Primary Radiotherapy for the Treatment of Keloids: A Pilot Study

This will be a single-institution pilot study to evaluate the safety and efficacy of radiation therapy (RT) for the treatment of unresected keloids. The primary endpoint will be toxicity within 10 weeks of follow-up. Secondary endpoints will include cessation of growth or shrinkage of keloids, symptomatic response, and impact on quality of life.

Risks of radiation therapy include acute and later toxicities. Acute toxicities of radiation therapy include radiation dermatitis (skin pain, itching, erythema, desquamation). Late toxicities include skin fibrosis, ulceration, telangiectasia, altered skin pigmentation, delayed wound healing for potential future wounds in the irradiated field, and radiation induced malignancy in the irradiated field (lifetime risk estimated to be 1% or less) Additionally, efficacy of the treatment is not known and there is a risk that the keloid will continue to grow immediately or in the future resulting in treatment providing patients with no benefit but with the included aforementioned acute and late toxicities of the RT. The potential benefits of this study include prevention of keloid progression, keloid improvement or resolution with symptomatic relief and cosmetic. This therapeutic option uniquely provides these benefits for patients who are otherwise lacking efficacious treatment options for their keloids. Previous published studies of similar regimens suggest that rates of symptom control and/or stable to reduced keloid size of 75% or higher may be achieved with our regimen.

Single-institution pilot study to evaluate the safety and efficacy of radiation therapy (RT) for the treatment of unresected keloids. The primary endpoint will be toxicity within 10 weeks of follow-up. Secondary endpoints will include cessation of growth or shrinkage of keloids, symptomatic response, and impact on quality of life.

radiation therapy (RT) for the treatment of unresected keloids. The primary endpoint will be toxicity within 10 weeks of follow-up. Secondary endpoints will include cessation of growth or shrinkage of keloids, symptomatic response, and impact on quality of life.

Inclusion Criteria: Clinically diagnosed keloid Surgical excision of keloid is either contraindicated or patient has declined treatment with surgical excision Note: patients with keloids that recurred after previous resection are eligible, as long as the current keloid is either unresectable or patient has decline resection. Age ≥18 Study specific informed consent provided Exclusion Criteria: Prior RT to the area of interest that would result in overlap of radiation therapy fields Females of child bearing age without a negative serum pregnancy test prior to initiation of RT or unwilling to use contraception prior to and during the radiation course Keloids in areas where radiation therapy introduces unacceptable high risk of toxicity as determined by the treating radiation oncologist Uncontrolled intercurrent illness (e.g. symptomatic congestive heart failure, uncontrolled cardiac arrhythmia, or psychiatric situation) that would limit compliance with study requirements as judged by the treatment physicians