Use of pentoxifylline and tocopherol in the management of osteoradionecrosis

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

doi:10.1016/j.bjoms.2015.11.027

Use of pentoxifylline and tocopherol in the management of osteoradionecrosis

Br J Oral Maxillofac Surg. 2016 Apr;54(3):342-5. doi: 10.1016/j.bjoms.2015.11.027. Epub 2016 Jan 19.

Authors

Vinod Patel¹, Yusuf Gadiwalla², Isabel Sassoon³, Chris Sproat⁴, Jerry Kwok⁵, Mark McGurk⁶

Affiliations

¹ Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Vinod.Patel@hotmail.co.uk.
² Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: yusuf.gadiwalla@nhs.net.
³ Department of Informatics, King's College London, Strand, London, WC2R 2LS. Electronic address: isabel.sassoon@kcl.ac.uk.
⁴ Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Chris.Sproat@gstt.nhs.uk.
⁵ Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Jerry.Kwok@gstt.nhs.uk.
⁶ 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.

PMID: 26794083
DOI: 10.1016/j.bjoms.2015.11.027

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.

Keywords: Osteoradionecrosis; Pentoxifylline; Tocopherol.

MeSH terms

Anti-Bacterial Agents / therapeutic use
Humans
Hyperbaric Oxygenation / adverse effects
Mandibular Diseases
Osteoradionecrosis / drug therapy*
Pentoxifylline / therapeutic use*
Retrospective Studies
Tocopherols / therapeutic use

Substances

Anti-Bacterial Agents
Tocopherols
Pentoxifylline