Clinical drawbacks of total lymphoid irradiation: the cons.
Neurology
; 38(7 Suppl 2): 38-41, 1988 Jul.
Article
em En
| MEDLINE
| ID: mdl-3386844
ABSTRACT
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.
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Base de dados:
MEDLINE
Assunto principal:
Radioterapia
/
Terapia de Imunossupressão
/
Tecido Linfoide
/
Esclerose Múltipla
Tipo de estudo:
Clinical_trials
Limite:
Humans
/
Male
Idioma:
En
Revista:
Neurology
Ano de publicação:
1988
Tipo de documento:
Article