids growth does not give satisfactory results due to the high frequency of recurrences. In this study 110 symptomatic cases were treated with 90Sr-90Y beta-radiation either alone for flat keloids or in combination with surgery for thick keloids. The results obtained with this method were found to be quite satisfactory. Patients were given four fractions of 5 Gy per fraction either as weekly or twice weekly schedules. Radiation dose of 2000 cGy given twice weekly in four fractions showed response in 86% of the cases as compared to 73% in those receiving four fractions of 5 Gy weekly. Further observations on different time dose fractionation schedules would open up newer dimensions in the radiotherapy of keloids.

Topics: Adolescent; Adult; Aged; Beta Particles; Child; Combined Modality Therapy; Female; Humans; Keloid; Male; Middle Aged; Postoperative Care; Radiotherapy Dosage; Recurrence; Strontium Radioisotopes; Time Factors; Yttrium Radioisotopes

Keloid disease is hard to fully eradicate. Recurrence and other unsatisfactory results were found in many patients. No current therapeutic modality has been determined to be most effective for treating keloid scars. Intralesional corticosteroid injections is most commonly recommended for primary management of small and young keloids as well as hypertrophic scars. However, it's difficult for patients to adhere to long-term triamcinolone acetonide injection therapy because of the pain, inconvenience or complications including hormonal imbalance or irregular menstruation.. We aimed to determine whether and how Strontium-90 brachytherapy as an adjuvant radiation could affect keloid recurrence after intralesional triamcinolone and 5-fluorouracil injections.. We included keloid patients from March 2019 to September 2019 and randomly allocated them to two groups after 3 intralesional triamcinolone and 5-fluorouracil injections at 3 weeks interval. The experimental group received Strontium-90 brachytherapy at a total dose of 15-20Gy, while the control group didn't receive any adjuvant treatment. We performed both Vancouver Scar Scale scoring and Color Doppler ultrasound examination to monitor and evaluate lesions regularly. A one-year follow-up was completed for each patient.. 31 patients who had 42 keloids in total were recruited. We found intralesional triamcinolone and 5-fluorouracil injections could effectively reduce the thickness and modify the hardness of small and young keloids. Strontium-90 brachytherapy reduced the one-year recurrence rate from 85.7 percent to 44.4 percent after 3 intralesional triamcinolone and 5-fluorouracil injections. The lesions' thickness or elasticity was not affected by Strontium-90 brachytherapy.. Strontium-90 brachytherapy as an adjuvant radiation could effectively reduce small sized keloids recurrence after intralesional triamcinolone and 5-fluorouracil injections. It worked by enhancing the lesions' stability post-injection.. The clinical trial registration number: ChiCTR2000030141. Name of trial registry: Chinese Clinical Trial Registry (http://www.chictr.org.cn/).

Topics: Adult; Brachytherapy; Elastic Modulus; Elasticity Imaging Techniques; Female; Fluorouracil; Humans; Injections, Intralesional; Keloid; Male; Recurrence; Strontium Radioisotopes; Triamcinolone Acetonide; Young Adult

Post-acne keloids have become a serious problem affecting the physical and mental health of adolescents. However, traditional single-treatment methods have a high recurrence rate and are highly susceptible to a variety of complications. Postoperative radiotherapy has rapidly become a popular choice for comprehensive postoperative treatment because of its painlessness, non-invasiveness, convenience, low recurrence rate, and few complications. 1 In the available literature, no serious complications have been reported. Here we introduce a case of keloid after acne with isotope strontium-90 as a comprehensive treatment regimen, which leads to extensive depigmentation in the maxillofacial region. Combined with knowledge of the relevant literature, the mechanisms, types, and timing and dose, and reflect on balancing of recurrence rates and complications to deepen our understanding of the disease.

Topics: Acne Vulgaris; Adolescent; Humans; Keloid; Postoperative Period; Recurrence; Strontium Radioisotopes; Treatment Outcome

The aim of this study was to evaluate the results of keloidectomy and strontium 90 brachytherapy in the prevention of keloid recurrence following excision and to identify outcome and the prognostic factors that predict keloid recurrence after irradiation.. Data of 612 patients with 892 keloids treated between 1992 and 2006 were evaluated retrospectively. Brachytherapy was performed using a Sr-90Y surface applicator. Total dose was 20 Gy in 10 fractions.. With a median follow-up of 61 months, the overall recurrence-free response rate for all keloids was 87.6%. Multivariate analysis revealed the following prognostic factors for recurrence: keloid size > 5 cm (p < 0.0001), burn scars as the keloid etiology (p < 0.0001), and previous treatment (p < 0.0001). Outcome was not found to be significantly related to the interval between surgery and radiotherapy, sex, or age. Pruritus and skin reddening were the most common symptoms of keloids, but all signs and symptoms abated with time after treatment. Cosmetic results from the keloid treatment were considered good or excellent in 70.6% of the patients.. Our study findings show that excision plus Sr-90 brachytherapy is effective in the eradication of keloids. Sr-90 radiotherapy (20 Gy in 10 fractions) achieved a similar local control rate, as have higher doses per fraction in other series. It also resulted in a good cosmetic rate and relief of symptoms. Our data further suggest that the initiation of postoperative irradiation within hours of surgical excision is not important to therapeutic outcome.

Topics: Adolescent; Adult; Brachytherapy; Female; Humans; Keloid; Male; Middle Aged; Radiotherapy Dosage; Recurrence; Regression Analysis; Strontium Radioisotopes; Young Adult

Topics: Adult; Brachytherapy; Cicatrix; Female; Humans; Keloid; Male; Strontium Radioisotopes

Topics: Adolescent; Adult; Aged; Beta Particles; Child; Child, Preschool; Combined Modality Therapy; Evaluation Studies as Topic; Female; Humans; Infant; Keloid; Male; Middle Aged; Radiotherapy Dosage; Strontium Radioisotopes

Keloids and hemangiomas of the cavernous type which require treatment respond very reliably to X-rays. Adequate use of this therapeutic possibility offers considerable advantages to the patients in many cases and in addition it is without danger. Treatment of hemangiomas with beta radiation in the form of Sr-90/Y-90 plates for shortterm application to the skin is so safe and at the same time so successful that, in view of the not at all rare unfavorable spontaneous course, it seems rather risky to delay the indication to begin radiation therapy at the earliest possible moment.

Topics: Adrenal Cortex Hormones; Burns; DNA, Neoplasm; Hemangioma; Humans; Keloid; Radiotherapy; Skin Neoplasms; Strontium Radioisotopes; Yttrium Radioisotopes

Topics: Adolescent; Adult; Child, Preschool; Dimethyl Sulfoxide; Female; Humans; Keloid; Male; Middle Aged; Neoplasm Metastasis; Neoplasms; Penile Induration; Skin Neoplasms; Strontium Radioisotopes; Vitamin A