Superficial Radiation-induced Fibrosis Research Articles

Kinetics of Response to Long-Term Treatment Combining Pentoxifylline and Tocopherol in Patients With Superficial Radiation-Induced Fibrosis

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. 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). 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. 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.

Pentoxifylline and vitamin E combination for superficial radiation-induced fibrosis: A phase II clinical trial

We treated 34 radiation-induced superficial fibrotic lesions with pentoxifylline and vitamin E for 3 months. Mean surface area of the lesions decreased from 112 to 65 cm 2 after treatment ( P<0.001). A subgroup of 21 fibrotic lesions received the medications for 6 months, in which surface area decreased from 80 to 27 cm 2 ( P<0.001). Pentoxifylline–vitamin E combination improved radiation-induced fibrosis.

1352 ORAL Kinetics of response to long-term treatment combining pentoxifylline and tocopherol in patients with superficial radiation-induced fibrosis

1352 ORAL Kinetics of response to long-term treatment combining pentoxifylline and tocopherol in patients with superficial radiation-induced fibrosis

Double-blind placebo-controlled randomised trial of vitamin E and pentoxifylline in patients with chronic arm lymphoedema and fibrosis after surgery and radiotherapy for breast cancer

Background and purposeTreatment-induced arm lymphoedema is a common and distressing complication of curative surgery and radiotherapy for early breast cancer. A number of studies testing alpha-tocopherol (vitamin E) and pentoxifylline suggest evidence of clinical regression of superficial radiation-induced fibrosis but there is only very limited evidence from randomised trials. Arm lymphoedema after lymphatic radiotherapy and surgery has been used in the present study as a clinical system for testing these drugs in a double-blind placebo-controlled randomised phase II trial. Patients and methodsSixty-eight eligible research volunteers with a minimum 20% increase in arm volume at a median 15.5 years (range 2–41) after axillary/supraclavicular radiotherapy (plus axillary surgery in 51/68 (75%) cases) were randomised to active drugs or placebo. All volunteers were given dl-alpha tocopheryl acetate 500mg twice a day orally plus pentoxifylline 400mg twice a day orally, or corresponding placebos, for 6 months. The primary endpoint was volume of the ipsilateral limb measured opto-electronically using a perometer and expressed as a percentage of the contralateral limb volume. ResultsAt 12 months post-randomisation, there was no significant difference between treatment and control groups in terms of arm volume. Absolute change in arm volume at 12 months was 2.5% (95% CI −0.40 to 5.3) in the treatment group compared to 1.2% (95% CI −2.8 to 5.1) in the placebo group. The difference in mean volume change between randomisation groups at 12 months was not statistically significant (P=0.6), −1.3% (95% CI −6.1 to 3.5), nor was there a significant difference in response at 6 months (P=0.7), where mean change in arm volume from baseline in the treatment and placebo groups was −2.3% (95% CI −7.9 to 3.4) and −1.1% (95% CI −3.9 to 1.7), respectively. There were no significant differences between randomised groups in terms of secondary endpoints, including tissue induration (fibrosis) in the irradiated breast or chest wall, pectoral fold or supraclavicular fossa, change in photographic breast/chest wall appearance or patient self-assessment of function and Quality of Life at either 6 or 12 months. ConclusionsThe study fails to demonstrate efficacy of dl-alpha tocopheryl acetate plus pentoxifylline in patients with arm lymphoedema following axillary surgery and lymphatic radiotherapy, nor does it suggest any benefits of these drugs in radiation-induced induration (fibrosis) in the breast, chest wall, pectoral fold, axilla or supraclavicular fossa.

Pentoxifylline and vitamin E combination improves superficial radiation-induced fibrosis

Pentoxifylline and vitamin E combination improves superficial radiation-induced fibrosis

34 Improvement of superficial radiation-induced fibrosis by pentoxifylline and vitamin E combination treatment

34 Improvement of superficial radiation-induced fibrosis by pentoxifylline and vitamin E combination treatment

Pentoxifylline and vitamin E combination improves superficial radiation-induced fibrosis

Pentoxifylline and vitamin E combination improves superficial radiation-induced fibrosis

Fibrose superficielle radio-induite et TGF-β1

Radiation-induced fibrosis is a late sequela of both therapeutic and accidental irradiations, which has been described in various tissues, including the lung, liver, kidney and skin. This review presents different aspects of superficial radiation-induced fibrosis, such as clinical observations, histological changes, cellular and molecular regulations, and medical management. Recent evidence on the critical role played by TGF-β1 in the initiation, development and persistence of fibrosis are discussed, as well as the possibility that this cytokine may constitute a specific target for antifibrotic agents.

791Abnormal phenotype of human cultured fibroblasts from superficial radiation-induced fibrosis (RIF)

791Abnormal phenotype of human cultured fibroblasts from superficial radiation-induced fibrosis (RIF)

161The association of pentoxifylline and tocopherol is useful in the treatment of human superficial radiation-induced fibrosis (RIF): Preliminary results

161The association of pentoxifylline and tocopherol is useful in the treatment of human superficial radiation-induced fibrosis (RIF): Preliminary results

790Skin microrelief study as a new tool for assesment of human superficial radiation-induced fibrosis (RIF)?

790Skin microrelief study as a new tool for assesment of human superficial radiation-induced fibrosis (RIF)?