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Postoperative single versus multiple fractions high-dose rate iridium-192 surface mould brachytherapy for keloid treatment: a comparative study

Published online by Cambridge University Press:  20 June 2017

Misbah Ahmad ,
Habib Ahmad ,
Muhammad Rauf Khattak ,
Kamran Ali Shah ,
Nabila Javed ,
Syed Jawad Ali Shah ,
Wajeeha Shaheen  and
Kehkashan Mansoor
Misbah Ahmad*
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Habib Ahmad
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Muhammad Rauf Khattak
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Kamran Ali Shah
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Nabila Javed
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Syed Jawad Ali Shah
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Wajeeha Shaheen
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
Kehkashan Mansoor
Affiliation:
Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus, Peshawar, Khyber Pakhtun Khwa, Pakistan
*
Correspondence to: Misbah Ahmad, Institute of Radiotherapy and Nuclear Medicine (IRNUM), University Campus , Peshawar, Khyber Pakhtun Khwa, Pakistan. Tel: +91922154. Fax: +919221223. E-mail: misbahirnum@gmail.com
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Abstract

Background and purpose

In 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 methods

From 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).

Results

The 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.

Findings

The 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.

Keywords

brachytherapyhigh-dose rateiridium-192keloidsurface mould
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 1 , March 2018 , pp. 60 - 65
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Copyright
© Cambridge University Press 2017 

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