Peran Radiasi Pada Tata Laksana Keloid
DOI:
https://doi.org/10.33820/mdvi.v45i4.45Abstract
Keloid merupakan salah satu lesi jinak pada kulit yang timbul akibat respons penyembuhan luka yang
abnormal. Meskipun bersifat jinak, namun keloid dapat menimbulkan gejala klinis yang mengganggu. Terdapat
banyak pilihan terapi untuk keloid yang bersifat invasif maupun non-invasif. Pembedahan merupakan modalitas
invasif yang paling umum digunakan, meskipun angka rekurensi pasca terapi tunggal dengan pembedahan
dinilai cukup tinggi yakni mencapai 50-100% dalam 5 tahun. Radioterapi dapat dilakukan sebagai monoterapi
maupun sebagai terapi adjuvan pasca bedah dalam tata laksana keloid. Terapi keloid dengan pembedahan
diikuti dengan radiasi menghasilkan angka rekurensi kurang dari 10% pada 1 tahun pertama pascaterapi.
Radioterapi yang dilakukan dapat berupa brakiterapi maupun radiasi eksterna. Radiasi dapat menurunkan
proliferasi fibroblas dan sel endotel yang selanjutnya mengurangi produksi kolagen. Radioterapi pascabedah
dianjurkan untuk dimulai dalam waktu kurang dari 48 jam dengan total dosis yang masih menjadi perdebatan.
Kaitan antara dosis dan efek radiasi dengan biologically equivalent dose (BED) menjadi dasar pembuatan
pedoman. BED lebih dari 30 Gy dianggap efektif untuk menurunkan angka rekurensi keloid.
Kata kunci: keloid, terapi, pascabedah, radiasi, rekurensi
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