Background: Several options are described to treat keloid scars, none of them being 100% successful. Radiotherapy is suggested to have the most significant effect on recurrence rate. The aim of the study is to evaluate the effectiveness of  High-dose brachytherapy combined with surgery and to evaluate patient satisfaction.

Methods and Material: We retrospectively enrolled 5 patients with 10 keloids, treated by surgical excision and high-dose-rate (HDR) brachytherapy. Total dose was 12 Gy in 3 fractions.

Results: The median size of the lesions before brachytherapy was 153.48 mm². The improvement of scars of scoring POSAS by observer and patient were 17.1±3.2 (11-32) and 20.8±11.5 (5-51), respectively. Mean of recurrent time was 26.3±0.9 months. With a median follow-up of 60 months, the overall recurrence-free response rate for all keloids was 20%. Except for one patient, in other patients seen no complications.

Conclusion: It seems that keloid excision followed by HDR brachytherapy is effective in the eradication of keloids in treatment. It also resulted in a good cosmetic rate and relief of symptoms.