Clinical Comparative Study On The Recurrence Rate Of Keloid Treated By Photodynamic Therapy Combined With Surgery And Superficial X-ray Radiotherapy

Backgroud Keloids occur as a result of abnormal wound healing.The exact cause for this disorder remains elusive despite ongoing research and hypotheses.Keloids are known for a lack of standardized treatment and a high propensity for recurrence.Despite the myriad options available,there is no universally accepted treatment for keloids.At present,the more classical treatment is surgery combined with superficial X?ray radiotherapy.In recent years,photodynamic therapy has become a method to treat skin tumors.As keloid is a benign hyperproliferative disorder and keloid flbrobalasts display similar bioenergetics of cancer cells,photodynamic therapy can be used to treat keloids.Aim To explore the application value of photodynamic therapy in the treatment of keloid,we conducted a preliminary comparative evaluation between photodynamic therapy combined with surgery and superficial X-ray radiotherapy and surgery combined with superficial X-ray radiotherapy.Method Sixty patients with keloids were included in this clinical study and divided into t.wo groups.One is photodynamic therapy combined with surgery and superficial X-ray radiotherapy(n=30),another one is surgery combined with superficial X-ray radiotherapy(n=30).The former group received topical 20%5-aminolevulinic acid.After incubating for 4 hours,patients were received red light for about 20 minutes.Photodynamic therapy was conducted per week.The whole treatment course was three times.We used international Vancouver scar scale,VSS,to evaluate the scar situation after 3 months,6 months,9 months and 12 months.We conducted descriptive assessment from four aspects,which are Melanin,M,Vascularity,V,Height,H and Pliability,P.VSS scores of each group were compared,and the changes of VSS scores of the two groups were compared.Result There were statistically significant differences in VSS scores before and after treatment between the surgery combined with superficial X-ray radiotherapy group and photodynamic therapy combined with the operation and superficial X-ray radiotherapy group,and VSS was significantly decreased after treatment.However,there was no significant difference in VSS between the two treatment groups.Conclusion Photodynamic therapy can be used as a beneficial supplement to the classic surgical treatment of keloid combined with superficial X-ray radiotherapy to improve the treatment benefits and reduce the local recurrence rate.