title: Use of pentoxifylline and tocopherol in the management of osteoradionecrosis.
abstract: Osteoradionecrosis (ORN) is a complication of radiotherapy, and is difficult to manage once established. However, its pathogenesis has been reinvestigated, and it is now thought to be potentially amenable to treatment with pentoxifylline and tocopherol (vitamin E). We made a retrospective analysis of 62 patients with established ORN who were treated in this way. When only pentoxifylline and vitamin E was used ORN resolved in 14/25 (56%) but paradoxically, when it was combined with antibiotics, only 6/22 resolved (27%). The next stage would ideally be to incorporate the treatment in a randomised clinical trial against both standard antibiotic treatment and hyperbaric oxygen.
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Vinod.Patel@hotmail.co.uk.
authors.forename: Vinod
authors.initials: V
authors.lastname: Patel
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: yusuf.gadiwalla@nhs.net.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gadiwalla
authors.affiliation: Department of Informatics, King's College London, Strand, London, WC2R 2LS. Electronic address: isabel.sassoon@kcl.ac.uk.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sassoon
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Chris.Sproat@gstt.nhs.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Sproat
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Jerry.Kwok@gstt.nhs.uk.
authors.forename: Jerry
authors.initials: J
authors.lastname: Kwok
authors.affiliation: Department of Oral and Maxillofacial Surgery, Atrium 3, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT. Electronic address: Mark.mcgurk@kcl.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: McGurk
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects; D008336:Mandibular Diseases; D010025:Osteoradionecrosis / Q000188:drug therapy*; D010431:Pentoxifylline / Q000627:therapeutic use*; D012189:Retrospective Studies; D024505:Tocopherols / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D024505:Tocopherols; D010431:Pentoxifylline
keywords: Osteoradionecrosis; Pentoxifylline; Tocopherol