Objective clinical outcome and patient satisfaction in self-assessment of postoperative electronic radiation for refractory keloids
10.3760/cma.j.cn113030-20210309-00093
- VernacularTitle:难治性瘢痕疙瘩术后电子线照射客观临床结果及患者满意度研究
- Author:
Shuai SUN
1
;
Xiansong SUN
;
Yijun WANG
;
Yu ZHANG
;
Lei HE
;
Fuquan ZHANG
Author Information
1. 中国医学科学院北京协和医学院北京协和医院放疗科 100730
- Keywords:
Keloids/electron beam irradiation;
Treatment outcome;
Patient satisfaction
- From:
Chinese Journal of Radiation Oncology
2021;30(6):582-586
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Objective To investigate the role of radiotherapy in the treatment of refractory keloids, evaluate the self-assessment degree of satisfaction of patients and compare with the objective outcomes.Methods:A total of 144 patients (290 lesions) with refractory keloids admitted to Peking Union Medical College Hospital from 2013 to 2018 were included in this study. The median age was 28 years old (range: 15-81 years old). All lesions were subjected to electronic radiation at postoperative 24h. The regime of 5 to 7MeV electron beam radiation therapy was adopted. The total dose was ranged from 16 to 18 Gy/2f (at 1-week interval). The median follow-up time was 48 months (range: 35-91 months). Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate the degree of satisfaction. Multivariate analysis was performed by Cox proportional hazards model.Results:Among 290 keloids, 52 keloids (17.9%) relapsed in 3 to 42 months from the end of radiotherapy (median 12 months). The main side effects were hyperpigmentation and local incisional extension. Univariate analysis showed that local incisional color darker than skin, pruritus, pain and young age were associated with recurrence. Multivariate analysis indicated that local incisional color darker than skin and pain were the independent prognostic factors for scar recurrence. Recurrence, hyperpigmentation and local incisional extension were the main reasons for patients′ dissatisfaction.Conclusions:Postoperative electronic radiation can achieve satisfactory efficacy in the treatment of refractory keloids. Local incisional color darker than skin and pain are the independent prognostic factors of keloid recurrence. Patient self-assessment results are not fully consistent with the objective clinical outcomes and recurrence status.
