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Published on: January 22, 2022
Computed tomography-based radiation therapy of ovarian remnants for symptomatic persistent endometriosis
Karl E Haglund1, Akila N Viswanathan
1Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Background:
Endometriosis, a major cause of pelvic pain in women, is driven by estrogen. Ovarian remnant irradiation may alleviate pelvic pain by eliminating estrogen production in appropriately selected women with endometriosis.
Case:
Three patients with endometriosis causing incapacitating pelvic pain received 3D-imaging-based external beam radiation to doses of 1,500 to 2,100 cGy. All had pre-irradiation premenopausal follicle stimulating hormone levels and imaging evidence of ovarian remnants. None were candidates for further medical or surgical interventions. By 3 months after radiation, follicle stimulating hormone levels reached postmenopausal levels in all three patients, with complete resolution of the severe pelvic pain.
Conclusion:
Radiation therapy effectively induced menopause and relieved refractory pain from endometriosis. Careful selection of patients is necessary, given the potential for an increased long-term risk of radiation-related complications.
