Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced osteoradionecrosis of the jaws-a case series

Support Care Cancer. 2021 Jun;29(6):3311-3317. doi: 10.1007/s00520-020-05847-6. Epub 2020 Oct 27.

Abstract

Background: The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of osteoradionecrosis of the jaws.

Methods: Twenty-five patients diagnosed with osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily (tid) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of osteoradionecrosis of the jaws.

Results: Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months.

Conclusion: Pentoxifylline and tocopherol may provide effective management of osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.

Keywords: Osteoradionecrosis; Pentoxifylline; Radiotherapy; Tocopherol.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antioxidants / pharmacology
  • Antioxidants / therapeutic use*
  • Female
  • Humans
  • Jaw / pathology*
  • Male
  • Middle Aged
  • Osteoradionecrosis / drug therapy*
  • Osteoradionecrosis / pathology
  • Osteoradionecrosis / surgery*
  • Pentoxifylline / pharmacology
  • Pentoxifylline / therapeutic use*
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Tocopherols / pharmacology
  • Tocopherols / therapeutic use*

Substances

  • Antioxidants
  • Platelet Aggregation Inhibitors
  • Tocopherols
  • Pentoxifylline