Is there an effective treatment for severe radiation fibrosis of the skin after radiotherapy to the breast or other areas?

I have used this regimen occasionally with moderate success. Worth a try. Topical Vitamin E as well can help.

I have had occasional successes with breast fibrosis. In the absence of other regimens, it's worth a 6-month trial.

I have only had a handful of patients with chronic radiation fibrosis in the last 6 years, but 3 of them benefited from Ultrasound therapy from a PT office that offers it.

The data behind this treatment comes from reports of Ultrasound therapy utilized to treat Lipodermatosclerosis.

These patients were also on alternating medium potency topical steroids and steroid alternatives q 2 weeks (i.e., triamcinolone and tacrolimus) as well.

Clinically speaking, the skin felt notably more pliable and softer. For the telangiectasias that can appear in areas of radiation fibrosis, I utilized a pulse dye laser to reduce the redness.

In one case several years ago, the radiation injury lead to chronic painful ulceration which was refractory to topical and ultrasound therapy. We ended up excising the area (partial thickness) and utilized a split-thickness graft.

Radiation fibrosis and ulceration are very challenging!

I have not been terribly impressed with the effectiveness of this regimen and have yet to find anything I am confident in recommending to patients who have significant radiation-induced fibrosis. For patients with associated pain, I've had modest success using gabapentin or similar agents.

Would you ever recommend pentoxifylline + Vitamin E to prevent fibrosis before it has occurred?