POSTOPERATIVE IRRADIATION OF EARLOBE

YOKOKAWA Tokuzou, SHIRAI Tatsuo, KAWASAKI Tsutomu, FURUI Shigeru

doi:10.11182/jastro.18.141

For keloid, postexcisional radiotherapy has been shown to reduce the recurrence rate. We investigated 25 earlobe keloids from piercing in 22 patients treated with radiotherapy immediately following excision between April 1998 and December 2004. The median follow-up time was three years and two months. Radiotherapy was given as a total doses ranging from 4 to 12 Gy using electron beam irradiation; 12 sites received a dose of 4 Gy in a single fraction and 13 received 8-12 Gy per one to three fractions. The overall recurrence rates were 40.0% (10/25), and 41.7% (5/12) when 4 Gy was delivered and 38.4% (5/13) when 8-12 Gy was given. The recurrence rate was 80.0% (8/10) for cases with prior keloid history or diameter over 2 cm, and 13.3% (2/15) for other cases. There were statistically significant differences (P=0.0014). We have found a high risk group of recurrence based on the volume of keloid tissue and history of keloid elsewhere. The high risk group was contained to 53.8% (7/13) in the 8 to 12 Gy and 25% (3/12) in the 4 Gy. Therefore this was considered to be the reason why no difference was observed in the total dose for 4 Gy versus 8-12 Gy. On the other hand, the recurrence rate for other cases except the high risk group given 4 Gy was 22.2% (2/9). The results suggested that we should change the treatment plans according to risk factor, such as that keloid with high risk of recurrence should receive escalated radiation doses and dose reduction may be possible to the cases without risk factor. In addition, there were no cases of radiation toxicity.

POSTOPERATIVE IRRADIATION OF EARLOBE

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