Pentoxifylline in the treatment of radiation-related soft tissue injury: preliminary observations.
Soft tissue or mucosal injuries following radiotherapy of head and neck cancer include ulceration (necrosis), fibrosis, pain, and atrophy. Current management includes analgesics, wound debridement, antibiotics, and physical therapy depending on the type of injury. Pentoxifylline is a methylxanthine derivative that produces dose-related hemorrheologic effects, lower blood viscosity, improved erythrocyte flexibility, and increased tissue oxygen levels. Twenty-six patients with late radiation complications (occurring more than two months after x-ray therapy) were given treatment with oral pentoxifylline: 15 for soft tissue necrosis (STN), six for fibrosis, and five for mucosal pain. Nine of 12 patients with STN completely healed. In all three failures osteoradionecrosis developed. Mucosal pain resolved in all five patients. Fibrosis improved in 67% of those patients. Pentoxifylline appears to accelerate healing of STN and reverse some late radiation injuries. This is the first series to our knowledge that documents activity of this agent in moderate radiotherapy complications such as fibrosis, pain, or mucosal fragility.
Futran
N D
ND
Division of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, U.S.A.
Trotti
A
A
Gwede
C
C
D000284:Administration, Oral; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001284:Atrophy; D003646:Debridement; D004305:Dose-Response Relationship, Drug; D004907:Erythrocyte Deformability / Q000187:drug effects; D005260:Female; D005355:Fibrosis; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D018056:Hemorheology / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy* / Q000209:etiology; D009061:Mouth Mucosa / Q000473:pathology / Q000528:radiation effects; D009336:Necrosis; D019226:Oral Ulcer / Q000188:drug therapy; D010025:Osteoradionecrosis / Q000209:etiology; D010101:Oxygen Consumption / Q000187:drug effects; D010146:Pain / Q000188:drug therapy; D010431:Pentoxifylline / Q000008:administration & dosage / Q000627:therapeutic use*; D026741:Physical Therapy Modalities; D011832:Radiation Injuries / Q000188:drug therapy*; D012074:Remission Induction; D017695:Soft Tissue Injuries / Q000188:drug therapy; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects
D000700:Analgesics; D000900:Anti-Bacterial Agents; D014665:Vasodilator Agents; D010431:Pentoxifylline