Radiotherapy Treatment for Keloid Patients: A Retrospective Case Study in Sub-Saharan Africa

Background: Keloid is an abnormal proliferation of scar tissue that extends beyond the boundaries of the original wound, commonly seen in individuals with darker skin. Hence this study seeks to investigate the radiotherapy treatment for keloid patients in sub-Saharan Africa.
Methodology: This retrospective study utilized data from both physical and electronic medical records at the NSIA-LUTH Cancer Centre, covering the period from May 2019 to January 2025. A total of 100 patients diagnosed with keloids during this time were reviewed. 73 keloid patients identified during the study period received radiotherapy (RT). Descriptive and inferential statistics, including Pearson correlation and Chi-square tests, were performed using SPSS version 27.0.
Results: Seventy-three patients with a mean age of 36.21 ± 13.72 years (range 15 - 84) were enrolled. More than half of the population 37 (50.7%) were female and 36 (49.3%) were male. Body mass index (BMI) showed that 15 (20.5%) were healthy weight, 13 (17.8%) each were overweight and obese. 14 (19.2%) reported a family history of keloids, and comorbidities were present in 6 (8.2%). Multiple site affectation were the commonest sites in 17 (23.3%) of cases and ear lobes accounting for 12 (16.4%). Recurrence was reported in 30 (41.1%) of patients. The most common causes of keloids in this population were injury and wound 11 (15.1%). The time elapsed between the onset of lesions and diagnosis was 10 years and above for most patients 20 (27.4%). 34 (46.6%) of patients had surgical excision. All patients were treated with electron beam therapy. Different RT dose regimens were applied in this study, including 12/4Gy 18 (25%), 12/3Gy 12 (16%), 9/3Gy 11 (15%), and 16/4Gy 9 (12%). There was a strong statistical significance between keloid recurrence and surgery (r = 0.544, p < 0.001).
Conclusion: This study highlights high incidence of keloids among young adults, especially females and rate of recurrence. This study dose regimens aligns with international best practices. There is a need for early detection of high-risk patients, combined therapy regimens, and tailored follow-up protocols to reduce recurrence.

Keloid, Predisposing factors, Recurrence

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