Tocopherols, the Potential Supplementations for the Prevention of Osteoradionecrosis

By Kyle J. Norton

Cancer is the class of diseases associated with the growth of the cells disorderly and uncontrollably due to the alternation of DNA.

Most cases of cancer begin in the cells on the surface of the inner lining tissues of the organ or gland. At the early stage, most cancers are asymptomatic.

However, at the advanced stage, most cancers not can induce common symptoms such as gastrointestinal discomforts, unintended weight loss, loss of appetite, and fatigue but also localized symptoms depending on the affected tissues and organs.

Cancers at this stage also can travel a distance away from the original site to induce secondary metastasis.

According to the statistics provided by the American cancer society, in 2018,1,735,350 new cases were diagnosed, representing more than 4,700 new cancer diagnoses each day.
The lifetime probability of being diagnosed with cancer is 39.7% for men and 37.6% for women.

Compared to all cancers, lung, breast, prostate, and colorectal cancers are the most common cancer in the US.


Osteoradionecrosis is a condition associated with bone death due to radiation or radiation treatment.

The death of bone cells is a result of radiation induce-damage of the blood vessel that supplies the nutrients to the bone.

Osteoradionecrosis is a rare side effect occurred sometime after radiation therapy has ended. The complication usually occurs in the lower jaw or mandible.

Tocopherols are phytochemicals of which many have vitamin E activity, belonging to the group of Lipids, found abundantly in butter, egg yolk, milk fat, some vegetable, and seed or nut oils, etc.

On finding a potential phytochemical for the treatment of side effects induced by radiotherapy, researchers evaluated the healing benefit provided by the antioxidant and antifibrotic properties of pentoxifylline-tocopherol or pentoxifylline-tocopherol-clodronate in combination therapy for osteoradionecrosis.

According to the research of the related study of subjects, the combination of pentoxifylline plus tocopherol with or without clodronate was effective for the treatment of mandibular osteoradionecrosis.

Most of the identified studies were found to be from retrospective case series.

The numbers of studies were generally scarce.

Furthermore, the combination of drug therapy was well tolerated and showed a promising result for the treatment of mandibular osteoradionecrosis.

Moreover, in an18 consecutive patients previously irradiated for head and neck cancer-induced mandible, ORN with the length of the exposed bone (L) was 13.4 +/- 8 mm, and the mean of 12.6 +/- 4.9, either given a daily oral combination of 800 mg of PTX and 1000 IU of vitamin E for 6 to 24 months between June 1995 and January 2002 with eight patients who were the worst cases were given 1600 mg/day clodronate 5 days a week, all patients improved at 6 months, with 84% mean L and 67% mean SOMA score reductions.

Additionally, 18 patients achieved complete recovery, 14 in 5 +/- 2.6 months, compared to only two patients who exhibited a 75% response at 6 months.

Collectively, researchers said, "PTX-vitamin E boosted by clodronate is an effective treatment of mandibular ORN that induces mucosal and bone healing in a median period of 6 months".

Taken altogether, tocopherols used in a combination with other medicines including pentoxifylline may be considered a supplement for reducing the side effects of radiotherapy, pending the confirmation of the larger sample size and multicenter human study.

Intake of tocopherols in the form of supplements should be taken with extreme care to prevent overdose acute liver toxicity.


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Author Biography
Kyle J. Norton (Scholar, Master of Nutrition, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published online, including worldwide health, ezine articles, article base, health blogs, self-growth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bioscience, ISSN 0975-6299.

Sources
(1) Pentoxifylline, tocopherol, and clodronate for the treatment of mandibular osteoradionecrosis: a systematic review by Martos-Fernández M1, Saez-Barba M2, López-López J3, Estrugo-Devesa A3, Balibrea-Del-Castillo JM4, Bescós-Atín C. (PubMed)
(2) Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: a phase II trial by Delanian S1, Depondt J, Lefaix JL. (PubMed)