The use of pentoxifylline in the prevention and treatment of osteoradionecrosis: Integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v13i9.46834

Keywords:

Osteoradionecrosis; Pentoxifylline; Radiation protectors.

Abstract

Osteoradionecrosis (ORN) is a severe complication that can lead to serious complications after oncological treatment with radiotherapy in the head and neck region. ORN presents as progressive necrosis of the irradiated bone, which can cause pain, infections, pathological bone fractures and complications to masticatory function. Pentoxifylline, a synthetic derivative of xanthine, has emerged as a promising therapeutic option in the prevention and treatment of osteoradionecrosis. The objective of this research was to identify, through published articles, the use of pentoxifylline in the prevention and treatment of osteoradionecrosis. An integrative review study was carried out researching the electronic databases SCOPUS® and MEDLINE®, using the descriptors standardized by the health system (DeCS) in Portuguese and English, respectively: Osteoradionecrosis, Osteoradionecrosis; Pentoxifylline, Pentoxifylline; Radiation-protective agents. It was concluded that pentoxifylline appears as an innovative drug in the therapeutic and prophylactic approach of ORN.

References

Arqueros-Lemus, M., Mariño-Recabarren, D., Niklander, S., Martínez-Flores, R., & Moraga, V. (2023). Pentoxifylline and tocopherol for the treatment of osteoradionecrosis of the jaws. A systematic review. Medicina oral, patologia oral y cirugia bucal, 28(3), e293–e300. https://doi.org/10.4317/medoral.25729

Barbosa, C. R., & Simonato, L. E. (2022). Manejo terapêutico e preventivo da osteorradionecrose. Revista Ibero-Americana De Humanidades, Ciências E Educação, 8(4), 1893–1904. https://doi.org/10.51891/rease.v8i4.5341

Cho, S. W., Han, S. Y., Song, Y., Kim, J. W., Kim, H. J., Kim, D. Y., Rhee, C. S., Bae, Y. J., Kim, J. H., Wu, H. G., Bang, J. S., & Won, T. B. (2021). Aggressive Treatment Including Endonasal Surgical Sequestrectomy with Vascularized Nasoseptal Flap Can Improve Outcomes of Skull Base Osteoradionecrosis. Journal of neurological surgery. Part B, Skull base, 83(Suppl 2), e15–e23. https://doi.org/10.1055/s-0040-1722669

Chronopoulos, A., Zarra, T., Ehrenfeld, M., & Otto, S. (2018). Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review. International dental journal, 68(1), 22–30. https://doi.org/10.1111/idj.12318

Du, X., Feng, H., Jiang, Y., Fan, Z., Zheng, H., & Zhu, J. (2023). Zhonghua wei zhong bing ji jiu yi xue, 35(9), 999–1003. https://doi.org/10.3760/cma.j.cn121430-20221031-00957

Granic, A., Mendonça, N., Hill, T. R., Jagger, C., Stevenson, E. J., Mathers, J. C., & Sayer, A. A. (2018). Nutrition in the Very Old. Nutrients, 10(3), 269. https://doi.org/10.3390/nu10030269

Huang, N., Wang, P., Gong, P., & Huang, B. (2023). The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis. Journal of oncology, 2023, 1440889. https://doi.org/10.1155/2023/1440889

Leonetti, J. P., Weishaar, J. R., Gannon, D., Harmon, G. A., Block, A., & Anderson, D. E. (2020). Osteoradionecrosis of the skull base. Journal of neuro-oncology, 150(3), 477–482. https://doi.org/10.1007/s11060-020-03462-3

Martos-Fernández, M., Saez-Barba, M., López-López, J., Estrugo-Devesa, A., Balibrea-Del-Castillo, J. M., & Bescós-Atín, C. (2018). Pentoxifylline, tocopherol, and clodronate for the treatment of mandibular osteoradionecrosis: a systematic review. Oral surgery, oral medicine, oral pathology and oral radiology, 125(5), 431–439. https://doi.org/10.1016/j.oooo.2018.02.004

Marx RE. Osteoradionecrosis: a new concepto f its pathophysiology. Journal of Oral and maxillofacial surgery, 41(5), 283-288, 1983.

