Do you advise patients to hold DMARDs for conditions such as psoriasis or rheumatoid arthritis while actively undergoing radiation treatment?

Topics: Radiation Oncology • Radiation Biology • General Radiation Oncology • Rheumatology

Does it depend on the DMARD type (biologic, targeted synthetic, or conventional synthetic)?

Answer from: Radiation Oncologist at Community Practice

Data in this setting is limited. I have usually not held DMARDs with RT unless treating with concurrent chemo RT or treating a site (pelvis) where myelosuppression caused by RT would further suppression immunity especially with biologics and methotrexate.

Comments

at Novant Health
Thanks. Are we concerned, in that case, about the ...

at MD Anderson Cancer Center
Methotrexate is considered radiosensitizing so rad...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
Since the dose of MTX is low for RA (usually weekl...

at MD Anderson Cancer Center
Thanks, many radiation oncologists at our center p...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
For breast, I have not held based on CMF data but ...

Answer from: Radiation Oncologist at Community Practice

I recommend withholding low-dose methotrexate when giving radiotherapy to the head and neck. MTX depletes the amount of purines and pyrimidine nucleotides. These patients are often on these meds chronically and so they do not have enough nucleotides to repair DNA damage. I have seen significant muco...

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