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Do you ever change your CNS radiation recommendations for patients with multiple sclerosis (MS)?

Would you ever defer radiation in patients with primary brain tumors or would you manage these patients similarly to non-MS patients? How do you counsel MS patients regarding their risks? At least one small series of 15 consecutive patients from Mayo suggested an increase in severe toxicity with older, large-field radiation (Miller, Robert C., et al. "Multiple sclerosis, brain radiotherapy, and risk of neurotoxicity: the Mayo Clinic experience." International Journal of Radiation Oncology• Biology• Physics 66.4 (2006): 1178-1186.
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Radiation Oncology · Columbia University Irving Medical Center
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I will counsel patients with MS about potential increased radiation-induced toxicity for intracranial radiotherapy. As the publication states, the techniques used may not be comparable to modern techniques. I don't routinely defer radiotherapy simply because a patient has MS and would have a convers...

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