Prophylactic use of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of the head and neck

Patel, Vinod; Gadiwalla, Yusuf; Sassoon, Isabel; Sproat, Chris; Kwok, Jerry; McGurk, Mark

doi:10.1016/j.bjoms.2016.02.024

Cited by 59 publications

(93 citation statements)

References 25 publications

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“…Patel et al . [ 12 ] reported that 7% of their patients could not tolerate one or other of these medications. Literature has also revealed few side effects of these drugs, which include dyspepsia, nausea, headache or vertigo, asthenia, hot flushes, epigastralgia, and allergy in some patients.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic use of pentoxifylline and tocopherol in patients undergoing dental extractions following radiotherapy for head and neck cancer

Aggarwal

Goutam²,

Singh³

et al. 2017

Niger J Surg

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Background:In head and neck cancer patients undergoing radiotherapy, osteoradionecrosis (ORN) of the jaw is one of the major but uncommon complications. Satisfactorily results have been observed while treating ORN patients with upcoming treatment modalities such as combination therapy of pentoxifylline and Vitamin E (PVe). It is believed that in patients undergoing dental extractions, these treatment modalities can be used prophylactically for lowering the risk of development of ORN. Hence, keeping all these things in mind, we planned the present study to assess the prophylactic role of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of head and neck.Materials and Methods:A total of 110 patients were included in this retrospective study, which had radiotherapy for cancer of the head and neck. After radiotherapy, a total of 450 dental extractions were done in these 110 patients.Results:External beam therapy was given in 92.72% of the patients. 7.27% and 40% of the patients received intensity modulated radiotherapy combination of chemotherapy and intensity modulated radiotherapy, respectively. ORN developed only in 2 patients. Patients had taken PVe for a mean of 12 (24) weeks preoperatively and 14 (18) weeks postoperatively. The incidence was lower than that normally associated with dental extractions in irradiated patients.Conclusion:In patients undergoing dental extractions, after receiving radiotherapy of head and neck region, combination therapy of pentoxifylline and tocopherol are sufficiently effective.

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Section: Discussionmentioning

confidence: 99%

Prophylactic use of pentoxifylline and tocopherol in patients undergoing dental extractions following radiotherapy for head and neck cancer

Aggarwal

Goutam²,

Singh³

et al. 2017

Niger J Surg

View full text Add to dashboard Cite

show abstract

“…To date, many preventive strategies for ORN have been proposed that have yet to be validated by high‐level evidence. These measures include, but are not limited to, pre‐RT dental evaluation and treatment, antibiotic treatment following post‐RT extractions, pentoxifylline and tocopherol prophylaxis, or hyperbaric oxygen (HBO) prophylaxis . Once diagnosed, treatment of ORN ranges from conservative surgical approaches, such as local surgical debridement and sequestrectomy, to more extensive surgical intervention, such as resection with or without osteomyocutaneous flaps.…”

Section: Introductionmentioning

confidence: 99%

The Use of Hyperbaric Oxygen for the Prevention and Management of Osteoradionecrosis of the Jaw: A Dana-Farber/Brigham and Women’s Cancer Center Multidisciplinary Guideline

et al. 2017

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Background. Osteoradionecrosis of the jaw (ORN) is an infrequent yet potentially devastating complication of radiation therapy to the head and neck region. Treatment options include antimicrobial therapy, local sequestrectomy, resection, and the use of hyperbaric oxygen (HBO). Published data on ORN are difficult to compare because of the lack of a universally accepted classification and staging system, and the literature on the use of HBO to either prevent or successfully manage ORN is controversial and inconclusive. Therefore, we aimed to establish a standard approach for using HBO at our institution.

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“…PENT-E has demonstrated promising results in the management of radiation-induced fibrosis in soft tissue and established ORN 25, 29, 30 , with a recent study showing therapeutic benefit in the prophylactic use of PENT-E in patients who required dental extractions after head and neck radiotherapy. In that study, 390 dental extractions were performed in 82 patients who had been irradiated to the head and neck; only one patient developed ORN post-dental extraction 31 , suggesting a promising application for PENT-E in the management of MRONJ.…”

Section: Discussionmentioning

confidence: 99%

Pentoxifylline and tocopherol in the management of cancer patients with medication-related osteonecrosis of the jaw: an observational retrospective study of initial case series

Owosho

Estilo

Huryn

et al. 2016

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Introduction Very few studies have evaluated the efficacy of pentoxifylline and tocopherol (PENT-E) in the management of medication-related osteonecrosis of the jaw (MRONJ), though studies have shown its therapeutic and prophylactic benefit in the management of osteoradionecrosis. We report the outcomes of MRONJ managed with PENT-E in patients with metastatic bone disease/multiple myeloma. Patients and Methods Seven patients diagnosed with refractory established cases of MRONJ due to anti-resorptive medications for management of metastatic bone tumors/multiple myeloma were provided PENT-E for a mean period of 16.8 months (range: 3 – 48 months). Results At latest follow-up visit, all patients demonstrated relief of symptoms. There was radiographic evidence of new bone fill of prior radiolucent defect in all patients. Two patients had resolution of exposed bone, 2 patients had partial resolution, in 1 patient no change in exposed bone and 1 patient with 3 sites of exposed bone prior to starting PENT-E had resolution of 1 site, partial resolution in another site and no change on the third site. PENT-E was well-tolerated in all patients. Conclusion Our case series illustrates that PENT-E could be a safe and effective adjunct in the management of MRONJ.

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Prophylactic use of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of the head and neck

Cited by 59 publications

References 25 publications

Prophylactic use of pentoxifylline and tocopherol in patients undergoing dental extractions following radiotherapy for head and neck cancer

Prophylactic use of pentoxifylline and tocopherol in patients undergoing dental extractions following radiotherapy for head and neck cancer

The Use of Hyperbaric Oxygen for the Prevention and Management of Osteoradionecrosis of the Jaw: A Dana-Farber/Brigham and Women’s Cancer Center Multidisciplinary Guideline

Pentoxifylline and tocopherol in the management of cancer patients with medication-related osteonecrosis of the jaw: an observational retrospective study of initial case series

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