Pentoxifylline and vitamin E drug compliance after adjuvant breast radiation therapy

Famoso, Justin; Laughlin, Brady; McBride, Ali; Gonzalez, Victor

doi:10.1016/j.adro.2017.09.004

Cited by 17 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinically, regimens consisting of pentoxifylline, a methylxanthine derivative used to improve locoregional blood flow, and vitamin E, an antioxidant, have been variably prescribed to treat patients with radiation fibrosis 48 – 51 . Despite some reported benefit, poor patient tolerance has unfortunately resulted in low compliance limiting their routine use 52 . Rebound fibrosis following cessation of therapy has also been observed 53 .…”

Section: Discussionmentioning

confidence: 99%

Prophylactic treatment with transdermal deferoxamine mitigates radiation-induced skin fibrosis

Shen

Borrelli

Adem

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Radiation therapy can result in pathological fibrosis of healthy soft tissue. The iron chelator deferoxamine (DFO) has been shown to improve skin vascularization when injected into radiated tissue prior to fat grafting. Here, we evaluated whether topical DFO administration using a transdermal drug delivery system prior to and immediately following irradiation (IR) can mitigate the chronic effects of radiation damage to the skin. CD-1 nude immunodeficient mice were split into four experimental groups: (1) IR alone (IR only), (2) DFO treatment for two weeks after recovery from IR (DFO post-IR), (3) DFO prophylaxis with treatment through and post-IR (DFO ppx), or (4) no irradiation or DFO (No IR). Immediately following IR, reactive oxygen species and apoptotic markers were significantly decreased and laser doppler analysis revealed significantly improved skin perfusion in mice receiving prophylactic DFO. Six weeks following IR, mice in the DFO post-IR and DFO ppx groups had improved skin perfusion and increased vascularization. DFO-treated groups also had evidence of reduced dermal thickness and collagen fiber network organization akin to non-irradiated skin. Thus, transdermal delivery of DFO improves tissue perfusion and mitigates chronic radiation-induced skin fibrosis, highlighting a potential role for DFO in the treatment of oncological patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Prophylactic treatment with transdermal deferoxamine mitigates radiation-induced skin fibrosis

Shen

Borrelli

Adem

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…As a result, it was concluded that pentoxifylline had a protective effect. [12,13] In a clinical study conducted by the same investigator on 87 cases, pentoxifylline did not have any effects on the early period effects of radiation (p>0.05), whereas there was a significant difference between the late-period results (p<0.05). [14] In a retrospective study examining the late-period effects of RT that are permanent and decrease the quality of life, 30 cases received pentoxifylline 400 mg three times daily for 8 weeks.…”

Section: Discussionmentioning

confidence: 92%

“…On the other hand, numerous studies have shown a reduction in the side effects of RT by pentoxifylline; accordingly, this drug is currently used in the treatment of inflammation-induced impairment of vascular circulation, diabetic nephropathy, post-ERCP edema, all types of vasculitis, newborn sepsis and burns, as well as in the prevention of fibrosis development following RT. [10,12] Pentoxifylline is used in the treatment of diabetic nephropathy, in which the circulation is compromised by inflammation, post-ERCP edema, all types of vasculitis, burns, neonatal sepsis, and in the prevention of fibrosis after RT. [9,10] In a randomized, controlled trial conducted by Jakobsen et al [3], 53 patients with breast cancer were divided into two groups.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Pentoxifylline in Protection the Breast Tissue Against Radiation Injury

