Randomized, Placebo-Controlled Trial of Combined Pentoxifylline and Tocopherol for Regression of Superficial Radiation-Induced Fibrosis

Delanian, S.; Porcher, Raphaël; Balla-Mekias, Saida; Lefaix, Jean-Louis

doi:10.1200/jco.2003.06.064

Cited by 324 publications

(221 citation statements)

References 24 publications

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“…Second, preliminary results have shown that TGF-b antagonists may inhibit or reduce the action of this growth factor (Border et al, 1990;Shah et al, 1992;Delanian et al, 1999;Lefaix et al, 1999;Delanian et al, 2003). The significant reduction of chronic RT damage obtained with the pentoxifylline and alpha-tocopherol combination (Delanian et al, 2003) does not support the concept that established RT sequelae such as radiation-induced subcutaneous fibrosis are irreversible. Third, evidence from the first analysis of the ATAC (Arimidex, Tamoxifen Alone or in Combination Trialists Group) trial supports the use of aromatase inhibitors such as anastrozole for the adjuvant treatment of early breast cancer in postmenopausal women (Baum et al, 2002).…”

Section: Discussionmentioning

confidence: 59%

Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients

et al. 2004

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Concomitant use of adjuvant tamoxifen (TAM) and radiation therapy (RT) is not widely accepted. We aim to assess whether this treatment is associated with an increased risk of developing subcutaneous fibrosis after conservative or radical surgery in breast cancer patients. We analysed 147 women with breast cancer treated with adjuvant RT, and who were included in the KFS 00539-9-1997/SKL 00778-2-1999 prospective study aimed at evaluating the predictive value of CD4 and CD8 T-lymphocyte apoptosis for the development of radiation-induced late effects. TAM (20 mg day À1 ) with concomitant RT was prescribed in 90 hormone receptorpositive patients. There was a statistically significant difference in terms of complication-relapse-free survival (CRFS) rates at 3 years, 48% (95% CI 37.2 -57.6%) vs 66% (95% CI 49.9 -78.6%) and complication-free survival (CFS) rates at 2 years, 51% (95% CI 40 -61%) vs 80% (95% CI 67 -89%) in the TAM and no-TAM groups, respectively. In each of these groups, the CRFS rates were significantly lower for patients with low levels of CD8 radiation-induced apoptosis, 20% (95% CI 10 -31.9%), 66% (95% CI 51.1 -77.6%), and 79% (95% CI 55 -90.9%) for CD8 p16, 16 -24, and 424%, respectively. Similar results were observed for the CFS rates. The concomitant use of TAM with RT is significantly associated with an increased incidence of grade 2 or greater subcutaneous fibrosis; therefore, caution is needed for radiosensitive patients.

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Section: Discussionmentioning

confidence: 59%

Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients

et al. 2004

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“…102 Combining agents with differing therapeutic targets (such as pentoxifylline (PTX), which improve perfusion due to vasodilatation and is anti-inflammatory, and Vitamin E, an antioxidant) may be beneficial. [103][104][105][106] These medications have been recommended by some authors, despite the lack of large randomised-controlled trials (RCTs). 107 …”

Section: Abdominal Visceral Painmentioning

confidence: 99%

Pain in cancer survivors

Brown

Ramirez

Farquhar-Smith

2014

British Journal of Pain

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Cancer and its treatment exert a heavy psychological and physical toll. Of the myriad symptoms which result, pain is common, encountered in between 30% and 60% of cancer survivors. Pain in cancer survivors is a major and growing problem, impeding the recovery and rehabilitation of patients who have beaten cancer and negatively impacting on cancer patients' quality of life, work prospects and mental health. Persistent pain in cancer survivors remains challenging to treat successfully. Pain can arise both due to the underlying disease and the various treatments the patient has been subjected to. Chemotherapy causes painful chemotherapy-induced peripheral neuropathy (CIPN), radiotherapy can produce late effect radiation toxicity and surgery may lead to the development of persistent post-surgical pain syndromes. This review explores a selection of the common causes of persistent pain in cancer survivors, detailing our current understanding of the pathophysiology and outlining both the clinical manifestations of individual pain states and the treatment options available.

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“…α-Tocopherol is the major antioxidant in the serum [55]. Perturbations of the oxidant-antioxidant equilibrium including α-tocopherol were shown to be associated with the toxicity of radiotherapy [56,57] or chemotherapy [58]. In prior reports, a decrease of serum α-tocopherol concentrations has been noted during the administration of systemic chemotherapy [52,53,59,60].…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant combination therapy with trastuzumab in a breast cancer patient with synchronous rectal carcinoma: a case report and biomarker study

et al. 2017

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Abstract:We report a patient who presented with synchronous second primary human epidermal growth factor receptor (HER)-2-positive breast cancer and rectal cancer that both required simultaneous neoadjuvant therapy. A modified regimen combining anti-HER-2 monoclonal antibody trastuzumab with chemotherapy and external beam radiation was selected. An organ-preserving surgical procedure was possible both in the breast and the rectum. Citrulline decreased rapidly after the start of the treatment, and then gradually returned to pre-treatment levels after the completion of chemoradiation. Urinary neopterin concentrations exhibited a fluctuating course. Both serum neopterin and C-reactive protein concentrations were more or less stable during the initial administration of trastuzumab, paclitaxel and carboplatin and then increased steeply during chemoradiation and subsequently declined to pre-treatment levels during the weekly trastuzumab administration. Changes were observed in the serum retinol concentrations. A decline in lymphocyte counts was accompanied by marked changes in peripheral blood cell count-derived ratios. The present case report demonstrates a successful combination of two neoadjuvant regimens in a patient with two synchronous different second primary tumors. Data from this case also illustrate the use of biomarkers for monitoring of intensive therapeutic regimens in medical and radiation oncology.

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Randomized, Placebo-Controlled Trial of Combined Pentoxifylline and Tocopherol for Regression of Superficial Radiation-Induced Fibrosis

Abstract: Six months' treatment of combined PTX/Vit E can significantly reduce superficial RIF. Synergism between PTX and Vit E is likely, as treatment with each drug alone is ineffective, but these results require confirmation in larger series.

Cited by 324 publications

References 24 publications

Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients

Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients

Pain in cancer survivors

Neoadjuvant combination therapy with trastuzumab in a breast cancer patient with synchronous rectal carcinoma: a case report and biomarker study

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