skip to main content

Title: Clinical drawbacks of total lymphoid irradiation: the cons

Success has been reported with use of total lymphoid irradiation (TLI) in organ transplant recipients and in patients with rheumatoid arthritis and other autoimmune diseases. In a well-conducted randomized double blind clinical trial, Cook et al have found that TLI was superior to sham irradiation of patients with multiple sclerosis (MS). However, it is clear from looking at this data that not all patients responded to TLI and that with time disease activity returned. Our own experience with TLI in two MS patients was very disappointing. Despite its apparent benefit in some conditions, considerable drawbacks are associated with TLI. These include high financial cost, unpleasant treatment-related side effects, and the possibility that more serious morbidity as well as mortality may be treatment-related. Furthermore, the optimum therapeutic regimen for TLI has not yet been established. Issues related to cumulative dose, dose per fraction, frequency of fractions, field of irradiation, and interaction with other therapies still need clarification. For these reasons we do not recommend TLI as a treatment for MS.
Authors:
; ; ; ;
Publication Date:
OSTI Identifier:
6999430
Resource Type:
Journal Article
Resource Relation:
Journal Name: Neurology; (United States); Journal Volume: 38
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; LYMPHATIC SYSTEM; IRRADIATION; NERVOUS SYSTEM DISEASES; RADIOTHERAPY; SIDE EFFECTS; FRACTIONATED IRRADIATION; IMMUNOSUPPRESSION; RADIATION DOSES; TRANSPLANTS; DISEASES; DOSES; MEDICINE; NUCLEAR MEDICINE; RADIOLOGY; THERAPY 560151* -- Radiation Effects on Animals-- Man; 550603 -- Medicine-- External Radiation in Therapy-- (1980-)