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Laryngoscope. 2019 Nov 20. doi: 10.1002/lary.28399. [Epub ahead of print]

Efficacy of pentoxifylline-tocopherol-clodronate in mandibular osteoradionecrosis.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Center Gabriel Montpied, Clermont-Ferrand, France.
2
Department of Maxillofacial Surgery, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, France.
3
Delegation for Clinical Research and Innovation, University Hospital Center Gabriel Montpied, Clermont-Ferrand, France.
4
Department of Oncology, Jean Perrin Center, Clermont-Ferrand, France.
5
and Department of Medical Imaging, University Hospital Center Gabriel Montpied, Clermont-Ferrand, France.

Abstract

OBJECTIVES/HYPOTHESIS:

PENTOCLO treatment, associating pentoxifylline, tocopherol, and clodronate, resolves radiation-induced fibrosis. The main aim of the present study was to prospectively assess efficacy in mandibular osteoradionecrosis (ORN).

STUDY DESIGN:

Prospective cohort study.

METHODS:

Twenty-seven patients with mandibular ORN were included in the Pentoclauvergne Study between January 2014 and February 2016. After an initial 28-day phase of antibiotic, antifungal, and corticosteroid therapy, they received the PENTOCLO association daily until cure or a maximum of 24 months. The main assessment criterion was exposed bone area (EBA); secondary criteria comprised the Subjective, objective, management, and analytic (SOMA) score.

RESULTS:

Under PENTOCLO, EBA decreased by 28% at 2 months, 55% at 6 months, and 92% at 24 months; the SOMA score decreased by 23%, 38%, and 50%, respectively. A complete treatment course cured 76.5% of patients at a mean 9.6 months.

CONCLUSIONS:

PENTOCLO is a simple, well-tolerated, and effective treatment for mandibular ORN.

LEVEL OF EVIDENCE:

4 Laryngoscope, 2019.

KEYWORDS:

Osteoradionecrosis; clodronate; mandible; pentoxifylline; tocopherol

PMID:
31747060
DOI:
10.1002/lary.28399

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