Background: In the radium era heparin prophylaxis was necessary to avoid thromboembolic events. Today with high-dose-rate (HDR) afterloading thromboembolic events are rare. Coagulation activation parameters were monitored during HDR afterloading to evaluate the necessity of heparin prophylaxis.

Patients and methods: Twenty patients with uterine carcinoma and no postoperative tumor residuals were randomized before their first 10 Gy OD HDR-afterloading application. Ten patients received heparin prophylaxis, the other ten patients received no prophylaxis. Blood samples were taken before, immediately after, 6 and 24 hours after HDR afterloading. D-Dimer, TAT, and F 1 + 2 were measured.

Results: No significant activation of the coagulation system was observed over the investigated time period and no differences have been detected between both groups. None of the patients of either group developed thromboembolic complications.

Conclusions: HDR afterloading has no direct influence on the plasmatic coagulation system. From this point of view heparin prophylaxis does not seem necessary.