Mendes KDS, Silveira RCCP, Galvão CM. (2008). Revisão integrativa: Método de pesquisa para a Incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm, Florianópolis, Out-Dez; 17(4): 758-64. https://doi.org/10.1590/S0104-07072008000400018

Moaddabi, A., Soltani, P., Yazdani, A., Nikbakht, M. H., Amani Beni, P., Modabber, E., Iaculli, F., & Spagnuolo, G. (2023). Application of Platelet-Rich Fibrin and Bone Morphogenetic Protein for Full-Mouth Implant-Based Oral Rehabilitation in a Case of Mandibular Osteoradionecrosis. Case reports in dentistry, 2023, 2449298. https://doi.org/10.1155/2023/2449298

Nabil, S., & Samman, N. (2011). Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. International journal of oral and maxillofacial surgery, 40(3), 229–243. https://doi.org/10.1016/j.ijom.2010.10.005

Nabil, S., & Samman, N. (2012). Risk factors for osteoradionecrosis after head and neck radiation: a systematic review. Oral surgery, oral medicine, oral pathology and oral radiology, 113(1), 54–69. https://doi.org/10.1016/j.tripleo.2011.07.042

Okunieff, P., Augustine, E., Hicks, J. E., Cornelison, T. L., Altemus, R. M., Naydich, B. G., Ding, I., Huser, A. K., Abraham, E. H., Smith, J. J., Coleman, N., & Gerber, L. H. (2004). Pentoxifylline in the treatment of radiation-induced fibrosis. Journal of clinical oncology : official journal of the American Society of ClinicalOncology, 22(11),2207–2213.https://doi.org/10.1200/JCO.2004.09.101

Patel, S., Patel, N., Sassoon, I., & Patel, V. (2021). The use of pentoxifylline, tocopherol and clodronate in the management of osteoradionecrosis of the jaws. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 156, 209–216. https://doi.org/10.1016/j.radonc.2020.12.027

Silva, A. T. S. da., Oliveira, A. B. L. de., Oliveira, G. R. W. de., Souza, H. K. B. de., Moura, M. P. de., & Lemos, M. A. (2021) Avaliação do tratamento preventivo e manejo terapêutico da osteorradionecrose dos maxilares em pacientes submetidos a radioterapia: uma revisão integrativa. Conjecturas. 15;21(7):386–400.

Silva, G. O. & Moreti, L. C. T. (2022). OSTEORRADIONECROSE: CAUSAS, CONSEQUÊNCIAS E TRATAMENTO. Revista Ibero-Americana De Humanidades, Ciências E Educação, 8(5), 1363–1374. https://doi.org/10.51891/rease.v8i5.5517

Samani, M., Beheshti, S., Cheng, H., Sproat, C., Kwok, J., & Patel, V. (2022). Prophylactic pentoxifylline and vitamin E use for dental extractions in irradiated patients with head and neck cancer. Oral surgery, oral medicine, oral pathology and oral radiology, 133(3), e63–e71. https://doi.org/10.1016/j.oooo.2021.08.007

Schwarz M. & Rohner D. (2016). Osteoradionecrosis of the Jaws: Definition, Diagnosis, and Management Revisited. Journal of Oral and Maxillofacial Surgery.74(5), 952-960.

Thesis, M. (2020). Management of osteoradionecrosis with pentoxifylline, tocopherol and clodronate: a systematic review. https://portalcris.lsmuni.lt/server/api/core/bitstreams/11a59b36-a4af-403e-b6a3-e01a544c5982/content.

Vorakulpipat, P., Suphangul, S., Fuangtharnthip, P., Ghanaati, S., & Vorakulpipat, C. (2023). Combination of Advanced Platelet-Rich Fibrin and Pentoxifylline/Tocopherol as a Novel Preventive Option in Osteoradionecrosis: A Case Report. European journal of dentistry, 17(1), 250–254. https://doi.org/10.1055/s-0042-1750777

Published

17/09/2024

How to Cite

TAVARES , G. S. B. .; CARVALHO , M. C. de .; BAEDER, F. M. .; TRINDADE , C. P. .; MAGALHAES , J. C. de A. .; CORAZZA, P. F. L. . The use of pentoxifylline in the prevention and treatment of osteoradionecrosis: Integrative review . Research, Society and Development, [S. l.], v. 13, n. 9, p. e5213946834, 2024. DOI: 10.33448/rsd-v13i9.46834. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/46834. Acesso em: 27 sep. 2024.

Issue

Section

Review Article