Use of pentoxifylline and tocopherol in the management of osteoradionecrosis

Patel, Vinod; Gadiwalla, Yusuf; Sassoon, Isabel; Sproat, Chris; Kwok, Jerry; McGurk, Mark

doi:10.1016/j.bjoms.2015.11.027

Cited by 49 publications

(46 citation statements)

References 19 publications

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“…Treatment was well tolerated and complete recovery was observed in a median time of 6 months. The favorable clinical outcome and the toxicity profile of the medical ORN treatment were duplicated by the same group in a larger prospective cohort of 54 HNC patients with refractory mandibular ORN, mainly after surgery and HBOT [155], and was confirmed by several other groups [152,156,157]. However, the true value of this strategy is yet to be confirmed in a randomized clinical trial setting [151].…”

Section: Mandible Osteoradionecrosismentioning

confidence: 93%

Treatment of late sequelae after radiotherapy for head and neck cancer

Strojan

Hutcheson

Eisbruch

et al. 2017

Cancer Treatment Reviews

242

171

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Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss.

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Section: Mandible Osteoradionecrosismentioning

confidence: 93%

Treatment of late sequelae after radiotherapy for head and neck cancer

Strojan

Hutcheson

Eisbruch

et al. 2017

Cancer Treatment Reviews

242

171

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“…PVe has been used with promising results across numerous oncological specialties and in particular breast cancer. Based on this evidence, it has gained popularity in managing ORN or as a prophylaxis against ORN following dental extractions. Unfortunately, some head and neck patients are unable to swallow the large tablet.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported side effects from liquid formulation of pentoxifylline and tocopherol in head and neck radiotherapy patients: an institutional experience and retrospective analysis

et al. 2018

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Aim Osteoradionecrosis (ORN) is a well‐recognised complication of head and neck radiotherapy. There is growing evidence that the use of pentoxifylline and tocopherol (PVe) is effective in managing established jaw necrosis and there is also early evidence for its use prophylactically to aid healing. The cohort of patients being prescribed these medications have radiation‐related problems such as dysphagia, xerostomia and trismus which means that swallowing large and multiple tablets is difficult or impossible. In such a situation, the solution is to prescribe liquid formulation of medications. Unfortunately, there is no commercial liquid formulation for pentoxifylline and so crushing the tablets and dissolving them in water produces an ad hoc form. The aim of this retrospective review was to determine patient‐reported side effects based on a named‐patient liquid formulation of pentoxifylline and liquid tocopherol. Method A total of 43 patients were prescribed liquid formulation of pentoxifylline and liquid tocopherol for either established ORN or as prophylaxis against ORN for a dental extraction. The dental records were retrospectively reviewed and assessed for side effects reported by the patient. Results Dysphagia was the most common indication for the prescription of liquid PVe (34/43 patients). Gastric irritation was reported in 2/43 (4.6%) patients while general side effects (nausea, malaise, vomiting) were reported in 11.6% (5/43) patients. Conclusion In comparison to other trials and studies reporting PVe side effects, this retrospective review did not appear to show a higher incidence when using the current manufactured liquid formulation of PVe.

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“…Radiation‐induced fibrosis (RIF) can be moderate‐to‐severe, and cause clinically‐meaningful events such as poor cosmesis, pain, and functional impairment, lymphedema, shoulder dysfunction, breast contracture, and failure of reconstructive procedures . There are numerous reports evaluating the potential role of pentoxifylline (PTX) and vitamin E for treatment and/or prevention of RIF, mostly in patients who were irradiated for the head and neck region and lungs. Pentoxifylline is a methylxanthine derivate that improves blood perfusion through the microcirculation via multiple processes; for example, reducing blood viscosity and decreasing the potential for platelet aggregation and thrombus formation .…”

Section: Introductionmentioning

confidence: 99%

“…There are numerous reports evaluating the potential role of pentoxifylline (PTX) and vitamin E for treatment and/or prevention of RIF, mostly in patients who were irradiated for the head and neck region and lungs. Pentoxifylline is a methylxanthine derivate that improves blood perfusion through the microcirculation via multiple processes; for example, reducing blood viscosity and decreasing the potential for platelet aggregation and thrombus formation . In vitro, PTX inhibits human fibroblast proliferation and extracellular matrix production, and increases collagenase activity .…”

Section: Introductionmentioning

confidence: 99%

“…Pentoxifylline is a methylxanthine derivate that improves blood perfusion through the microcirculation via multiple processes; for example, reducing blood viscosity and decreasing the potential for platelet aggregation and thrombus formation. 5,6,10 In vitro, PTX inhibits human fibroblast proliferation and extracellular matrix production, and increases collagenase activity. 11 Vitamin E is a wellknown antioxidant that scavenges free radicals 2 .…”

Section: Introductionmentioning

confidence: 99%

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Pentoxifylline and vitamin E for treatment or prevention of radiation-induced fibrosis in patients with breast cancer

Kaidar‐Person¹,

Marks²,

Jones³

2018

Breast J

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Radiation therapy (RT) plays an important role in the management of breast cancer. Radiation-induced fibrosis is a side effect of radiation therapy and may occur in up to 13% of the cases in patients (Radiother Oncol, 2009;90:80), fortunately usually is modest/localized and not associated with marked symptoms. However, occasionally, fibrosis can be moderate-to-severe, and cause clinically-meaningful symptoms. The current review summarizes the use of pentoxifylline and vitamin E of treatment or prevention of radiation-induced fibrosis in breast cancer patients. Even though data are limited, this regimen may reduce RT-associated toxicity.

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Use of pentoxifylline and tocopherol in the management of osteoradionecrosis

Cited by 49 publications

References 19 publications

Treatment of late sequelae after radiotherapy for head and neck cancer

Treatment of late sequelae after radiotherapy for head and neck cancer

Patient‐reported side effects from liquid formulation of pentoxifylline and tocopherol in head and neck radiotherapy patients: an institutional experience and retrospective analysis

Pentoxifylline and vitamin E for treatment or prevention of radiation-induced fibrosis in patients with breast cancer

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