ESTRO 2024 - Abstract Book

S2124

Clinical - Sarcoma, skin cancer, melanoma

ESTRO 2024

"Unlocking the Potential of Radiotherapy in Keloid Scar Treatment: A Holistic Assessment"

Pedro Soares, Alice Alves, Daniela Saraiva, João Casalta Lopes, Gabriel Farinha, Patricia Varzim, Gabriela Pinto

Centro Hospitalar e Universitário de São João, Radiotherapy, Porto, Portugal

Purpose/Objective:

Keloid scars are benign dermal anomalies characterized by the excessive activation of fibroblasts, leading to an abnormal accumulation of collagen within the skin. These scars, although benign, can vary in symptoms from being asymptomatic to causing discomfort, itching (pruritus), and pain, collectively impacting an individual's quality of life. Notably, keloid scars are notorious for their high recurrence rates, necessitating consideration of combined treatment approaches.Among these approaches, adjuvant radiotherapy (RT) has emerged as a promising intervention with a track record of effectively reducing local recurrence. In light of this, our study sets out to comprehensively evaluate the outcomes associated with adjuvant electron beam RT, using a dual assessment approach involving both patients and clinicians. The primary focus of our investigation is to assess the impact of this intervention on scar-related outcomes and, more critically, its efficacy in preventing the recurrence of keloid scars. This research aims to contribute valuable insights to the field of keloid scar management and the improvement of patients' overall quality of life.

Material/Methods:

We conducted a retrospective study that included all patients diagnosed with keloid scars who had undergone surgical excision followed by adjuvant electron beam RT at our hospital between May 2016 and October 2023. Data for this study was extracted from patients' medical charts.

For the evaluation of scar outcomes after radiotherapy, we use our medical assessment as physicians and the level of patient satisfaction (symptom relief and aesthetic improvement).

Patients in the study received a prescribed dose of 18 Gy delivered in 2 fractions (9 Gy per fraction) with a 7-day interval between fractions. The radiation was administered using 6 and 9 MeV electron beams and a 3D conformal technique (with a 1 cm thick bolus). Notably, all radiotherapy treatments were initiated within 24 hours following the surgical excision.

Results:

55

patients

and

68

keloid

scars

that

underwent

RT

were

evaluated.

No reported. The follow-up period in our study ranged from as long as 7.5 years. This range reflects the diverse timelines during which patients have been observed and evaluated after undergoing the combined surgical excision and adjuvant radiotherapy treatment. Only three recurrences were observed (3/68 – 4.4%). It is evident that ongoing and extended follow-up is essential to ensure the sustained low recurrence rate. It is noteworthy that our patient cohort has seen a steady increase in numbers over time. This growth can be attributed to the high level of patient satisfaction with the treatment, as well as the endorsement and referrals from fellow surgeons who have observed the successful outcomes of our approach. The low recurrence rate observed in our study, similar to that of keloids managed solely through surgical excision, major treatment-related adverse events were