title: Prophylactic use of pentoxifylline (Trental) and vitamin E to prevent capsular contracture after implant reconstruction in patients requiring adjuvant radiation.
abstract: BACKGROUND
  The combination of pentoxifylline (Trental) and vitamin E has been reported to reverse significant consequences of radiation after mastectomy with immediate reconstruction, such as severe capsular contracture or loss of implants. We questioned whether prophylactic use could prevent these consequences.
  
  
  METHODS
  Thirty women with implants or tissue expanders after mastectomy that underwent adjuvant radiation were treated with Trental and vitamin E for 180 days. All subjects then entered a 12-month observational phase.
  
  
  RESULTS
  Of the 26 evaluable subjects, 3 subjects required implant revisions. One due to malposition of the nonradiated breast and 2 were due to contracture (7.7%). There were no implant losses.
  
  
  CONCLUSIONS
  The combination of Trental and vitamin E can prevent severe contracture and implant losses allowing for immediate reconstruction with implant or tissue expander even if radiation is planned after mastectomy.
authors.affiliation: Oncology Clinical Research, Legacy Health, Portland, OR, USA.
authors.forename: Madeline
authors.initials: M
authors.lastname: Cook
authors.affiliation: Legacy Medical Group- Surgical Oncology, NW 1040 22nd Ave, Portland, OR, 97210, USA. Electronic address: nemtipi@aol.com.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Johnson
authors.affiliation: Portland Plastic Surgery Group, Portland, OR, USA.
authors.forename: Henry Daniel
authors.initials: HD
authors.lastname: Zegzula
authors.affiliation: Legacy Medical Group- Radiation Oncology, Portland, OR, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Schray
authors.affiliation: Legacy Medical Group- Surgical Oncology, NW 1040 22nd Ave, Portland, OR, 97210, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Glissmeyer
authors.affiliation: Oncology Clinical Research, Legacy Health, Portland, OR, USA; Legacy Medical Group- Surgical Oncology, NW 1040 22nd Ave, Portland, OR, 97210, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Sorenson
mesh_terms: D000328:Adult; D019928:Breast Implantation / Q000009:adverse effects* / Q000379:methods; D018427:Breast Implants / Q000009:adverse effects; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D057910:Implant Capsular Contracture / Q000517:prevention & control*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D010431:Pentoxifylline / Q000008:administration & dosage*; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D016896:Treatment Outcome; D014810:Vitamin E / Q000008:administration & dosage*
chemical_list: D014810:Vitamin E; D010431:Pentoxifylline
keywords: Capsular contracture; Immediate reconstruction; Pentoxifylline (Trental); Radiation-induced fibrosis; Vitamin E