Kucera H, Huber H, Weghaupt K
Strahlentherapie. 1984 Apr;160(4):220-3.
423 patients with benign recurrent uterine bleeding resistant to other therapy were treated by intracavitary radiotherapy. In all cases there was a contraindication for the operative removal of the uterus. Since 1980 radiomenolysis was performed by high-dose Iridium-192 irradiation (afterloading technique). In 94.3% of our cases with Radium-226 irradiation the bleeding could be treated successfully. Side effects of the irradiation occurred only in a minimal and neglectible percentage. In all cases irradiated with Iridium-192 the bleeding stopped after treatment. Side effects could not be observed. Therefore the intrauterine contact-irradiation therapy with high-dose Iridium-192 should be remembered in cases of uterine bleeding resistant to hormonal therapy or in cases of high risk for operation. With the afterloading device the molestation for the patients could be reduced to a minimum. By intrauterine exfoliative smear performed before and after irradiation the cytomorphologic effect of an Iridium-192 afterloading irradiation was demonstrated. The examinations showed that the cytologic findings were characteristic for the effect if ionizing radiation of the histologically unchanged, not radiosensitive, normal cylindrical epithelium. A marked cellular diathesis and augmentation of size of nuclei and plasma is a characteristic result of the irradiation with Iridium-192.
423例对其他治疗方法耐药的良性复发性子宫出血患者接受了腔内放射治疗。所有病例均存在子宫手术切除的禁忌证。自1980年起,采用高剂量铱-192照射(后装技术)进行放射溶解治疗。在我们接受镭-226照射的病例中,94.3%的出血得到了成功治疗。放射治疗的副作用仅发生在极小且可忽略不计的比例。在所有接受铱-192照射的病例中,治疗后出血停止。未观察到副作用。因此,对于激素治疗耐药的子宫出血病例或手术风险高的病例,应记住高剂量铱-192的宫内近距离照射治疗。使用后装装置可将对患者的骚扰降至最低。通过照射前后进行的宫内脱落涂片检查,证实了铱-192后装照射的细胞形态学效应。检查表明,细胞学结果对于组织学未改变、无放射敏感性的正常柱状上皮的电离辐射效应具有特征性。明显的细胞素质以及细胞核和细胞质大小的增大是铱-192照射的特征性结果。