Comparison And Analysis Of Curative Effect Of Simple Superficial X-ray Radiotherapy And Operation Combined With Superficial X-ray Radiotherapy On Keloid

Objective: Keloid is secondary to trauma or spontaneously skin and excessive growth of pathological scar tissue formation,its etiology is complex,including genetic predisposition,endocrine factors,infection,high local tension,and excessive inflammation factors,such as a variety of mechanisms involved in the disease process,cytokines,cell signal transduction pathways,collagen metabolism,gene expression and cell proliferation and apoptosis in keloid onset process.Skin lesions tend to occur in the front of the chest,shoulder and back and ears and other parts.There are many clinical treatments for keloid,including surgery combined with radiotherapy,drug injection,laser and other comprehensive therapies,but due to its high recurrence rate,it brings great trouble for clinical treatment.Working at low voltage energies,superficial X-ray sources have many of the advantages of established radiotherapy methods and can be applied to the treatment of neoplastic diseases such as keloid in dermatology.In this study,by comparing the efficacy of simple superficial X-ray radiotherapy and surgery combined with superficial X-ray radiotherapy,a reasonable treatment scheme was determined to provide a reference for clinical diagnosis and treatment.Methods: A total of 135 keloid patients(155 lesions)were selected from the outpatient service of our department from 2017 to 2018.During the telephone follow-up,41 patients(51 lesions)received X-ray therapy alone,and 94 patients(104 lesions)received surgical resection of keloid combined with superficial X-ray radiotherapy.4 of them(4 lesions)were found to have slight scar hyperplasia at the original site within 1 year after the operation,so they were given radiotherapy again.One year later,they were followed up by telephone again to observe the curative effect.According to the standard curative effect is divided into cure,obvious effect,invalid.Results: 51 cases were treated with X-ray alone,5 cases were cured(9.80%),15 cases showed significant effect(29.41%),and the effective rate was 39.21%.After surgical resection of keloid combined with superficial X-ray radiotherapy in 104 cases,84 cases(80.77%)were cured,11 cases(10.58%)showed significant effect,and the effective rate was 91.35%.4 cases were treated with radiotherapy again within 1 year after surgery,2 cases were cured and 2 cases were not effective.Conclusion:1.The effective rate of operation combined with superficial X-ray radiotherapy is significantly higher than that of X-ray radiotherapy alone.2.A short course of treatment and a high segmentation dose were the best strategies.The effective rate of combined treatment showed no significant difference in age or single or multiple scars,and the effective rate of women was higher than that of men.The effective rate of ear and neck was higher than that of chest,shoulder,back,vulva and other parts.3.Postoperative follow-up,proper education on scar management and active treatment are of great significance in preventing recurrence of keloid in the whole process,and radiotherapy again is a feasible adjuvant treatment.