Pentoxifylline in prevention of radiation-induced lung toxicity in patients with breast and lung cancer: A double-blind randomized trial

Purpose: Pentoxifylline (Ptx) is thought to be helpful in preventing radiotoxicity by inhibiting platelet aggregation and tumor necrosis factor. We assessed whether prophylactic use of Ptx could prevent early and late normal lung tissue damage due to radiotherapy in a double-blind, randomized trial. Methods and Materials: A total of 40 patients with lung or breast cancer were randomized to receive Ptx (400 mg) or a placebo, 3 times daily, during the entire period of radiotherapy. We used the late effects normal tissue-subjective, objective, management, and analytic (LENT-SOMA) scale to evaluate and compare toxicity, including the findings of pulmonary function tests and radiologic and scintigraphic evaluations performed before and at 3 and 6 months of follow-up. Results: According to the LENT score, a statistically significant difference was found between the two groups in favor of Ptx (p = 0.016). The difference in diffusing capacity of the lung for carbon monoxide and regional perfusion scan results were found to be statistically significant between the groups at 3 and 6 months (p <0.05). The use of Ptx resulted in a noticeable reduction in the higher degrees of lung injury detected radiologically. Conclusion: Our study showed a significant protective effect of Ptx for both early and late lung radiotoxicity. We recommend the prophylactic use of Ptx, finding it to be safe and effective. (C) 2004 Elsevier Inc.