通讯作者: 李敏杰, liminjie0326@sina.com

DOI：10.12201/bmr.202410.00014

Analysis of the efficacy and influencing factors of radiotherapy after keloid surgery

• 摘要：目的　探讨瘢痕疙瘩术后不同时间开始20Gy/5次大分割放疗的疗效,并分析影响疗效的因素。方法　收集2021年1月至2023年6月期间接受术后20Gy/5次放疗方案的76名患者的临床资料进行回顾性分析,定期随访并记录患者放疗后的治疗效果、不良反应发生情况,通过单因素分析及多因素Logistic分析影响瘢痕疙瘩患者复发的因素。结果　放疗后瘢痕疙瘩复发共21例,无继发性恶性肿瘤发生。根据是否复发将瘢痕疙瘩分为有效组(79例)和复发组(21例),单因素分析发现不同的家族史(c2=4.571,P=0.033)、瘢痕疙瘩部位(c2=8.012,P=0.018)、瘢痕切口大小(c2=4.002,P=0.045)、术后放疗时间(c2=6.944,P=0.031)之间的差异有统计学意义。多因素Logistic回归分析发现术后放疗时间、瘢痕切口长度与治疗后复发有关,术后7小时内放疗(OR＞1,P=0.022)是治疗后复发的独立危险因素,瘢痕切口≤5厘米(OR＜1,P=0.028)是治疗后复发的独立保护因素。结论　手术切除结合大分割放射治疗是防治瘢痕疙瘩复发的有效措施之一,但躯干部位瘢痕疙瘩尚需要更有效的治疗方案。术后7-48小时放疗的复发率相对最低,值得临床推广应用。

  关键词： 瘢痕疙瘩; 放射治疗; 复发; 疗效

   

  Abstract: Objective　To explore the efficacy of hypofractionated radiotherapy at different time intervals after surgery for keloid, and to analyze the factors affecting the efficacy. Methods　A retrospective analysis was conducted on the clinical data of 76 patients who received 20Gy/5 fractions of radiotherapy from January 2021 to June 2023. Regularly follow up and record the patients’ treatment outcome and occurrence of adverse reactions after radiotherapy. Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors affecting the efficacy of patients with keloid treatment. Results　The recurrence rate of keloids after radiotherapy was 21% and no secondary malignancies occurred.. Based on recurrence status,keloids were categorized into an effective group (79 cases) and a recurrent group (21 cases). Univariate analysis revealed statistically significant differences in family history (χ2=4.571, P=0.033), keloid location (χ2=8.012, P=0.018), keloid incision size (χ2=4.002, P=0.045), and time to postoperative radiotherapy (χ2=6.944, P=0.031). Multivariate Logistic regression analysis showed that postoperative radiotherapy time and keloid incision size were associated with post-treatment recurrence. Radiotherapy within ≤7 hours post-surgery (OR＞1, P=0.022) was an independent risk factor for post-treatment recurrence, while keloid incision size ≤5 cm (OR＜1, P=0.028) was an independent protective factor for post-treatment recurrence. Conclusion　Surgical excision combined with hypofractionated radiotherapy is one of the effective measures to prevent and treat keloid recurrence, though keloids on the trunk may need more effective treatment options. The recurrence rate of radiotherapy initiated 7-48 hours after surgery is relatively the lowest, and it is worthy of clinical promotion and application.

  Key words: ; ; ; 

  提交时间：2024-10-08

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• 序号	提交日期	编号	操作
  1	2024-09-28	bmr.202410.00014V1	下载

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