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] × 30 [± 3] × 20 [± 2] vs. 30 [± 7] × 22 [± 3] × 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.