12. Postoperative irradiation of a giant keloid of the upper arm
using a high-dose-rate brachytherapy mold
Shigehiko Kuribayashi, Tsuguhiro Miyashita
Department of Radiation Oncology, Nippon Medical School Hospital, Tokyo,
Japan
Postoperative radiation for keloids with long dimensions or on a
markedly curved surface is difficult because the radiation dose is
distributed non-uniformly, which may cause keloid relapse. We reported
on the use of postoperative radiotherapy using a high-dose-rate (HDL)
brachytherapy mold for a huge keloid of the arm. An 18-year-old man with
a keloid >25 cm on the right upper arm underwent surgical excision and
postoperative irradiation using a HDR brachytherapy mold. A shell
matching the shape of the arm was made and used as a bolus. The
applicator tubes were put on the shell to conform to the operation wound
lines. Dose evaluation points were established from the source axis, and
15 Gy was given in two fractions over two days. No relapse or side
effects were observed in three months of irradiation. The HDR
brachytherapy mold could be used for postoperative irradiation for
patients with keloids under special conditions.
