Computed tomography-based radiation therapy of ovarian remnants for symptomatic persistent endometriosis.
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.


METHODS
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.


CONCLUSIONS
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.
Haglund
Karl E
KE
Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Viswanathan
Akila N
AN
D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011881:Radiotherapy, Computer-Assisted; D014057:Tomography, X-Ray Computed