Objectives

This study presents the initial clinical experience using Rhenium-188 (188Re) skin cancer therapy (SCT) with a specialized applicator system (Oncobeta) for treating recurrent keloids.
It demonstrates the feasibility and effectiveness of 188Re SCT as an alternative treatment for keloids that have failed other therapies.
The treatment achieved a complete response in 72% of lesions, with a 7% recurrence rate after a median follow-up of 37 months.

Methodology

The study utilized a specialized applicator system (Rhenium SCT - Oncobeta) to apply a topical 188Re gel matrix to keloid lesions.
A personalized treatment time was calculated for each patient using the VARSKIN 5 software system, aiming to deliver 30 Gy to the deepest part of the lesion (up to 3 mm).
The treatment involved a single session of 188Re application, with the exception of four patients who received two sessions.

A total of 59 lesions in 29 patients were treated.
The mean treated area was 4.65 cm² (range: 0.25–46.25 cm²).
The mean administered activity was 256.7 MBq (range: 35–663.50 MBq).
The average treatment time was 350.89 minutes (range: 85–1304 minutes).
Complete response was observed in 72% (43/59) of lesions.
Partial response was observed in 10% (6/59) of lesions.
Progression was observed in 7% (4/59) of lesions.
Stable disease was observed in 10% (6/59) of lesions.
The recurrence rate was 7% after a median follow-up of 37 months (range: 11-59 months).

The study demonstrates promising results for 188Re SCT in treating recurrent keloids, but the sample size is relatively small (29 patients, 59 lesions).
The follow-up period is variable (11-59 months), and while the median is 37 months, a longer, more uniform follow-up would strengthen the assessment of long-term efficacy and recurrence rates.
The study lacks a direct comparison group (e.g., patients receiving standard treatments like surgery or intralesional steroids). This makes it difficult to definitively conclude that 188Re SCT is superior to existing therapies.
While the study mentions hypopigmentation as a common side effect, a more detailed analysis of the severity and duration of side effects, including other potential complications, would be beneficial.
The study could benefit from incorporating standardized quality-of-life questionnaires to assess the impact of treatment on patients' subjective well-being.