Although postsurgical radiotherapy is common in keloid management, factors influencing its efficacy remain unclear. The aim of this study is to investigate postoperative electron beam radiotherapy’s impact on recurrence and adverse effects. A retrospective study was conducted to evaluate the recurrence rates and complications across three radiation schemes: 17.5 Gy/5 fractions, 20 Gy/4 fractions, and 18 Gy/2 fractions. The overall recurrence rate was 6.5%, with the lowest recurrence (2.8%) observed in the 18 Gy/2-fraction regimen. Radiation schemes, lesion condition (type, location, and duration), and family history were associated with postsurgical recurrence. Furthermore, hyperpigmentation (32%) and dermatitis (11.8%) as significant adverse events. No radiation-related cancers were observed during follow-up. The 18 Gy/2-fraction regimen postsurgical electron beam radiotherapy emerged as the most effective and safe option for keloid recurrence prevention. Features, including lesion type, location, family history, and disease duration should be combined to guide therapeutic strategy. • Factors influencing the efficacy of postoperative radiotherapy for keloids remain unclear. • A retrospective analysis assessed clinical characteristics, treatment outcomes, and complications in 619 keloid cases. • Significant associations were found between recurrence and factors like radiation scheme, lesion type/location, and family history. • Optimized postoperative electron beam radiotherapy is effective and safe for keloid management.
Chen et al. (Sun,) studied this question.