Radiation Oncology/Benign/Rheumatoid arthritis

Rheumatoid Arthritis


 * Stanford -- total lymphoid irradiation 20 Gy vs 2 Gy
 * Randomized. 26 patients, intractable rheumatoid arthritis. Arm 1) total lymphoid irradiation 20 Gy vs. Arm 2) total lymphoid irradiation 2 Gy
 * 1985 PMID 3883868 -- "Efficacy of total lymphoid irradiation in intractable rheumatoid arthritis. A double-blind, randomized trial." (Strober S, Ann Intern Med. 1985 Apr;102(4):441-9.)
 * Outcome: Alleviation of joint disease significantly better in 20 Gy group at 3 and 6 months. Marked reduction in T-lymphocyte function and numbers in 20 Gy group, no change in 2 Gy group
 * Toxicity: Transient neutropenia, thrombocytopenia, pericarditis, and pleurisy
 * Conclusion: 20 Gy dose more effective, but also more side effects