Günay¹

2020

TJ Oncol

View full text Add to dashboard Cite

To investigate the protective effect of pentoxifylline against radiation injury in patients with breast cancer. METHODS A total of 82 patients with early-stage breast cancer who underwent breast-conserving surgery and intraoperative electron radiotherapy (RT) as a boost followed by whole-breast RT in the past circa 5 years and completed the full RT dose at least 1 year before were included into this retrospective study. The patients who received prophylactic pentoxifylline (n=44) were assigned to Group A, and those who did not (n=38) to Group B. All cases were evaluated a month (early) and 1 year (late) later, scored according to the Late Effects Normal Tissue Task Force-Subjective, Objective, Management, Analytic scale and analyzed using an independent t-test. RESULTS In Group A, the score was 0,1, 2, and 3 in 24,11,seven, and two cases, respectively, in the early period and in 26,10, five, and three cases, respectively, in the late period. In Group B, the score was 0,1, 2, and 3 in 20,10, five, and three cases, respectively, in the early period, and in 15, 12, six, and five cases, respectively, in the late period. The average scores in Groups A and B were, respectively, 0.90/0.86 in the early and 0.65/1.02 in the late period. According to the t-test, there was a significant difference in the late period (p=0.001) in favor of Group A. CONCLUSION Penthoxifylline was effective in protection against the radiation injury.

show abstract

“…Pareek et al developed a protocol for a Cochrane systematic review to examine the individual and combined effects of pentoxifylline and vitamin E for preventing and treating the side effects of radiation therapy and concomitant chemoradiotherapy, the results of which are yet to be published. 21 More recently, Famoso et al examined patient compliance with pentoxifylline and vitamin E treatment after breast radiation in 90 patients and found a poor compliance rate in 33 of 87 patients (38%); the main side effect was related to nausea. 22 Illsley et al examined the effect of irradiation on collagen production by fibroblasts cultured from the skin of patients undergoing radiotherapy.…”

Section: Late Effects Of Radiotherapymentioning

confidence: 99%

Effects of radiotherapy on wound healing

Robinson

Holloway

2019

Journal of the EWMA (JEWMA)

View full text Add to dashboard Cite

Background Radiotherapy is widely used to treat cancer, but it can influence the normal wound-healing process. Aim To present a narrative review of the current evidence related to the effects of radiotherapy on normal wound healing. Findings Fractionated radiotherapy treatment induces a repetitive cycle of inflammation. The acute effects of radiotherapy are mostly transient and are resolved within 4 weeks of the last dose, which correlates with the normal pathogenesis of skin regeneration. Two main theories exist with regards to the late effects of radiotherapy and the development of a chronic wound. One hypothesis is that there is a hypoxic-hypocellular-hypovascular effect. Other authors have argued that damage occurs as a result of changes to the microvasculature, in addition to the depletion of parenchymal and stromal cells. Conclusion: Recent evidence indicates that advances in treatment modalities, for example, the use of proton therapy and intensity-modulated radiotherapy, can positively influence patient outcomes in relation to tissue injury. Further advancements in our understanding of radiotherapy and its effects may lead to an improvement in the type of treatment modalities available, thereby helping prevent tissue injury altogether. Clinicians need to appreciate that healing of a radiation wound may not be realistic. Symptom-relieving treatment is of paramount importance to address the deleterious consequences of a radiotherapy related wound. Effects of radiotherapy on wound healing Clinicians also need to be cognisant of the need to maintain the patient's self-esteem and maximise their quality of life. Key Messages This review explores the existing evidence related to the effects of radiotherapy on normal wound healing. The main observations from the studies examined indicate that ionising radiation damages cellular molecules primarily through strand breaks of deoxyribonucleic acid (DNA) or by the production of free radicals and reactive oxygen species, affecting both normal and tumour cells. Radiotherapy can impair the normal healing process in any phase of tissue repair as a result of cellular depletion, alteration in the extracellular matrix (ECM), and impairment of the microvasculature with subsequent tissue hypoxia. The acute effects of radiotherapy on the tissues range in severity from erythema to dry desquamation and hyperpigmentation. In the months or years following radiotherapy, tissue breakdown may occur leading to skin atrophy, dryness, telangiectasia, dyschromia, and dyspigmentation.

show abstract

Pentoxifylline and vitamin E drug compliance after adjuvant breast radiation therapy

Cited by 17 publications

References 16 publications

Prophylactic treatment with transdermal deferoxamine mitigates radiation-induced skin fibrosis

Prophylactic treatment with transdermal deferoxamine mitigates radiation-induced skin fibrosis

Effect of Pentoxifylline in Protection the Breast Tissue Against Radiation Injury

Effects of radiotherapy on wound healing

Contact Info

Product

Resources

About