How young is too young to treat a child's keloid with radiation?  

What dose/fractionation regimen is most appropriate? 

-i.e. 12 Gy in 4 fractions, but would you modify that approach in a young patient?

What is the most appropriate age cutoff?

Should it be considered for all patients under age 21?

How many non-irradiative options should have been tried prior to?

If the parents are advocating treatment, should the child’s opinion come into play?

-i.e. Some children may be susceptible to teasing from adverse cosmetic appearances which may drive a desire to try “everything”

Are electrons preferred? What about HDR brachytherapy?

Is the recommendation for RT location dependent? 

-i.e. Are there certain locations where radiotherapy should not be considered?