PALLIATION OF RECURRENT ENDOMETRIOSIS WITH RADIOTHERAPEUTIC ABLATION OF OVARIAN REMNANTS

Objective: To review the use of radiotherapy for relieving the symptom s of recurrent endometriosis caused by functioning ovarian remnants. D esign: Retrospective study (case report). Patient(s): A woman with rec urrent endometriosis of 14 years' duration. Intervention(s): After hys terectomy and bilateral oophorectomy, hormonal management, and multipl e explorations for recurrent endometriosis, cycling ovarian remnants w ere confirmed histologically. Pelvic irradiation was used to ablate th is tissue. A dose of 15 Gy in 10 daily fractions was given through ant erior and posterior opposed fields using 18-mV photons. Result(s): The patient had a prompt increase in FSH levels associated with castratio n levels of serum E-2. A review of the literature on the use of radiot herapy in this clinical situation is presented. Conclusion(s): Radioth erapy should be considered in selected patients when ovarian castratio n is not a viable surgical option and hormonal therapies have failed. (C) 1997 by American Society for Reproductive Medicine.