摘要
目的评价术后即时电子线放射治疗在瘢痕疙瘩治疗中的地位和价值。方法选取自2004年1月至2006年12月在武汉同济医院治疗的116例瘢痕疙瘩患者进行分析。所有患者均在手术切除瘢痕疙瘩后24 h内接受放射治疗,照射使用6 MeV电子线,处方剂量共21 Gy分7次完成,每周照射3次,每次3 Gy。通过临床观察和定期随访记录治疗疗效、毒性反应以及患者满意程度。结果在116例瘢痕疙瘩中17例（14.7%）出现复发,复发率与病变部位相关（χ^2=29.91,P〈0.01）,大部分复发发生于胸部（10/43）和肩部（5/13）,全组症状改善率为88.8%。急性毒性反应主要表现为1-2级皮肤红斑（100%）、伤口愈合延迟（7.8%）和伤口感染（4.3%）;晚期毒性反应主要包括1-2级色素沉着（30.2%）、1-2级色素减退（11.2%）和1级毛细血管扩张（5.2%）,没有严重毒性反应和第二原发肿瘤发生。72.4%患者对治疗结果表示满意或非常满意,不满意者占15.5%。结论术后即时电子线放射治疗是预防瘢痕疙瘩复发的有效方法,毒性反应轻,患者对治疗结果满意程度高。
Objective To evaluate the role of postoperative electron beam radiotherapy in the management of keloids.Methods Between January 2004 and December 2006,116 cases of keloids were treated with 6 MeV electron beam radiotherapy within 24 h after surgical resection of the keloids.All patients had received a total of 21 Gy in seven daily 3-Gy fractions.Treatment was started at the 24th h after surgery.Patients were followed up and the information regarding treatment results,early and late radiation toxicity,and the satisfaction level by self-assessments was recorded.Results Recurrence occurred in 17 cases of keloids（14.7%）,and was correlated with site of the lesions（χ^2=29.91,P〈0.01）.Most recurrences were observed at site of sternum（10/43）and shoulder（5/13）.Keloid associated symptoms,e.g.itching and pain,were improved in 88.8%.For early toxicity outcomes,100% had grade 1-2 skin erythema,7.8% had wound delayed union,and 4.3% had infection.For late toxicity outcomes,30.2% reported grade 1-2 hyperpigmentation,11.2% grade 1-2 hypopigmentation,and 5.2% grade 1 telangiectasia.No severe complications or secondary malignancies were observed.72.4% patients described the results of treatment as excellent or good,and 15.5% patients were not satisfied with the treatment results.Conclusion Postoperative electron radiotherapy is well tolerated and effective in preventing keloid recurrence.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2009年第5期683-685,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
