Radiation Oncology/Benign/Rheumatoid arthritis

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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