Objective　To explore the therapeutic effect of postoperative electron beam radiotherapy for intractable keloid and the influencing factors of recurrence, and to evaluate patients’ satisfaction with the therapeutic effect. Methods　From 2019 to 2021, 37 patients with refractory keloids, including 40 keloids, were treated with electron beam irradiation after operation.

The radiotherapy was conducted with 6-9 MeV electron beam irradiation from the skin, and the irradiation dose was 20 Gy/5

Gy/4 F. The general clinical data of patients were collected and followed up regularly after operation. After the observation,

questionnaires were distributed to all patients to evaluate their satisfaction. The treatment effect and adverse reactions of patients

were analyzed, and the factors affecting recurrence were analyzed by Logistic regression. Results　Among the 40 scars, 4 cases

(10%) recurred after treatment, and 5 cases (12.5%) had no obvious change after treatment, and the effective rate was 77.5%.

The main adverse reactions were skin pigmentation and incision expansion. Univariate analysis showed that sex, past history,

time interval from operation to radiotherapy, continuous irradiation and plasma fibrinogen content were related to recurrence.

Multivariate analysis showed that the interval between operation and radiotherapy for more than 24 hours was an independent

risk factor for recurrence, and continuous irradiation was an independent protective factor. Recurrence, incision expansion

and pigmentation were the main reasons for patients’ dissatisfaction. Conclusion　Surgery combined with electron beam radiotherapy is an effective method for the treatment of refractory keloid. The time from operation to radiotherapy and continuous