Delanian S, Porcher R, Rudant J, Lefaix JL, et al.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. Date of publication 2005 Dec 1;volume 23(34):8570-9.
1. J Clin Oncol. 2005 Dec 1;23(34):8570-9. Epub 2005 Oct 31.
Kinetics of response to long-term treatment combining pentoxifylline and
tocopherol in patients with superficial radiation-induced fibrosis.
Delanian S(1), Porcher R, Rudant J, Lefaix JL.
Author information:
(1)Service d'Oncologie-Radiothérapie, Hôpital Saint-Louis, 1 Ave Claude
Vellefaux, 75010 Paris, France. sylvie.delanian@sls.ap-hop-paris.fr
Comment in
J Clin Oncol. 2005 Dec 1;23(34):8551-2.
PURPOSE: Significant regression of radiation (RT) -induced fibrosis (RIF) has
been achieved after treatment combining pentoxifylline (PTX) and alpha-tocopherol
(vitE). In this study, we focus on the maximum response, how long it takes to
achieve response, and changes after treatment discontinuation.
PATIENTS AND METHODS: Measurable superficial RIF was assessed in patients treated
by RT for breast cancer in a long-treatment (24 to 48 months) PTX-vitE (LPE)
group of 37 patients (47 RIFs) and in a short-treatment (6 to 12 months) PTX-vitE
(SPE) group of seven patients (eight RIFs). Between April 1995 and April 2000,
women were treated with a daily combination of PTX (800 mg) and VitE (1,000 IU).
RESULTS: Combined PTX-vitE was continuously effective and resulted in exponential
RIF surface area regression (-46% for LPE and -68% for SPE at 6 months, -58% for
LPE and -69% for SPE at 12 months, -63% for LPE and -62% for SPE at 18 months,
and -68% for LPE at 24 and 36 months). The mean estimated maximal treatment
effect was 68% RIF surface area regression. The mean time to this effect was 24
months and was shorter (16 months) in more recent RIF (< 6 years since RT) than
in older RIF (28 months; P = .0003). Symptom severity (Subjective Objective
Medical Management and Analytic Evaluation score) was halved in both groups.
After treatment discontinuation, mean RIF surface area at 1 year had increased by
+40% in the SPE group (rebound) and +8.5% in the LPE group.
CONCLUSION: Under combined PTX-vitE treatment, RIF regression was exponential,
with a two-thirds maximum response after a mean of 2 years. There was a risk of a
rebound effect if treatment was too short. Long treatment (>/= 3 years) is
recommended in patients with severe RIF.
DOI: 10.1200/JCO.2005.02.4729
PMID: 16260695 [Indexed for MEDLINE]
