Efficacy of PENTOCLO Therapy in Treating Head & Neck Osteoradionecrosis: A Systematic Review.

Arianna V Ramirez, Janisah Amirah I Saripada, Amy Wang, Viran J Ranasinghe, Orly M Coblens, Sepehr Shabani
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Abstract

Importance: Osteoradionecrosis (ORN) has been shown to affect up to 20% of all head and neck cancer patients receiving radiation therapy. Despite its prevalence, a standard definitive therapy to treat this condition has yet to be available. A novel treatment modality with pentoxifylline, tocopherol, and clodronate (PENTOCLO) was first reported in the literature in 2005. There has since been a steady rise in the number of studies exploring the efficacy of PENTOCLO in treating ORN in head and neck patients.

Objective: This article investigates the efficacy of PENTOCLO in treating ORN in head and neck cancer patients.

Evidence review: PubMed, Scopus, Cochrane Library, and Medline were used to review articles on PENTOCLO use for head and neck ORN from 2005 to the present. Two reviewers independently screened titles and abstracts from 114 articles, and inclusion was based on pair consensus. The main inclusion criteria were human clinical studies using PENTOCLO for at least 6 months in treating ORN in head and neck cancer patients. The selected main outcomes to determine the efficacy of PENTOCLO therapy were wound healing status after treatment, reduction in the percentage of exposed bone, and symptom surveys post-PENTOCLO therapy. Eight studies were selected for final statistical analysis.

Findings: The primary site of ORN in most studies was mandible (77%). Of the 141 patients encompassed in this review, 66 (46.8%) patients had complete resolution, and 61 (43.3%) patients had significant wound healing. Total wound healing was achieved on an average of 10 months. The mean area of exposed bone decreased by 96% and the symptom survey scores decreased by 93% after treatment.

Conclusion and relevance: These results suggest PENTOCLO may be an effective treatment option in patients with head and neck ORN.

PENTOCLO治疗头颈部骨放射性坏死的疗效:系统评价。
重要性:在接受放射治疗的头颈癌患者中,有高达20%的人患有骨放射性坏死(ORN)。尽管它很普遍,但治疗这种疾病的标准明确疗法尚未出现。2005年文献首次报道了一种新的治疗方法:己酮茶碱、生育酚和氯膦酸盐(PENTOCLO)。此后,探索PENTOCLO治疗头颈部ORN疗效的研究数量稳步上升。目的:探讨本品治疗头颈部恶性肿瘤ORN的疗效。证据回顾:使用PubMed、Scopus、Cochrane Library和Medline对2005年至今有关PENTOCLO用于头颈部ORN的文章进行回顾性分析。两位审稿人独立筛选114篇文章的标题和摘要,并基于对共识进行纳入。主要入选标准是使用PENTOCLO治疗头颈癌患者ORN至少6个月的人类临床研究。确定PENTOCLO治疗效果的主要结果是治疗后伤口愈合状况、暴露骨百分比的减少以及PENTOCLO治疗后的症状调查。最终选取8项研究进行统计分析。结果:在大多数研究中,ORN的主要部位是下颌骨(77%)。在本综述纳入的141例患者中,66例(46.8%)患者完全痊愈,61例(43.3%)患者伤口显著愈合。伤口完全愈合平均10个月。治疗后平均暴露骨面积减少96%,症状调查评分下降93%。结论及意义:本研究结果提示PENTOCLO可能是头颈部ORN患者的有效治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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