Uterine restoration by radiation sequelae regression with combined pentoxifylline-tocopherol: a phase II study.
OBJECTIVE
To determine whether combined pentoxifylline (PTX) and tocopherol (vitamin E) treatment can improve uterine radiation-induced sequelae, resulting in an improved embryo implantation rate.


METHODS
Retrospective phase II clinical trial.


METHODS
Volunteers in an oocyte donation program in a public hospital.


METHODS
Six women aged 31 +/- 4 years, who were irradiated 25 years previously for childhood cancer with 20 to 40 Gy including the pelvic area.


METHODS
Four women had taken hormone replacement therapy for primary amenorrhea, and two had retained their natural cycle. Treatment consisted of at least 12 months of pentoxifylline at 800 mg/day combined with 1000 IU/day of tocopherol.


METHODS
Endometrial thickness, uterine volume, and uterine artery blood flow were assessed by ultrasonography before and after pentoxifylline-tocopherol treatment, under usual estrogen-progesterone (OP) administration.


RESULTS
This treatment was well tolerated. All six patients improved significantly in endometrial thickness (6.2 +/- 0.6 vs. 3.2 +/- 1.1 mm), myometrial dimensions (44 [+/- 5] x 30 [+/- 3] x 20 [+/- 2] vs. 30 [+/- 7] x 22 [+/- 3] x 16 [+/- 2] mm), and diastolic uterine artery flow.


CONCLUSIONS
In young women who want to bear children, the combination of pentoxifylline and vitamin E can reduce fibroatrophic uterine lesions after childhood irradiation.
Letur-Könirsch
Hélène
H
Fertility Center, Department of Obstetrics and Assisted Reproductive Technics, Institut Mutualiste Montsouris, Paris, France. helene.letur@imm.fr
Guis
F
F
Delanian
Sylvie
S
D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001158:Arteries / Q000000981:diagnostic imaging; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D010431:Pentoxifylline / Q000009:adverse effects / Q000627:therapeutic use*; D011674:Pulse; D011832:Radiation Injuries / Q000188:drug therapy*; D011837:Radiation-Protective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011878:Radiotherapy / Q000009:adverse effects*; D012039:Regional Blood Flow / Q000187:drug effects; D024505:Tocopherols / Q000627:therapeutic use*; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects / Q000528:radiation effects
D000975:Antioxidants; D011837:Radiation-Protective Agents; D004958:Estradiol; D024505:Tocopherols; D010431:Pentoxifylline