The use of pentoxifylline within the medical regime for the management and prevention of osteoradionecrosis in patients with cardiac‐, cerebrovascular and thromboembolic conditions

Abstract

Osteoradionecrosis (ORN) is a serious and late complication following radiotherapy for head and neck cancer (HNC). Current medical management involves the use of pentoxifylline, which is advised to be used with caution in certain patients with cardiac‐ or cerebrovascular conditions. This retrospective review aims to assess the clinical outcomes of patients medically managed on the background of pre‐existing cardiac‐ and cerebrovascular conditions or treatment with anticoagulant/antiplatelet therapy for thromboembolic disease.Clinical records of 36 patients were identified and reviewed retrospectively. Patients were split into two subgroups—patients having treatment for established ORN (n = 21) and patients ‘at risk’ of ORN following dentoalveolar surgery (n = 15).In the established ORN group, 38% healed, and 57% were considered stable. In the prophylaxis group, 100% of cases healed with no ORN. Overall, across both groups, most patients reported no major side effects from pentoxifylline, with the most common being gastric irritation (n = 3, 8%).This retrospective review provides early valuable insight on pentoxifylline for patients with existing cardiac‐, cerebrovascular and thrombo‐embolic conditions who have been treated with radiotherapy for HNC, both prophylactically to help prevent ORN and as treatment for established ORN.