title: Tissue repair in osteoradionecrosis using pentoxifylline and tocopherol--report of three cases.
abstract: OBJECTIVE
  Osteoradionecrosis is a complication of head and neck radiotherapy, with a difficult resolution and no well-established treatment. The disease progression can cause important loss on patient's quality of life after cancer treatment. The options for treatment are limited and include clinical monitoring, prescription, or surgical procedures. As an alternative for bone necrosis treatment, a combination of drugs, pentoxifylline and tocopherol, can be used. Studies have shown that this combination significantly reduces chronic radiotherapy damage. The article reports successful treatment with this prescription protocol.
  
  
  METHODS
  We report three cases of patients referred to the Service of Oral and Maxillofacial Surgery at Erasto Gaertner Hospital, in Curitiba, Brazil. They were submitted to radiotherapy for the treatment of malignant head and neck tumors and later developed osteoradionecrosis. They were treated with the combination pentoxifylline and tocopherol.
  
  
  RESULTS
  All patients achieved complete remission in less than 1 year, with complete healing of bone exposure and without clinical symptoms.
  
  
  CONCLUSIONS
  This results show that this combination of drugs is beneficial in cases of bone necrosis induced by radiation, avoiding more aggressive treatments and reducing morbidity.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Erasto Gaertner Hospital, Rua Dr. Ovande do Amaral, 201, Curitiba, PR, 81520-060, Brazil.
authors.forename: Joslei Carlos
authors.initials: JC
authors.lastname: Bohn
authors.affiliation: Department of Oral and Maxillofacial Surgery, Erasto Gaertner Hospital, Rua Dr. Ovande do Amaral, 201, Curitiba, PR, 81520-060, Brazil. juliana.schussel24@gmail.com.|Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, PR, Brazil. juliana.schussel24@gmail.com.
authors.forename: Juliana Lucena
authors.initials: JL
authors.lastname: Schussel
authors.affiliation: Department of Oral and Maxillofacial Surgery, Erasto Gaertner Hospital, Rua Dr. Ovande do Amaral, 201, Curitiba, PR, 81520-060, Brazil.
authors.forename: Roberta Targa
authors.initials: RT
authors.lastname: Stramandinoli-Zanicotti
authors.affiliation: Department of Oral and Maxillofacial Surgery, Erasto Gaertner Hospital, Rua Dr. Ovande do Amaral, 201, Curitiba, PR, 81520-060, Brazil.
authors.forename: Laurindo Moacir
authors.initials: LM
authors.lastname: Sassi
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000175:diagnosis / Q000188:drug therapy*; D010039:Otorhinolaryngologic Neoplasms / Q000532:radiotherapy*; D010431:Pentoxifylline / Q000627:therapeutic use*; D018714:Radiotherapy, Adjuvant; D024505:Tocopherols / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects
chemical_list: D024505:Tocopherols; D010431:Pentoxifylline
keywords: Osteoradionecrosis; Pentoxifylline; Radiotherapy; Tocopherol