目的：報告一家教學醫院用放射線治療術後瘢瘤的經驗。材料與方法：我們收集自1999到2003年在本院執行瘢瘤或肥厚疤痕患者在術後進行放療的結果，並分析當中可能的因素。結果：這段期間共有九個患者的治療被觀察，其中一位男性，八位女性。五位對其結果感到滿意，二位還可以，二位感到失望。感到失望的患者中，一位的瘢瘤長成腫塊狀，另一位開刀過了17天才來放療。感到滿意的患者中，一位開刀過了6天才來放療，其他則開過刀2天內就開始放療。總共九個患者中，8位接受了15 Gy，分五次照射完畢；另一位接受了12 Gy，分四次照射完畢。研究期間沒有看到次發性惡性腫瘤是因為放療引起的。經過分析所有的變數之後發現初始症狀有醜型問題者和治療滿意度有相關，但沒有一個變數和預後結果有關。結論：劑量在12到15 Gy間，分4到5次照射，對瘢瘤或肥厚疤痕的術後放射治療是適宜的。術後應在2-3天內即開始放療。就算在此條件下放療，治療反應仍可能不佳，尤其是已經長成腫塊狀的瘢瘤。

Purpose: To report the experience of postoperative radiation therapy (RT) for keloid at a teaching hospital. Material and Methods: We recruited patients with keloid or hypertrophic scar lesions who received excision and postoperative RT from 1999 to 2003 at a teaching hospital. We use 6 MeV electron beam covered with 0.5-1 cm Superflap as bolus to enhance skin dose, and the electron beam margin was designed as 0.5 to 1 cm from re-operative suture line area. All of them were treated with 15 Gy of RT in five fractions in consecutive days, except one who had problems in scheduling the last treatment and received 12 Gy in four fractions. We summarized information on their outcomes and evaluated the possible prognostic factors. Results: A total of nine patients were observed during the study period, including one man and eight women. Five of them were satisfied with their outcomes, two had fair outcome, and two felt disappointed. Of the two disappointed patients, one had a gross keloid, and the other had an elapsed time of 17 days between excision and radiation. One of the patients with satisfactory outcome, however, had an elapsed time of 6 days. All the other six patients who had satisfactory or fair outcomes started RT within 2 days after surgery. Eight patients received 15 Gy in five fractions, and one received 12 Gy in four fractions. No second malignancy was observed during the study period. Among all variables evaluated, ugly as the initial symptom was the only significant factor associated with satisfaction, but none was associated with the outcome. Conclusion: The dose-fractions between 12 and 15 Gy in four or five fractions are feasible in postoperative RT for keloid or hypertrophic scar. Starting the RT within 2 to 3 days should be suggested after excision. Unsatisfactory response is still possible under this timing and dose-fractions, especially for gross lesions.