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Uterine restoration by radiation sequelae regression with combined pentoxifylline-tocopherol: a phase II study
Hélène Letur-Könirsch1, F Guis, Sylvie Delanian
1Fertility Center, Department of Obstetrics and Assisted Reproductive Technics, Institut Mutualiste Montsouris, Paris, France. helene.letur@imm.fr
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.