DS02: Treatment of keloid with radioisotope Re188 incorporated radioactive skin patch: a novel noninvasive therapeutic modality
Kaushal Verma, Priyanka Gupta and Rakesh Kumar
All India Institute of Medical Sciences, New Delhi, India
Treatment of keloid remains a challenge, despite the availability of several invasive/noninvasive therapeutic modalities, and recurrences are common. We evaluated the effectiveness and safety of radioactive skin patches containing beta-emitting isotope Re188 as a novel, noninvasive treatment modality for keloids and their recurrence. Clinically diagnosed adult patients with keloids were included in the study and treated with radioisotope Re188 skin patches with 37 MBq (1 mCi) cm–2 radioactivity. The patches were applied on the lesions for 45 min, to deliver a radiation dose of 10 Gy cm–2 in a single fraction. The patches were applied on alternate days to deliver a total dose of 50 Gy cm–2 to each lesion in five fractions. The patients were followed after 2, 4, 8 and 12 weeks, to determine response to therapy and adverse effects. The study had 21 patients [nine men and 12 women; mean (SD) age 36·4 (12·6) years (range 22–62)] with 58 keloids ranging in area from 1 to 58 cm2 [mean (SD) area 11·46 (12·93 cm2)] on the trunk, hands and face for a mean (SD) duration of 6·57 (3·26) years (range 2–16 years). All patients completed the treatment and follow-up. There was an excellent response (80–100% improvement) in 37 (64%) lesions, a very good response (50–79%) in 10 (17%), a good response (20–49%) in seven (12%) and a poor response (< 20%) in four (7%) lesions. Mean (SD) lesion area reduced from 11·46 (12·93) cm2 to 3·30 (7·23) cm2 (P < 0·001) following treatment. There were no significant side-effects of therapy, except transient local inflammation and pain. Importantly, there was no relapse of lesion after 32–48 months [mean (SD) duration 39·85 (6·89) months] of follow-up. Therefore, radioisotope Re188 skin patches appear to be effective and safe for the treatment of keloids, with lasting improvement. However, further studies are needed to confirm our results.
