Postoperative radiotherapy of auricular keloids: A 26-year experience

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Abstract
Background: Auricular keloids are very frequent and often have a peculiar response to therapy. Despite a variety of treatment options, recurrence is the norm. An integrated surgical–radiotherapy approach is suggested to have the most significant effect on recurrence rate, varying from 3.5% to 27%. The aim of this study was to assess, through a retrospective review of our cases, the effectiveness and safety of postoperative radiotherapy performed over 26 years and to observe whether all localizations of auricular keloids behave in the same way. Methods: Sixty patients affected by 76 auricular keloids were included in this study. The median time interval between the surgery and the beginning of radiotherapy was 3 days. The total dose administered ranged from 10 Gy to 45 Gy, by means of weekly fractions of 5 Gy each. Results: The mean follow-up was 47.85 months. In 10 cases (13.2%) a recurrence occurred. The 5-year relapse-free rate from the end of the combined treatment was 79.84%. The cosmetic result was judged as good in all cases. No late stochastic or non-stochastic damages were observed. Conclusion: Our data significantly support the dermatologic postoperative radiotherapy role in the treatment approach of all auricular keloids.