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- Title
Postoperative single versus multiple fractions high-dose rate iridium-192 surface mould brachytherapy for keloid treatment: a comparative study.
- Authors
Ahmad, Misbah; Ahmad, Habib; Khattak, Muhammad Rauf; Shah, Kamran Ali; Javed, Nabila; Shah, Syed Jawad Ali; Shaheen, Wajeeha; Mansoor, Kehkashan
- Abstract
Background and purposeIn developing countries like Pakistan the cost effectiveness and patient convenience in any treatment modality is a question of major concern. The purpose of this study was two-fold; first to report our experience with a high-dose rate Iridium-192 surface mould brachytherapy of keloid scars after surgical excision, using different radiation treatment regimen and second to establish the most convenient and cost effective treatment protocol having no compromise on the treatment outcomes.Materials and methodsFrom January 2012 to April 2015 a total 51 patients with 65 keloid lesions underwent postoperative Iridium-192 high-dose rate surface mould brachytherapy. The dose regimen used was: 8 Gy in a single fraction, 10 Gy in a single fraction, 15 Gy in three fractions and 18 Gy in three fractions. The median follow-up period was 33 months (range 15–53 months).ResultsThe success rates were 57·2, 89·5, 85 and 89·5% for the treatment regimen of 8 Gy/F×1, 10 Gy/F×1, 5 Gy/F×3 and 6 Gy/F×3, respectively. Grade 2 or above radiation induced toxicity was not observed.FindingsThe results of this study show that a dose regimen of 10 Gy (biological effective dose=20 Gy) in a single fraction have comparable results with a dose regimen of 15 Gy in three fractions or 18 Gy in three fractions. 10 Gy in a single fraction is therefore the most convenient and cost effective dose regimen for the management of keloid scars in developing countries like Pakistan, while 8 Gy in a single fraction is considered suboptimal and discouraged in practice.
- Subjects
PAKISTAN; COMPARATIVE studies; COST effectiveness; IRIDIUM; POSTOPERATIVE care; RADIATION doses; RADIOISOTOPE brachytherapy; TREATMENT effectiveness; DESCRIPTIVE statistics; KELOIDS
- Publication
Journal of Radiotherapy in Practice, 2018, Vol 17, Issue 1, p60
- ISSN
1460-3969
- Publication type
Article
- DOI
10.1017/S1460396917000395