Inclusion Criteria:  Clinically diagnosed keloid Surgical excision of keloid is either contraindicated or patient has declined treatment with surgical excision Note: patients with keloids that recurred after previous resection are eligible, as long as the current keloid is either unresectable or patient has decline resection. Age ≥18 Study specific informed consent provided  Exclusion Criteria:  Prior RT to the area of interest that would result in overlap of radiation therapy fields Females of child bearing age without a negative serum pregnancy test prior to initiation of RT or unwilling to use contraception prior to and during the radiation course Keloids in areas where radiation therapy introduces unacceptable high risk of toxicity as determined by the treating radiation oncologist Uncontrolled intercurrent illness (e.g. symptomatic congestive heart failure, uncontrolled cardiac arrhythmia, or psychiatric situation) that would limit compliance with study requirements as judged by the treatment physicians