Efficacy of pentoxifylline-tocopherol-clodronate in mandibular osteoradionecrosis

Laryngoscope. 2020 Nov;130(11):E559-E566. doi: 10.1002/lary.28399. Epub 2019 Nov 20.

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, 130:E559-E566, 2020.

Keywords: Osteoradionecrosis; clodronate; mandible; pentoxifylline; tocopherol.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents / therapeutic use*
  • Clodronic Acid / therapeutic use*
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Mandibular Diseases / drug therapy*
  • Middle Aged
  • Osteoradionecrosis / drug therapy*
  • Pentoxifylline / therapeutic use*
  • Prospective Studies
  • Tocopherols / therapeutic use*
  • Treatment Outcome

Substances

  • Bone Density Conservation Agents
  • Drug Combinations
  • pentoxifylline-tocopherol-clodronate
  • Clodronic Acid
  • Tocopherols
  • Pentoxifylline