105例瘢痕疙瘩术后电子线联合^(192)Ir敷贴放疗疗效观察

Postoperative electronic irradiation combined with brachytherapy by ^(192)Ir for keloid:an analysis of 105 patients

目的:观察瘢痕疙瘩术后电子线常规分割联合后程^(192)Ir敷贴放射治疗瘢痕疙瘩术后切口的临床疗效。方法:将我院2003年1月至2013年12月单发性瘢痕疙瘩患者203例分为观察组(A组)105例和对照组(B组)98例,均于术后24 h内进行放射治疗,采用直线加速器4~6 Me V电子线行伤口局部照射。观察组(A组)每天1次,每次2 Gy,5次/周,照射总剂量为DT 10Gy/5次,以后联合192Ir敷贴放射治疗,5 Gy/次,2次/周,共2次完成,参考点总剂量为10 Gy。对照组(B组)每天1次,每次4Gy,每周5次,总剂量为DT 20 Gy/5次。临床疗效标准参考Darzi的瘢痕疙瘩疗效分级标准进行评价。结果:术后随访12个月以上,105例患者中治愈65例,显效33例,有效率93.33%(98/105),无效病例为7例。结论:瘢痕疙瘩术后电子线常规分割联合后程^(192)Ir敷贴放射治疗是治疗瘢痕疙瘩的有效方法,能有效提高治愈率,降低复发率。

Objective：To observe the clinical efficacy of postoperative electronic irradiation combined with brachytherapy by -（192） Ir for keloid. Methods：Totally 203 cases of keloid from January 2003 to December 2013 were divided into observation group（n=105,group A） and control group（n=98,group B）. Radiotherapy was given within 24 h after operation in 105 patients with keloid. The lesions were treated by 4-6 Me V-E by Varian 2 300C/D medical linear accelerator. In group A,radiotherapy was given once a day（5 times a week） with a dosage of 2 Gy each time（10 Gy for 5 times）;then electronic irradiation combined with brachytherapy by192 Ir was given twice a week（2 times in total） with a dosage of 5 Gy each time（10 Gy for 2 times）. In group B,treatment was given once a day（5times a week） with a dosage of 4 Gy each time（20 Gy 1for 5 times）. Darzi＇s criteria were used to do the evaluation and statistical analysis was made using SPSS 13.0. χ-2test was used and P〈0.05 was considered statistical significant. Results ：Postoperative follow-up lasted for 12 months or more in 105 patients,65 were cured 33 were excellent;the effective rate was 93.33%;7 cases were invalid. Conclusion：Postoperative electronic line in keloid by normal radiotherapy combined with late course-（192）Ir brachytherapy is effective in improving the cure rate and reducing recurrence rate.