| Objective(s):To compare the effect of different radiotherapy methods(electron beam or isotope)in preventing postoperative recurrence of ear keloid,and to explore the best way of postoperative radiotherapy for keloid,so as to provide a basis for guiding the selection of clinical treatment methods.Methods:A total of 52 patients(71 lesions included)who received isotope therapy or linear accelerator radiation therapy after ear keloid resection in plastic surgery department of XX Hospital from June 2019 to December 2021were retrospectively studied.The general information of the patients was as follows:Gender of the patients:12 males and 40 females;The maximum age was 67,the minimum was 8,and the average age was 25.The shortest course of disease is 3 months,the longest is 3 years.Causes:52 lesions of ear puncture,11 lesions of surgery,2 lesions of trauma,3 lesions of acne,3lesions without obvious inducement;Keloid size:1.0cm×1.5cm～3.7cm×4.1cm;Lesion sites:30 lesions in the ear,39 lesions in the ear lobe,33lesions on the left side,38 lesions on the right side;The lesions were unilateral in 39 cases and bilateral in 13 cases.According to the different sizes and ranges of keloids,the surgical methods were to remove the kernel or completely resect the kernel,respectively removing 15 lesions and completely resecting 56 lesions.Two kinds of radiotherapy were performed after surgery:electron line therapy in 26 cases and isotope therapy in 26 cases.The patients were followed up for at least 1 year after surgery,and the efficacy and satisfaction of the two groups were compared.The continuous modified Chi-square test and rank sum test were used to analyze the differences between the two groups,and conclusions were drawn.Results:A total of 55 patients were included in this study,of which 52 were successfully followed up(71 ear keloid lesions in total),with a follow-up rate of 94.55%.3 patients were lost to follow-up,all of which were lost to follow-up due to the change of phone number.Of the 52 patients who were followed up successfully,26(50%)received electron wire therapy and 26(50%)received isotope therapy.Epidemiology:There were 18 female patients and 8 male patients in the electronic wire group,and 22 female patients and 4male patients in the isotope group.The median age of the electron line group was 22.5 years old,and that of the isotope group was 25 years old.There was no statistical significance in gender,age and other basic information between the two groups(p>0.05).Lesion distribution:Among 36 ear keloid lesions treated with electronic wire,18 lesions were located in the ear and 18 lesions in the earlobe;Among 35 ear keloid lesions treated with isotope,12 lesions were located in the ear and 23 lesions were located in the earlobe.For ear keloid lesions treated with electron wire,16 lesions were on the left side and20 lesions were on the right side.For ear keloid lesions treated with isotope,17lesions were on the left side and 18 lesions were on the right side.Lesion side:Among the 26 patients treated with electronic wire,unilateral lesions occurred in 17 cases and bilateral lesions in 9 cases;among the 26 patients treated with isotope,unilateral lesions occurred in 22 cases and bilateral lesions in 4 cases.There was no significant difference in the distribution site and side of scar lesions between the two groups(p>0.05).Comparison of surgical methods:Complete resection of 27 lesions and keratectomy of 9lesions were performed in 36 ear keloids treated with electronic wire.In 35 ear keloids treated with isotope,29 lesions were completely resected and 6 lesions were performed cicatric keratectomy.There was no statistical significance in the surgical methods between the two groups(p>0.05).Comparison of the number of treatment courses:The number of treatment courses in the electronic wire group after surgery:at least 5 times,at most 10 times,and the average number of treatment:5.52 times;the number of treatment courses in the isotope group:at least 3 times,at most 12 times,and the average number of treatment times 4.73.There was no statistical ignificance in the number of treatment between the two groups(p>0.05).The effective rates of electron line treatment group and isotope treatment group were 91.7%(33/36),97.1%(34/35),X~2=0.236,p=0.627(p>0.05),with no statistical significance.The satisfaction rate of the electronic line treatment group was 88.5%,the satisfaction rate was 92.3%,Z=-0.519,p=0.604((p>0.05)),there was no statistical significance in the satisfaction between the two groups.Adverse reactions:No adverse reactions were observed in the patients included in this group during follow-up.Conclusion(s):Both electron beam and isotope therapy after ear keloid surgery can achieve satisfactory results,which can be used as clinical methods to prevent the recurrence of ear keloid surgery.Due to the long cycle of isotope therapy,patients’compliance is poor,which may affect patients’choice of treatment. |
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