PENTOXIFYLLINE IN THE TREATMENT OF RADIATION-RELATED SOFT-TISSUE INJURY - PRELIMINARY-OBSERVATIONS

Soft tissue or mucosal injuries following radiotherapy of head and nec k cancer include ulceration (necrosis), fibrosis, pain, and atrophy. C urrent management includes analgesics, wound debridement, antibiotics, and physical therapy depending on the type of injury, Pentoxifylline is a methylxanthine derivative that produces dose-related hemorrheolog ic effects, lower blood viscosity, improved erythrocyte flexibility, a nd increased tissue oxygen levels. Twenty-six patients with late radia tion complications (occurring more than two months after x-ray therapy ) were given treatment with oral pentoxifylline: 15 for soft tissue ne crosis (STN), six for fibrosis, and five for mucosal pain. Nine of 12 patients with STN completely healed. In all three failures osteoradion ecrosis developed. Mucosal pain resolved in all five patients. Fibrosi s improved in 67% of those patients. Pentoxifylline appears to acceler ate healing of STN and reverse some late radiation injuries, This is t he first series to our knowledge that documents activity of this agent in moderate radiotherapy complications such as fibrosis, pain, or muc osal fragility.