Radiotherapy in benign uterine bleeding disorders. The Radiumhemmet metropathia cohort 1912-1977. Short and long term results.

Radiotherapy was earlier a method of choice for treatment of benign bleeding disorders (metropathia), especially in women of high surgical risk. During the period 1912 to 1977 933 women with benign bleeding disorders were treated at Radiumhemmet with intracavitary brachytherapy or external irradiation or a combination of both. The result with regard to cure of the uterine bleedings was good (48%). Hormonal withdrawal symptoms after treatment were noted in 45% of the patients. In the long term follow up an increased risk of cardiovascular death was found in women treated before menopause. Malignant tumours occurred in 107 cases versus 90.2 expected (RR 1.19). The estimated ovarian dose of ionizing radiation varied from 3.5 Gy to 6.0 Gy for the three standard techniques. Two women gave birth to a healthy child 4 and 5 years after intracavitary radium treatment. The estimated absorbed dose to the ovaries in these two women were 1 Gy and 4 Gy, respectively.

[Intracavitary radiotherapy of benign recurrent uterine bleedings (author's transl)]. / Intrakavitäre Kontaktbestrahlung bei rezidivierenden Blutungen gutartiger Histogenese.

387 patients with uterine bleeding resistant to other therapy were treated by intracavitary radium-therapy. In all cases there was a contraindication for the operative removal of the uterus. In 94,3% of our cases the bleeding could be treated successfully by the radium-application. Side effects of the irradiation occurred only in a minimal and neglectable percentage. Therefore the intrauterine contact-irradiation-therapy should be remembered in cases of uterine bleeding resistant to hormonal therapy or in cases of high risk for operation. With the new and modern afterloading device the molestation for the patients could be reduced to a minimum.