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Pentoxifylline, tocopherol, and clodronate in radiation-induced lumbosacral polyradiculopathy

Pentoxifylline, tocopherol, and clodronate seem to be effective in radiation-induced lumbosacral polyradiculopathy, as reported by a case study. This is important, although the evidence is weak (case report), as to date there is not one single therapy found to be of use in this late complication of radiation induced polyradiculopathy.

Radiation-induced peripheral neuropathy

Radiation-induced peripheral neuropathy is a rare and also quite severe delayed complication of radiotherapy. This complication is that is irreversible and is characterized by demyelination, axonal degeneration, and fibrosis. As said, there is currently no medical treatment to limit or reduce symptoms, neither are there indications how to treat painful radiation induced neuropathy.

In two patients of progressive leg radiation-induced polyradiculopathy significant improvement in neurological symptoms over several years was achieved with a treatment combining pentoxifylline, tocopherol, and clodronate (Pentoclo).^[1]

Treatment regime: Pentoclo treatment combining daily 800mg pentoxifylline, 1000mg tocopherol, and 1600mg clodronate five days/week alternating with 20mg prednisone two days/week, was started with a follow-up visit every 6months.

German groups demonstrated a comparable therapeutic effect of a differen radiation damage: the combination treatment with pentoxifylline and tocopherol in their hands seems to have a benefit in patients with grade I-II radiation-induced proctitis/enteritis. ^[2]

September 2010, prof. dr. Jan M. Keppel Hesselink

Referenties

[1]: McCormick SD, Sakamoto T, Hasegawa S, Hirano T. | Osmoregulatory actions of insulin-like growth factor-I in rainbow trout (Oncorhynchus mykiss). | J Endocrinol. | 1991 Jul;130(1):87-92.

[2]: Hille A, Christiansen H, Pradier O, Hermann RM, Siekmeyer B, Weiss E, Hilgers R, Hess CF, Schmidberger H. | Effect of pentoxifylline and tocopherol on radiation proctitis/enteritis. | Strahlenther Onkol. | 2005 Sep;181(9):606-14.