What pentoxifylline and vitamin E dose do you typically use for both the prevention and treatment of radiation-associated fibrosis after breast RT?

Pentoxifylline 400 mg three times daily and Vit E 400 iU once daily.

In a small retrospective review, tolerance to Pentoxifylline was improved with the use of concurrent antiemetic therapy. Of those on antiemetic therapy, 89% completed pentoxifylline as prescribed versus 48% of those without antiemetics (P < .001). Famoso et al., PMID 29556575.

For treatment of fibrosis at any site, I generally use 1,000 IU of Vitamin E once daily, and pentoxifylline I usually start at 400 mg twice daily and increase to three times per day if tolerated. I tell my patients that it may take several months to notice any improvement and they may need to stay on the regimen indefinitely if tolerated.

I have not used this regimen for prophylaxis.