Medical Oncology

, Volume 24, Issue 3, pp 308–311 | Cite as

Pentoxifylline and alpha-tocopherol in prevention of radiation-induced lung toxicity in patients with lung cancer

  • Cem H. Misirlioglu
  • Taciser Demirkasimoglu
  • Bulent Kucukplakci
  • Ergun Sanri
  • Kadri AltundagEmail author
Original Article


Combined use of pentoxifylline and vitamin E is reported to reduce radiation-induced toxicity in normal tissues at molecular level. We plan to evaluate the role of combined use of pentoxifylline (PTX) and alpha-tocopherol (vitamin E; Vit E) for minimizing radiation-induced lung toxicity. A total of 91 lung cancer patients were randomized. Among them, 44 received PTX (400 mg three times a day orally and Vit E 300 mg twice a day orally during the entire period of radiotherapy. PTX and Vit E were further administered at doses of 400 mg once a day and 300 mg once a day, respectively for 3 months after radiotherapy. A total of 47 patients were assigned as a control group. Radiation related acute and late toxicities are evaluated by radiation RTOG/EORTC toxicity scale. Median age was 59 (range, 41–75). Median follow-up was 13 months (range, 3–28 months). Radiation-induced lung toxicity was more frequent in control group for all phases than in pentoxifylline and alpha-tocopherol group (acute phase, P = 0.042, subacute phase P = 0.0001, late phase P = 0.256). PTX and Vit E combination might be considered especially in patients with lung cancer who receive concurrent chemo-radiotherapy, or have a poor respiratory function tests.


Lung cancer Radiation-induced lung toxicity Pentoxifylline Alpha-tocopherol 


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  1. 1.
    McDonald S, Rubin P, Phillips TL, Marks LB. Injury to the lung from cancer therapy: clinical syndromes, measurable endpoints, and potential scoring systems. Int J Radiat Oncol Biol Phys 1995;31:1187–203.PubMedCrossRefGoogle Scholar
  2. 2.
    Robnett TJ, et al. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys 2000;48:89–94.PubMedCrossRefGoogle Scholar
  3. 3.
    Inoue A, et al. Radiation pneumonitis in lung cancer patients: a retrospective study of risk factors and the long-term prognosis. Int J Radiat Oncol Biol Phys 2001;49:649–55.PubMedCrossRefGoogle Scholar
  4. 4.
    Ozturk B, Egehan I, Atavci S, Kitapci M. Pentoxıfylline in prevention of radiation-induced lung toxicity in patients with breast and lung cancer: a double-blind randomized trial. Int J Radiat Oncol Biol Phys 2004;58:213–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Rosen II, et al. Correlation between lung fibrosis and radiation therapy dose after concurrent radiation therapy and chemotherapy for limited small cell lung cancer. Radiology 2001;221:614–22.PubMedCrossRefGoogle Scholar
  6. 6.
    Rube CE, et al. Modulation of radiation-induced tumour necrosis factor a (TNF-a) expression in the lung tissue by pentoxifylline. Radiother Oncol 2002;64:177–88.PubMedCrossRefGoogle Scholar
  7. 7.
    Delanian S, Lefaix J-L. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol 2004;73:119–31.PubMedCrossRefGoogle Scholar
  8. 8.
    Dion MW, et al. Preliminary results of a pilot study of pentoxifylline in the treatment of late radiation soft tissue necrosis. Int J␣Radiat Oncol Biol Phys 1990;19:401–7.PubMedGoogle Scholar
  9. 9.
    Delanian S, Balla-Mekias S, Lefaix JL. Striking regression of chronic radiotherapy damage in a clinical trial of combined pentoxifylline and tocopherol. J Clin Oncol 1999;17:3283–90.PubMedGoogle Scholar
  10. 10.
    Lefaix JL, et al. Striking regression of subcutaneous fibrosis induced by high doses of gamma rays using a combination of pentoxifylline and alpha-tocopherol: an experimental study. Int J␣Radiat Oncol Biol Phys 1999;43:839–47.PubMedCrossRefGoogle Scholar
  11. 11.
    Dion MW, Hussey DH, Osborne JW. The effect of pentoxiflylline on early and late radiation injury following fractionated irradiation in C3H mice. Int J Radiat Oncol Biol Phys 1989;17:101–7.PubMedGoogle Scholar
  12. 12.
    Futran ND, Trotti A, Gwede C. Pentoxifylline in the treatment of radiation-related soft tissue injury: preliminary observations. Laryngoscope 1997;107:391–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Chua DT, Lo C, Yuen J, Foo YC. A pilot study of pentoxifylline in the treatment of radiation-induced trismus. Am J Clin Oncol 2001;24:366–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Aygenc E, et al. Prophylactic effect of pentoxifylline on radiotherapy complications: a clinical study. Otolaryngol Head Neck Surg 2004;130:351–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Delanian S, Porcher R, Balla-Mekias S, Lefaix J-L. Randomized placebo-controlled trial combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis. J Clin Oncol 2003;21:2545–50.PubMedCrossRefGoogle Scholar
  16. 16.
    Makimoto T, et al. Risk factors for severe radiation pneumonitis in lung cancer. Jpn J Clin Oncol 1999;29:192–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Miller KL, Shafman TD, Marks LB. A practical approach to pulmonary risk assessment in the radiotherapy of lung cancer. Semin Radiat Oncol 2004;14:298–307.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Cem H. Misirlioglu
    • 1
  • Taciser Demirkasimoglu
    • 1
  • Bulent Kucukplakci
    • 1
  • Ergun Sanri
    • 1
  • Kadri Altundag
    • 2
    Email author
  1. 1.Department of Radiation OncologyAnkara Oncology HospitalAnkaraTurkey
  2. 2.Department of Medical OncologyHacettepe University Institute of OncologyAnkaraTurkey

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