222例瘢痕疙瘩患者术后放射治疗的疗效观察及预后影响因素分析

The curative effect observation and prognostic factors: Analysis of 222 keloids patients received radiation therapy after operation

目的：评价电子线放疗瘢痕疙瘩的疗效及影响因素。方法：2009年1月至2011年12月间收治可随访到的瘢痕患者222例共222处瘢痕疙瘩,年龄6~73岁（中位年龄29岁）。术后1天内开始放疗,放疗采用6MEV电子线源皮距照射技术,照射野为瘢痕切口（包括缝线针眼）外扩1cm,照射剂量20Gy/5f,术后24h开始照射。随访时间12~36个月（中位时间24个月）。结果：222处瘢痕疙瘩治疗后有效为204处（91.8%）,痊愈97处（43.7%）,显效63处（28.4%）,有效44处（19.8%）,无效18处（8%）,单因素分析显示年龄、瘢痕部位为影响疗效因素（P=0.048,0.001）,多因素分析显示瘢痕部位为影响疗效独立预后因素（P=0.001）。结论：采用电子线治疗瘢痕疙瘩可取得满意疗效,放疗面平坦度是保证电子线治疗瘢痕效果的重要因素。

Objective： To evaluate the efficacy and inf luencing factors of the electron radiotherapy for the treatment of keloids. Methods： From 2009 to 2011,222 lesions in 222 patients received radiotherapy. The median age was 29 years old （range 6 ~73 years old）. There were 222 keloids received radiotherapy within 1 day after operation. 6 Mev electron - beam were used. The total dose was 20Gy/5f. The treatment fields include entire keloid scars with a 1cm - margin around the lesion. The follow - up time was 12 -36 months （ median time was 24 months）. Results ： There were 204（91.8% ） of 222 lesions with radiotherapy cases were effective,97 lesions（43. 7% ） were cured,63 lesions （28.4% ） were markedly effective,44 cases（19. 8% ） were effective,and 18 cases（8% ） were ineffective. The univa-riate analysis showed that age and keloids location were the influencing factors of outcomes （P =0.048,0.001） ,the multivariate analysis showed that keloids location remained statistically significant differences （ P ： =0. 001）. Conclu-sion： The electron radiotherapy for keloids can receive good outcomes. Flat treatment fields is very important for elec-tron radiotherapy.