Department of Oral Oncology, Hospital of Cancer of Pernambuco (HCP - PE), Recife, Pernambuco, Brazil.
Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.
Support Care Cancer. 2021 Jun;29(6):3311-3317. doi: 10.1007/s00520-020-05847-6. Epub 2020 Oct 27.
The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of osteoradionecrosis of the jaws.
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.
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.
Pentoxifylline and tocopherol may provide effective management of osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.
本研究旨在评估己酮可可碱和生育酚治疗颌骨放射性骨坏死的疗效。
评估了 25 名接受己酮可可碱 400mg+生育酚 400mg 每日三次（tid）治疗的颌骨放射性骨坏死患者。回顾了临床记录和影像学检查。所有患者均曾接受头颈部放射治疗，并经临床和影像学诊断为颌骨放射性骨坏死。
在接受己酮可可碱和生育酚治疗后，76%（19/25）的患者出现完全黏膜愈合，其中 47.3%（9/19）未行清创术。在这一组中，77.7%（7/9）处于 I 期，33.3%（3/9）使用该方案长达 3 个月。行清创术的患者中，有 52.7%（19/19）出现完全黏膜愈合。其中，60%（6/10）处于 I 期，100%的患者使用该方案超过 3 个月。在所有其他患者中，由于疾病处于晚期，仅观察到黏膜的部分愈合。这些患者占样本的 24%（6/25），66.6%（4/6）处于 III 期，60%（4/6）使用该方案超过 6 个月。
己酮可可碱和生育酚可能为颌骨放射性骨坏死提供有效的治疗，与清创术联合应用可避免大手术。
