Uterine restoration by radiation sequelae regression with combined pentoxifylline-tocopherol: a phase II study

Abstract

Objective: To determine whether combined pentoxifylline (PTX) and tocopherol (vitamin E) treatment can improve uterine radiation-induced sequelae, resulting in an improved embryo implantation rate.

Design: Retrospective phase II clinical trial.

Setting: Volunteers in an oocyte donation program in a public hospital.

Patient(s): Six women aged 31 +/- 4 years, who were irradiated 25 years previously for childhood cancer with 20 to 40 Gy including the pelvic area.

Intervention(s): Four women had taken hormone replacement therapy for primary amenorrhea, and two had retained their natural cycle. Treatment consisted of at least 12 months of pentoxifylline at 800 mg/day combined with 1000 IU/day of tocopherol.

Main outcome measure(s): Endometrial thickness, uterine volume, and uterine artery blood flow were assessed by ultrasonography before and after pentoxifylline-tocopherol treatment, under usual estrogen-progesterone (OP) administration.

Result(s): This treatment was well tolerated. All six patients improved significantly in endometrial thickness (6.2 +/- 0.6 vs. 3.2 +/- 1.1 mm), myometrial dimensions (44 [+/- 5] x 30 [+/- 3] x 20 [+/- 2] vs. 30 [+/- 7] x 22 [+/- 3] x 16 [+/- 2] mm), and diastolic uterine artery flow.

Conclusion(s): In young women who want to bear children, the combination of pentoxifylline and vitamin E can reduce fibroatrophic uterine lesions after childhood irradiation.