{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:03:02Z","timestamp":1788238982709,"version":"build-2803163510"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772079"],"award-info":[{"award-number":["81772079"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Keloid disease is hard to fully eradicate. Recurrence and other unsatisfactory results were found in many patients. No current therapeutic modality has been determined to be most effective for treating keloid scars. Intralesional corticosteroid injections is most commonly recommended for primary management of small and young keloids as well as hypertrophic scars. However, it\u2019s difficult for patients to adhere to long-term triamcinolone acetonide injection therapy because of the pain, inconvenience or complications including hormonal imbalance or irregular menstruation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to determine whether and how Strontium-90 brachytherapy as an adjuvant radiation could affect keloid recurrence after intralesional triamcinolone and 5-fluorouracil injections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included keloid patients from March 2019 to September 2019 and randomly allocated them to two groups after 3 intralesional triamcinolone and 5-fluorouracil injections at 3 weeks interval. The experimental group received Strontium-90 brachytherapy at a total dose of 15-20Gy, while the control group didn\u2019t receive any adjuvant treatment. We performed both Vancouver Scar Scale scoring and Color Doppler ultrasound examination to monitor and evaluate lesions regularly. A one-year follow-up was completed for each patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>31 patients who had 42 keloids in total were recruited. We found intralesional triamcinolone and 5-fluorouracil injections could effectively reduce the thickness and modify the hardness of small and young keloids. Strontium-90 brachytherapy reduced the one-year recurrence rate from 85.7 percent to 44.4 percent after 3 intralesional triamcinolone and 5-fluorouracil injections. The lesions\u2019 thickness or elasticity was not affected by Strontium-90 brachytherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Strontium-90 brachytherapy as an adjuvant radiation could effectively reduce small sized keloids recurrence after intralesional triamcinolone and 5-fluorouracil injections. It worked by enhancing the lesions\u2019 stability post-injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec006\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      The clinical trial registration number:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\/showprojen.aspx?proj=030141\" xlink:type=\"simple\">ChiCTR2000030141<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      Name of trial registry: Chinese Clinical Trial Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\/\" xlink:type=\"simple\">http:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      )\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0248799","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T13:51:20Z","timestamp":1616507480000},"page":"e0248799","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Strontium-90 brachytherapy following intralesional triamcinolone and 5-fluorouracil injections for keloid treatment: A randomized controlled trial"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6454-9129","authenticated-orcid":true,"given":"Ke","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuewen","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4574-7880","authenticated-orcid":true,"given":"Yong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"pone.0248799.ref001","first-page":"33","article-title":"Keloids: 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Chinese expert consensus on clinical prevention and treatment of scar","volume":"6","author":"K Lv","year":"2018","journal-title":"Burn trauma"},{"key":"pone.0248799.ref013","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/02844310500430003","article-title":"Long-term outcome of intralesional injection of triamcinolone acetonide for the treatment of keloid scars in Asian patients","volume":"40","author":"G Muneuchi","year":"2006","journal-title":"Scand J Plast Reconstr Surg hand Surg"},{"key":"pone.0248799.ref014","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.burns.2018.08.011","article-title":"Comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: Randomised control trial","volume":"45","author":"FA Khalid","year":"2019","journal-title":"Burns"},{"key":"pone.0248799.ref015","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/iwj.12629","article-title":"Efficacy and safety of triamcinolone acetonide alone and in combination with 5-fluorouracil for treating hypertrophic scars and keloids: a systematic review and meta-analysis","volume":"14","author":"Y Ren","year":"2017","journal-title":"Int Wound J"},{"key":"pone.0248799.ref016","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.bjps.2018.05.052","article-title":"Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections\u2013a randomized controlled trial","volume":"72","author":"KE Hietanen","year":"2019","journal-title":"J Plast Reconstr Aesthetic Surg"},{"key":"pone.0248799.ref017","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.4103\/0366-6999.209896","article-title":"Radiation therapy in keloids treatment: History, strategy, effectiveness, and 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