Role of Pentoxifylline and Vitamin E in Attenuation of Radiation-Induced Fibrosis

Cancer and its treatment exert a heavy psychological and physical toll. Of the myriad symptoms which result, pain is common, encountered in between 30% and 60% of cancer survivors. Pain in cancer survivors is a major and growing problem, impeding the recovery and rehabilitation of patients who have beaten cancer and negatively impacting on cancer patients' quality of life, work prospects and mental health. Persistent pain in cancer survivors remains challenging to treat successfully. Pain can arise both due to the underlying disease and the various treatments the patient has been subjected to. Chemotherapy causes painful chemotherapy-induced peripheral neuropathy (CIPN), radiotherapy can produce late effect radiation toxicity and surgery may lead to the development of persistent post-surgical pain syndromes. This review explores a selection of the common causes of persistent pain in cancer survivors, detailing our current understanding of the pathophysiology and outlining both the clinical manifestations of individual pain states and the treatment options available.

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“…[103][104][105][106] These medications have been recommended by some authors, despite the lack of large randomised-controlled trials (RCTs). 107 …”

Section: Abdominal Visceral Painmentioning

confidence: 99%

Pain in cancer survivors

Brown

Ramirez

Farquhar-Smith

2014

British Journal of Pain

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“…Its derivatives exhibit protective effects against DNA damage (Sweetman et al 1997, Kumar et al 2002. The combination of PTX and aT was shown to reduce late chronic damage, fibrosis and necrosis in vivo , Letur-Konirsch et al 2002, Delanian & Lefaix 2002, Chiao & Lee 2005, whereas aT or PTX alone had no beneficial or toxic effects (Delanian et al 2003, Chiao & Lee 2005.…”

Section: Introductionmentioning

confidence: 99%

DNA damage in cultured skin microvascular endothelial cells exposed to gamma rays and treated by the combination pentoxifylline and α-tocopherol

Laurent¹,

Voisin²,

Pouget³

2006

International Journal of Radiation Biology

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Purpose: This in vitro study aims at evaluating the effect of the combination of pentoxifylline (PTX) and trolox (Tx), the water-soluble analogue of a-tocopherol, on the oxidative state and DNA damage in dermal microvascular endothelial cells exposed to doses up to 10 Gy of ionizing radiation. Materials and methods: Confluent primary cultures of dermal endothelial cells were gamma irradiated at 3 and 10 Gy, and 0.5 mM of both drugs, PTX and Tx, was added either before (15 min) or after (30 min or 24 h) irradiation. Reactive oxygen species (ROS), measured by the dichlorodihydrofluorescein diacetate assay, and DNA damage, assessed by the comet and micronucleus assays, were measured at different times after exposure (0 -21 days). Results: The PTX/Tx treatment decreased the early and delayed peak of ROS production by a factor of 2.8 in 10 Gy-irradiated cells immediately after irradiation and the basal level by a factor of 2 in non-irradiated control cells. Moreover, the level of DNA strand breaks, as measured by the comet assay, was shown to be reduced by half immediately after irradiation when the PTX/Tx treatment was added 15 min before irradiation. However, unexpectedly, it was decreased to a similar extent when the drugs were added 30 min after radiation exposure. This reduction was accompanied by a 2.2-and 3.6-fold higher yield in the micronuclei (MN) frequency observed on days 10 and 14 post-irradiation, respectively. Conclusion: These results suggest that oxidative stress and DNA damage induced in dermal microvascular endothelial cells by radiation can be modulated by early PTX/Tx treatment. These drugs acted not only as radical scavengers, but they were also responsible for the increased MN frequency in 10 Gy-irradiated cells. Thus, these drugs may cause a possible interference with DNA repair processes.

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“…Though the previous studies suggested that PTX or Vit. E alone was unable to reverse human RIF, they possessed all the major properties necessary to make them antifibrotic agents (25). Haddad reported 34 radiation-induced superficial fibrotic lesions were treated with PTX and Vit.…”

Section: Design Of the Studymentioning

confidence: 99%

Studies on Pentoxifylline and Tocopherol Combination for Radiation-Induced Heart Disease in Rats

Liu

Xiong

Xia

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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Role of Pentoxifylline and Vitamin E in Attenuation of Radiation-Induced Fibrosis

Abstract: Overall, pentoxifylline is well tolerated and is one of the few commercially available drugs with clinical data for management of RIF. Despite a lack of large, well-designed clinical trials, pentoxifylline plus vitamin E should be considered as an option in patients with symptomatic RIF.

Cited by 75 publications

References 26 publications

Pain in cancer survivors

Pain in cancer survivors

DNA damage in cultured skin microvascular endothelial cells exposed to gamma rays and treated by the combination pentoxifylline and α-tocopherol

Studies on Pentoxifylline and Tocopherol Combination for Radiation-Induced Heart Disease in Rats

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