华中科技大学学报（医学版）
華中科技大學學報（醫學版）
화중과기대학학보（의학판）
ACTA UNIVERSITATIS MEDICINAE TONGJI
2009年
5期
683-685
,共3页
瘢痕疙瘩%电子线%放射治疗
瘢痕疙瘩%電子線%放射治療
반흔흘탑%전자선%방사치료
keloid%electron beam%radiotherapy
目的 评价术后即时电子线放射治疗在瘢痕疙瘩治疗中的地位和价值.方法 选取自2004年1月至2006年12月在武汉同济医院治疗的116例瘢痕疙瘩患者进行分析.所有患者均在手术切除瘢痕疙瘩后24 h内接受放射治疗,照射使用6 MeV电子线,处方剂量共21 Gy分7次完成,每周照射3次,每次3 Gy.通过临床观察和定期随访记录治疗疗效、毒性反应以及患者满意程度.结果 在116例瘢痕疙瘩中17例(14.7%)出现复发,复发率与病变部位相关(χ~2=29.91,P<0.01),大部分复发发生于胸部(10/43)和肩部(5/13),全组症状改善率为88.8%.急性毒性反应主要表现为1～2级皮肤红斑(100%)、伤口愈合延迟(7.8%)和伤口感染(4.3%);晚期毒性反应主要包括1～2级色素沉着(30.2%)、1～2级色素减退(11.2%)和1级毛细血管扩张(5.2%),没有严重毒性反应和第二原发肿瘤发生.72.4%患者对治疗结果表示满意或非常满意,不满意者占15.5%.结论 术后即时电子线放射治疗是预防瘢痕疙瘩复发的有效方法,毒性反应轻,患者对治疗结果满意程度高.
目的 評價術後即時電子線放射治療在瘢痕疙瘩治療中的地位和價值.方法 選取自2004年1月至2006年12月在武漢同濟醫院治療的116例瘢痕疙瘩患者進行分析.所有患者均在手術切除瘢痕疙瘩後24 h內接受放射治療,照射使用6 MeV電子線,處方劑量共21 Gy分7次完成,每週照射3次,每次3 Gy.通過臨床觀察和定期隨訪記錄治療療效、毒性反應以及患者滿意程度.結果 在116例瘢痕疙瘩中17例(14.7%)齣現複髮,複髮率與病變部位相關(χ~2=29.91,P<0.01),大部分複髮髮生于胸部(10/43)和肩部(5/13),全組癥狀改善率為88.8%.急性毒性反應主要錶現為1～2級皮膚紅斑(100%)、傷口愈閤延遲(7.8%)和傷口感染(4.3%);晚期毒性反應主要包括1～2級色素沉著(30.2%)、1～2級色素減退(11.2%)和1級毛細血管擴張(5.2%),沒有嚴重毒性反應和第二原髮腫瘤髮生.72.4%患者對治療結果錶示滿意或非常滿意,不滿意者佔15.5%.結論 術後即時電子線放射治療是預防瘢痕疙瘩複髮的有效方法,毒性反應輕,患者對治療結果滿意程度高.
목적 평개술후즉시전자선방사치료재반흔흘탑치료중적지위화개치.방법 선취자2004년1월지2006년12월재무한동제의원치료적116례반흔흘탑환자진행분석.소유환자균재수술절제반흔흘탑후24 h내접수방사치료,조사사용6 MeV전자선,처방제량공21 Gy분7차완성,매주조사3차,매차3 Gy.통과림상관찰화정기수방기록치료료효、독성반응이급환자만의정도.결과 재116례반흔흘탑중17례(14.7%)출현복발,복발솔여병변부위상관(χ~2=29.91,P<0.01),대부분복발발생우흉부(10/43)화견부(5/13),전조증상개선솔위88.8%.급성독성반응주요표현위1～2급피부홍반(100%)、상구유합연지(7.8%)화상구감염(4.3%);만기독성반응주요포괄1～2급색소침착(30.2%)、1～2급색소감퇴(11.2%)화1급모세혈관확장(5.2%),몰유엄중독성반응화제이원발종류발생.72.4%환자대치료결과표시만의혹비상만의,불만의자점15.5%.결론 술후즉시전자선방사치료시예방반흔흘탑복발적유효방법,독성반응경,환자대치료결과만의정도고.
Objective To evaluate the role of postoperative electron beam radiotherapy in the management of ke-loids. Methods Between January 2004 and December 2006,116 cases of keloids were treated with 6 MeV electron beam radiotherapy within 24 h after surgical resection of the keloids. All patients had received a total of 21 Gy in seven daily 3-Gy fractions. Treatment was started at the 24th h after surgery. Patients were followed up and the information regarding treatment results, early and late radiation toxicity,and the satisfaction level by self-assessments was recorded. Results Recurrence occurred in 17 cases of keloids(14. 7%),and was correlated with site of the lesions(χ~2 =29. 91,P<0. 01). Most recurrences were observed at site of sternum (10/43) and shoulder (5/13 ). Keloid associated symptoms, e. g. itching and pain, were improved in 88. %%. For early toxicity outcomes, 100% had grade 1～2 skin erythema,7. 8% had wound delayed union,and 4. 3% had infection. For late toxicity outcomes, 30. 2% reported grade 1～2 hyperpigmentation, 11. 2% grade 1～2 hypopigmentation, and 5. 2% grade 1 telangiectasia. No severe complications or secondary malignancies were observed. 72. 4% patients described the results of treatment as excellent or good,and 15. 5% patients were not satisfied with the treatment results. Conclusion Postoperative electron radiotherapy is well tolerated and effective in preventing keloid recurrence.
