Radiation Oncology/Benign/Multiple sclerosis

Multiple Sclerosis


 * US Multi-Institutional
 * Randomized. 46 patients with progressive multiple sclerosis. Arm 1) Modified total lymphoid irradiation (TLI) + low dose prednisone vs. Arm 2) sham TLI + identical prednisone. Modified TLI given as AP/PA 19.8/11 using modified mantle and smaller inverted Y, excluding spleen and ovaries
 * 1997 PMID 9415539 -- "Modified total lymphoid irradiation and low dose corticosteroids in progressive multiple sclerosis." (Cook SD, J Neurol Sci. 1997 Nov 25;152(2):172-81.)
 * Outcome: Fewer TLI patients showed sustained decline (SS); risk for relapse reduced 54% (SS); fewer new MRI lesions (SS)
 * Toxicity: mild
 * Conclusion: Total lymphoid irradiation and systemic immunosuppression have beneficial effect in progressive forms of MS