Guidelines for Complications of Cancer Treatment Vol VIII Part B

the patients responded to HBO alone. Annane et al.,evaluated the role of HBO in treatment of overt ORN ina randomized, placebo controlled trial. The trial had tobe concluded prematurely as HBO did not show anybenefit over placebo (19% versus 33%), neither did itslow progression of disease or relieve pain. In a recentphase II clinical trial the role of pentoxyphylline andtocopheraol with the addition of clodronate have beenevaluated and found to be promising. In the absence ofadequately powered prospective trials, prospective dataon the use of this new protocol may define the role andplace of HBO and these newer protocols. Surgical intervention is reserved for pathologicalfractures, non responding lesions and progressivedisease.Suggested protocols (Delanian S et al., LOE: 2):Patients requiring dental extractions could be given:T. Pentoxifylline, 400 mg twice daily, for eight weeks withtocopherol 1000 IU, starting a week before the procedure. IfORN developed then they could be continued for a further 6months with clodronate prescribed after 3 months if there hasbeen no appreciable response.Management of ORN162