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brachytherapy, keloids, plastic surgery, radiotherapy, scar, wound



  1. Daurade, Mathieu MD
  2. Breton, Pierre MD, PhD
  3. Rouard, Nathalie MD
  4. Lorchel, Fabrice MD
  5. Ibrahim, Badr MD
  6. Sigaux, Nicolas MD


OBJECTIVE: To demonstrate the efficacy of a protocol combining surgical excision and high-dose-rate brachytherapy for treatment of keloids.


METHODS: The authors performed a unicentric retrospective cohort study between 2013 and 2018. The minimum follow-up was 12 months. All patients treated for keloids at the authors' institution were included. Extralesional excision was performed with placement of a brachytherapy sheath under the skin. The total dose of irradiation was 18 Gy. The postoperative results were evaluated for aesthetic and functional outcomes with a validated scale, as well as the presence or absence of recurrence.


RESULTS: Fifteen patients were lost to follow-up. Thirty-eight patients with 67 keloids were included. The control rate was 94%. The aesthetic and functional outcomes were considered good in 62% of cases. The main limitation of the study was the small patient population.


CONCLUSIONS: Extralesional excision combined with postoperative high-dose-rate brachytherapy seems to be one of the most effective invasive protocols to treat and prevent keloids.