瘢痕疙瘩术后放疗的疗效及影响因素分析  

Analysis of the efficacy and influencing factors of radiotherapy after keloid surgery

作　　者：周笑笑 吴冬梅 田玉龙 段清源 李敏杰[1] ZHOU Xiaoxiao;WU Dongmei;TIAN Yulong;DUAN Qingyuan;LI Minjie(Department of Radiotherapy,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第五附属医院放疗科,河南郑州450052

出　　处：《中国现代医生》2025年第2期9-11,23,共4页China Modern Doctor

基　　金：河南省医学科技攻关计划项目(LHGJ20220568)。

摘　　要：目的探讨瘢痕疙瘩术后不同时间开始20Gy/5次大分割放疗的疗效并分析影响疗效的因素。方法选取2021年1月至2023年6月于郑州大学第五附属医院接受术后20Gy/5次放疗方案的76例患者作为研究对象,共计瘢痕疙瘩100处,根据是否复发将瘢痕疙瘩分为有效组(n=79)和复发组(n=21)。定期随访并记录患者放疗后的治疗效果、不良反应发生情况,采用多因素Logistic分析瘢痕疙瘩患者复发的影响因素。结果多因素Logistic回归分析发现术后放疗时间、瘢痕切口长度与治疗后复发有关,术后7h内放疗是治疗后复发的独立危险因素(OR>1,P=0.022),瘢痕切口≤5cm是治疗后复发的独立保护因素(OR<1,P=0.028)。结论手术切除结合大分割放射治疗防治瘢痕疙瘩复发有效,术后7~48h放疗的复发率相对最低。Objective To explore the efficacy of hypofractionated radiotherapy at different time intervals after surgery for keloid,and to analyze the factors affecting the efficacy.Methods A total of 76 patients who underwent 20 Gy/5 postoperative radiotherapy regimen in the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to June 2023 were selected as study subjects,and a total of 100 keloids were divided into effective group(n=79)and recurrence group(n=21).Regular follow-up and record of the patients after radiotherapy treatment effect and adverse effects,and multivariate Logistic was used to analyze factors of recurrence in keloid patients.Results Multivariate Logistic regression analysis found that postoperative radiotherapy time and scar incision length were related to recurrence after treatment,radiotherapy within 7h of surgery was an independent risk factor for recurrence after treatment(OR>1,P=0.022),and scar incision≤5cm was an independent protective factor for recurrence after treatment(OR<1,P=0.028).Conclusion Surgical excision combined with hypofractionated radiotherapy is one of the effective measures to prevent and treat keloid recurrence,though keloids on the trunk may need more effective treatment options.The recurrence rate of radiotherapy initiated 7-48h after surgery is relatively the lowest,and it is worthy of clinical promotion and application.

关 键 词：瘢痕疙瘩 放射治疗 复发 疗效 

分 类 号：R619.6[医药卫生—外科学] R815.2[医药卫生—临床医学]