ANGKA KEBERHASILAN TERAPI EKSISI DAN RADIOTERAPI ADJUVAN PADA PASIEN KELOID YANG DIOPERASI DI RUMAH SAKIT UNAND
DOI:
https://doi.org/10.36973/jkih.v13i1.709Keywords:
Keloid, Excision, Adjuvant Radiotherapy.Abstract
Keloid is a benign fibroproliferative tumor of the dermal that extends beyond the original wound and invades adjacent dermal tissue due to an abnormal healing response from the wound in the dermis. Keloids can have a disturbing impact on individuals such as cosmetic disorders, pruritus, pain, and in severe cases, limited joint movement so that it is very necessary to be managed. One of the keloid therapies with quite promising results is surgical excision and adjuvant radiotherapy. This aim of this research was to determine the success rate of excision therapy and adjuvant radiotherapy in keloid patients operated on at Unand Hospital. This research is an observational descriptive study and uses a cross- sectional design using a total sampling technique of 12 samples. Data analysis uses univariate analysis and research data is presented in the form of a table of success rates. The Results In this study, the highest success rate was found in the 12-16 year age group, female gender, lower extremity predilection. All patients received external radiation with the highest success rate in the group of patients who were given a total dose of 20 Gy in 5 fractions, a follow-up interval of 6 months, and a distance of excision and adjuvant radiotherapy for <3x24 hours, and adhered to the fixed therapy protocol. The success of therapy is largely influenced by predilection, age, gender, radiation dose, and patient compliance with therapy.
Downloads
References
Alhady, S., & Sivanantharajah, K. (1969). Keloids In Various Races: A Review of 175 Cases. Plastic and Reconstructive Surgery, 44(6), 564–566. https://doi.org/10.1097/00006534-196912000-00006
Andrews, J., Marttala, J., Macarak, E., Rosenbloom, J., & Uitto, J. (2016). Keloids: The paradigm of skin fibrosis - Pathomechanisms and treatment. Matrix Biology, 51(37), 37–46. https://doi.org/10.1016/j.matbio.2016.01.013
Azzahra, A., Perdanakusuma, D., Indramaya, D., & Saputro, I. (2023). Keloid and Hypertrophic Scar Post-Excision Recurrence: A Retrospective Study. Jurnal Plastik Rekonstruksi., 9(2).
Betarbet, U., & Blalock, T. (2020). Betarbet U, Blalock TW. Keloids: A Review of Etiology, Prevention, and Treatment. Journal Clin Aesthet Dermatol, 1(13), 33–43.
Brock, D. (1991). The ideal of shared decision making between physicians and patients. Kennedy Institute of Ethics Journal, 1(1), 28–47. https://doi.org/10.1353/ken.0.0084
Cecarani, O. (2017). Profil Keloid Pada Pasien RSUP DR. M. DJAMIL PADANG Tahun 2016-2020. Universitas Andalas.
Choirunnada, A. (2019). Profil Gangguan Kualitas Hidup akibat keloid pada Mahasiswa Fakultas Kedokteran Universitas Udayana Angkatan 2012-2014. Jurnal Medika Udayana, 8(8).
Gozal, F., & Sekarutami, M. (2018). Tinjauan Pustaka Peran Radiasi Pada Tata Laksana Keloid. Media Dermato-Venereologica Indonesiana, 45(4). https://doi.org/10.33820/mdvi.v45i4.45
Hedvall, G. (1991). Conginetal heart defect among children are surveyed in a Swedish registry. Lakartidningen, 88(24), 30–31.
