Evidence map›Paper›PMID 41714790›Full record

SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

Adverse effects of the PENTO(CLO) protocol in the prevention and management of iatrogenic head and neck bone necrosis in cancer patients: A systematic review and meta-analysis.

Marco Tulio Leandro Ribeiro, Caique Mariano Pedroso, Mariana Mayume Carvalho Kadooka, Maria Eduarda Pérez-de-Oliveira, Fabio Ramoa Pires, Márcio Ajudarte Lopes, Alan Roger Santos-Silva

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Marco Tulio Leandro RibeiroDepartment of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901 - CEP, Piracicaba, 13414-903, Brazil.ORCID http://orcid.org/0000-0001-7548-4618
Caique Mariano PedrosoDepartment of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901 - CEP, Piracicaba, 13414-903, Brazil.ORCID http://orcid.org/0000-0002-7504-7597
Mariana Mayume Carvalho KadookaDepartment of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901 - CEP, Piracicaba, 13414-903, Brazil.
Maria Eduarda Pérez-de-OliveiraDepartment of Clinical and Preventive Dentistry, Center for Health Sciences, Federal University of Pernambuco, Recife, Brazil.ORCID http://orcid.org/0000-0003-3265-2671
Fabio Ramoa PiresOral Pathology, Department of Diagnosis and Therapeutics, Dental School, Rio de Janeiro State University, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0003-0317-8878
Márcio Ajudarte LopesDepartment of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901 - CEP, Piracicaba, 13414-903, Brazil.ORCID http://orcid.org/0000-0001-6677-0065
Alan Roger Santos-SilvaDepartment of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901 - CEP, Piracicaba, 13414-903, Brazil. alan@unicamp.br.ORCID http://orcid.org/0000-0003-2040-6617

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the proportion of adverse effects (AEs) associated with the use of PENTO or PENTOCLO protocols for the prevention and management of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ).

methodsA systematic literature search was conducted across six databases (PubMed, Scopus, Embase, Web of Science, LILACS, and Cochrane Library) and gray literature, with no restrictions on date or language. Studies were eligible if they involved adults (≥ 18 years) with or at risk for ORN or MRONJ and reported AEs associated with PENTO or PENTOCLO for prevention or treatment. A proportion meta-analysis estimated the overall frequency of AEs. Subgroup analyses compared AE rates between prevention and treatment contexts and between the two regimens.

resultsOf 1,075 records screened, 9 studies met the inclusion criteria. No studies reported AEs in MRONJ patients; all focused on ORN. The pooled AE proportion was 15% (95% CI: 3.6%-11.5%; p < 0.1; I

conclusionThe PENTO(CLO) protocols were associated with a 15% overall AE rate, predominantly gastrointestinal symptoms. AEs occurred more often during treatment and with the PENTOCLO regimen. These findings highlight the need for close monitoring and further studies to assess safety in MRONJ patients.

Indexed as

Head and Neck NeoplasmsOsteoradionecrosisPentoxifyllineHumansIatrogenic DiseasePentoxifyllineAdverse effectsClodronic acidOsteonecrosis of the jawsOsteoradionecrosisPentoxifyllineTocopherols

Identifiers

PMID41714790
PMCPMC12920728

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.