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

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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.

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Authors and Affiliations

  1. Department of Oral Oncology, Hospital of Cancer of Pernambuco (HCP – PE), Recife, Pernambuco, Brazil

    Raíssa Soares dos Anjos, Giovana Nóbrega de Pádua Walfrido, Rômulo Oliveira de Hollanda Valente & Igor Henrique Morais Silva

  2. Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil

    Luiz Alcino Gueiros, Alessandra Albuquerque Tavares Carvalho & Jair Carneiro Leão

  3. Prosthodontics UCL Eastman Dental Institute, London, UK

    Preeyan Patel

  4. Oral Medicine, UCL Eastman Dental Institute, London, UK

    Stephen Porter

  5. Departamento de Odontologia Clínica, Hospital de Câncer de Pernambuco, Avenida Cruz Cabugá 1597 – Santo Amaro, Recife, PE, CEP 50040-000, Brazil

    Igor Henrique Morais Silva

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  1. Raíssa Soares dos Anjos
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Correspondence to Igor Henrique Morais Silva.

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dos Anjos, R.S., de Pádua Walfrido, G.N., de Hollanda Valente, R.O. et al. Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced osteoradionecrosis of the jaws—a case series. Support Care Cancer 29, 3311–3317 (2021). https://doi.org/10.1007/s00520-020-05847-6

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