Huan, C., Liu, L., You, Z., Du, Y., & Ogawa, R. (2019). Managing keloid scars: From radiation therapy to actual and potential drug deliveries. International Wound Jour, 16(3), 852–859. https://doi.org/10.1111/iwj.13104
Kataria, T., Cutter, T., & Apfelbaum, J. (2013). Patient selection in outpatient surgery. Clinics in Plastic Surgery, 40(3), 371–382. https://doi.org/10.1016/j.cps.2013.04.004
Kim, H., Hwang, S., Lim, K., Jung, Y., Ahn, S., & J, K. S. (2013). Recurrent Auricular Keloids during Pregnancy. Archives of Plastic Surgery, 40(1), 70–72. https://doi.org/10.5999/aps.2013.40.1.70
Lee, J., & Seol, K. (2021). Adjuvant Radiotherapy after Surgical Excision in Keloids. Medicina (Kaunas, Lithuania), 57(7), 730. https://doi.org/10.3390/medicina57070730
Li, Y., Zhang, D., Hang, B., & Wang, H. (2022). The Efficacy of Combination Therapy Involving Excision Followed by Intralesional 5-Fluorouracil and Betamethasone, and Radiotherapy in the Treatment of Keloids: A Randomized Controlled Trial. Clinical, Cosmetic and Investigational Dermatology, 15(November), 2845–2854. https://doi.org/10.2147/CCID.S388717
Limandjaja, G., Niessen, F., Scheper, R., & Gibbs, S. (2020). The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models. Frontiers in Cell and Developmental Biology, 26(8). https://doi.org/10.3389/fcell.2020.00360
Liu, C., & Yuan, Z. (2019). Retrospective study of immediate postoperative electron radiotherapy for therapy-resistant earlobe keloids. Archives of Dermatological Research, 311(6), 469–475. https://doi.org/10.1007/s00403.019-01922-z
Lu, W., Zheng, X., Yao, X., & Zhang, L. (2015). Clinical and epidemiological analysis of keloids in Chinese patients. Archives of Dermatological Research, 307(2), 109–114. https://doi.org/10.1007/s00403-014-1507-1
Mari, W., Alsabri, S., Tabal, N., Younes, S., Sherif, A., & Simman, R. (2015). Novel Insights on Understanding of Keloid Scar: Article Review. Journal of the American College of Clinical Wound Specialists, 7, 1–7. https://doi.org/10.1016/J.JCCW.2016.10.001
Miles, O., Zhou, J., Paleri, S., Fua, T., & Ramakrishnan, A. (2021). Chest keloids: effect of surgical excision and adjuvant radiotherapy on recurrence, a systematic review and meta-analysis. ANZ Journal of Surgery, 91(6), 1104–1109. https://doi.org/10.1111/ans.16561
Mohamed, R., Elawadi, A., Al-Gendi, R., Al-Mohsen, S., Wani, S., & Wafa, A. (2022). The outcome of postoperative radiation therapy following plastic surgical resection of recurrent ear keloid: a single institution experience. Journal of the Egyptian National Cancer Institute, 34(1). https://doi.org/10.1186/s43046-022-00105-8
Nang’ole, F., Anzala, O., Ogeng’o, J., & Agak, G. (2023). Determinants of Keloid study: The nairoby keloid requrrence scoring system; A cohort, prospective study. International Journal of Surgery Open, 52. https://doi.org/10.1016/J.IJSO.2023.100596
Ogawa, R., Dohi, T., Tosa, M., Aoki, M., & Akaishi, S. (2021). The latest strategy for keloid and hypertrophic scar prevention and treatment: The nippon medical school (NMS) protocol. Journal of Nippon Medical School, 88(1), 2–9. https://doi.org/10.1272/jnms.JNMS.2021_88-106
Oriji, G., & Keiser, H. (1997). Protein kinase C mediates angiotensin II-induced contractions and the release of endothelin and prostacyclin in rat aortic rings. Prostaglandins, Leukotrienes, and Essential Fatty Acids, 57(2), 135–141. https://doi.org/10.1016/s0952-3278(97)90003-x
Shaffer, J., Taylor, S., & Cook-Bolden, F. (2002). Keloidal scars: a review with a critical look at therapeutic options. Journal of the American Academy of Dermatology, 46(2 Suppl Understanding), S63–S97. https://doi.org/10.1067/mjd.2002.120788
Wagner, W., Alfrink, M., Micke, O., Schäfer, U., Schüller, P., & Willich, N. (2000). Results of prophylactic irradiation in patients with resected keloids--a retrospective analysis. Acta Oncologica (Stockholm, Sweden), 39(2), 217–220. https://doi.org/10.1080/028418600430806
Widiatmoko, A., Brahmanti, H., Padesa, T., & Pranowo, B. (2019). Kombinasi Bedah Eksisi Injeksi Kortikosteroid Intralesi, dan Gel Silikon pada Tata Laksana Keloid di Cuping Telinga. 2019. Media Dermato-Venereologica Indonesiana, 46(2). https://doi.org/10.33820/mvdi.v46i2.61
Wu, C., Wu, P., Fang, A., & Lan, C. (2012). FK506 inhibits the enhancing effects of transforming growth factor (TGF)-β1 on collagen expression and TGFβ/Smad signalling in keloid fibroblasts: implication for new therapeutic approach. British Journal of Dermatology, 167(3), 532–541. https://doi.org/10.1111/j1365-2133.2012.11023.x
Yoshiaki, C., & Rei Ogawa, H. (2019). Sex Differences in Keloidogenesis: An Analysis of 1659 Keloid Patients in Japan. Dermatology and Theraphy, 9(4), 747–754. https://doi.org/10.1007/S13555-019-00327-0
Zainib, M., & Amin, N. (2025). Terapi Radiasi dalam Pengobatan Keloid. Treasure Island (FL).
