Efficacy of pentoxifylline-tocopherol-clodronate in mandibular osteoradionecrosis.

Objectives/hypothesis: PENTOCLO treatment, associating pentoxifylline, tocopherol, and clodronate, resolves radiation-induced fibrosis. The main aim of the present study was to prospectively assess efficacy in mandibular osteoradionecrosis (ORN).
Study Design: Prospective cohort study.
Methods: Twenty-seven patients with mandibular ORN were included in the Pentoclauvergne Study between January 2014 and February 2016. After an initial 28-day phase of antibiotic, antifungal, and corticosteroid therapy, they received the PENTOCLO association daily until cure or a maximum of 24 months. The main assessment criterion was exposed bone area (EBA); secondary criteria comprised the Subjective, objective, management, and analytic (SOMA) score.
Results: Under PENTOCLO, EBA decreased by 28% at 2 months, 55% at 6 months, and 92% at 24 months; the SOMA score decreased by 23%, 38%, and 50%, respectively. A complete treatment course cured 76.5% of patients at a mean 9.6 months.
Conclusions: PENTOCLO is a simple, well-tolerated, and effective treatment for mandibular ORN.
Level of Evidence: 4 Laryngoscope, 130:E559-E566, 2020.
(© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)