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Radiation Oncology/Benign/Multiple sclerosis
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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 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