Pentoxifylline and vitamin E treatment for prevention of radiation-induced side-effects in women with breast cancer: A phase two, double-blind, placebo-controlled randomised clinical trial (Ptx-5)

Magnusson, Marie; Höglund, Peter; Johansson, Karin; Jönsson, Charlotta; Killander, Fredrika; Malmström, Per; Weddig, Anna; Kjellén, Elisabeth

doi:10.1016/j.ejca.2009.05.015

Cited by 75 publications

(73 citation statements)

References 23 publications

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“…These impressive findings prompted suggestions for their combined use as a prophylaxis to prevent ORN 51 . Supported by the potential benefit achieved using pentoxifylline as prophylaxis to prevent radiation tissue injury 2,52,65 , it was suggested that pentoxifylline 400 mg twice daily and tocopherol 1000 IU once daily, be given 1 week before extraction and continued for a further 8 weeks 51 . These drugs are well tolerated with few side effects, which include dyspepsia, nausea, headache or vertigo, asthenia, hot flushes, epigastralgia and allergy in some patients 2,26,32,52 .…”

Section: Authormentioning

confidence: 99%

“…Supported by the potential benefit achieved using pentoxifylline as prophylaxis to prevent radiation tissue injury 2,52,65 , it was suggested that pentoxifylline 400 mg twice daily and tocopherol 1000 IU once daily, be given 1 week before extraction and continued for a further 8 weeks 51 . These drugs are well tolerated with few side effects, which include dyspepsia, nausea, headache or vertigo, asthenia, hot flushes, epigastralgia and allergy in some patients 2,26,32,52 . Until data on the effectiveness of these modalities for the prevention of ORN become available, physicians are limited to the traditional options of HBO and antibiotics because using HBO, ultrasound, pentoxifylline or tocopherol requires weeks of preparation, which could be an issue in cases of pain or acute infection.…”

Section: Authormentioning

confidence: 99%

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Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review

Nabil

Samman

2011

International Journal of Oral and Maxillofacial Surgery

283

266

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Section: Authormentioning

confidence: 99%

Section: Authormentioning

confidence: 99%

Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review

Nabil

Samman

2011

International Journal of Oral and Maxillofacial Surgery

283

266

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“…Results of small randomized clinical trials provided mixed data on the efficacy of aforementioned drugs combination 38,74–76. In some of them, the effect of pentoxifylline ± tocopherol on RIF was not higher than placebo 75,76. However, a study conducted by Delanian et al show a clear reduction of superficial fibrosis in a group of 44 women who received pentoxifylline (800 mg/day) plus tocopherol (1000 units/day) for 6–48 months 77.…”

Section: Treatmentmentioning

confidence: 99%

Chronic radiation-induced dermatitis: challenges and solutions

Spałek

2016

CCID

107

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Chronic radiation dermatitis is a late side effect of skin irradiation, which may deteriorate patients’ quality of life. There is a lack of precise data about its incidence; however, several risk factors may predispose to the development of this condition. It includes radiotherapy dose, fractionation, technique, concurrent systemic therapy, comorbidities, and personal and genetic factors. Chronic radiation dermatitis is mostly caused by the imbalance of proinflammatory and profibrotic cytokines. Clinical manifestation includes changes in skin appearance, wounds, ulcerations, necrosis, fibrosis, and secondary cancers. The most severe complication of irradiation is extensive radiation-induced fibrosis (RIF). RIF can manifest in many ways, such as skin induration and retraction, lymphedema or restriction of joint motion. Diagnosis of chronic radiation dermatitis is usually made by clinical examination. In case of unclear clinical manifestation, a biopsy and histopathological examination are recommended to exclude secondary malignancy. The most effective prophylaxis of chronic radiation dermatitis is the use of proper radiation therapy techniques to avoid unnecessary irradiation of healthy skin. Treatment of chronic radiation dermatitis is demanding. The majority of the interventions are based only on clinical practice. Telangiectasia may be treated with pulse dye laser therapy. Chronic postirradiation wounds need special dressings. In case of necrosis or severe ulceration, surgical intervention may be considered. Management of RIF should be complex. Available methods are rehabilitative care, pharmacotherapy, hyperbaric oxygen therapy, and laser therapy. Future challenges include the assessment of late skin toxicity in modern irradiation techniques. Special attention should be paid on genomics and radiomics that allow scientists and clinicians to select patients who are at risk of the development of chronic radiation dermatitis. Novel treatment methods and clinical trials are strongly needed to provide more efficacious therapies.

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“…Two randomized trials have tested pentoxifylline given prophylactically after radiation, specifically examining whether it decreased the development of cutaneous fibrosis. In 83 breast cancer patients (Magnusson et al 2009) and 78 head and neck cancer patients (Aygenc et al 2004), administration of the drug following radiation decreased fibrosis and improved post-treatment range of motion.…”

Section: Prevention and Managementmentioning

confidence: 97%