己酮可可碱在乳腺癌手术患者中的应用疗效。

Efficacy of using pentoxifylline in patients undergoing breast cancer surgery.

作者信息

Dewidar Samar A, Mansour Noha O, Hamdy Omar, Elebedy Dina A, Soliman Moetaza M, Shams Mohamed E E

机构信息

Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.

Surgical Oncology Department, Oncology Center, Mansoura University, Mansoura, Egypt.

出版信息

Front Pharmacol. 2025 Jul 16;16:1560805. doi: 10.3389/fphar.2025.1560805. eCollection 2025.

DOI:10.3389/fphar.2025.1560805

PMID:40741002

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12307360/

Abstract

INTRODUCTION

Breast cancer surgery presents several challenges, including postoperative pain, and wound healing complications. Pentoxifylline is a synthetic methylxanthine derivative known for its anti-inflammatory properties and ability to improve microcirculation, decreasing the inflammatory markers as well as restoring the antioxidant status. This study aims to investigate the potential benefits of pentoxifylline in improving pain control and wound healing in patients undergoing mastectomy.

METHODS

In a randomized, single-blinded clinical trial, ninety-two breast cancer patients were assigned to receive pentoxifylline or not. The primary outcome was the measurement of postoperative pain level using the Numeric Rating Scale (NRS) at multiple time points within 24 h post-surgery. Secondary outcomes included determining the time till wound healing and the incidence of postoperative complications.

RESULTS

Eighty-eight participants completed this study, 42 patients in the control group while 46 patients in the pentoxifylline group. Patients receiving pentoxifylline demonstrated a significant decrease in NRS scores as compared to the control group (median (IQR) of total area under the curve (AUC) over 24 h were 90 (73.5-102), and 153 (123-168), respectively ( < 0.001)), indicating clinically meaningful reductions in pain intensity. Additionally, pentoxifylline-treated patients experienced faster wound healing, reflected by earlier suture removal (mean ± SD: 15 ± 4.4 days vs. 19.3 ± 6.7 days; respectively (= 0.001)). The incidence of postoperative complications was significantly lower in the pentoxifylline group (2.2%) compared the control group (19%). Fewer cases of seroma, wound infection, and wound dehiscence were observed in the pentoxifylline group.

CONCLUSION

Preoperative oral administration of pentoxifylline in patients undergoing breast surgery may reduce postoperative pain and improve recovery in those patients. However, further investigations are imperative to validate these findings.

CLINICAL TRIAL REGISTRATION

https://clinicaltrials.gov/study/NCT06087237, identifier NCT06087237.

摘要

引言

乳腺癌手术面临诸多挑战，包括术后疼痛和伤口愈合并发症。己酮可可碱是一种合成的甲基黄嘌呤衍生物，以其抗炎特性和改善微循环的能力而闻名，可降低炎症标志物并恢复抗氧化状态。本研究旨在探讨己酮可可碱在改善乳房切除术患者疼痛控制和伤口愈合方面的潜在益处。

方法

在一项随机、单盲临床试验中，92例乳腺癌患者被分配接受或不接受己酮可可碱治疗。主要结局是在术后24小时内的多个时间点使用数字评分量表（NRS）测量术后疼痛水平。次要结局包括确定伤口愈合时间和术后并发症的发生率。

结果

88名参与者完成了本研究，对照组42例患者，己酮可可碱组46例患者。与对照组相比，接受己酮可可碱治疗的患者NRS评分显著降低（24小时曲线下总面积（AUC）的中位数（IQR）分别为90（73.5 - 102）和153（123 - 168），P < 0.001），表明疼痛强度有临床意义的降低。此外，己酮可可碱治疗的患者伤口愈合更快，表现为拆线更早（平均±标准差：分别为15±4.4天和19.3±6.7天；P = 0.001）。己酮可可碱组术后并发症的发生率（2.2%）显著低于对照组（19%）。己酮可可碱组观察到的血清肿、伤口感染和伤口裂开病例较少。