The purpose of this study is to determine whether pentoxifylline and vitamin E are effective in prevention of radiotherapy- induced toxicity in head and neck cancer patients treated with concurrent chemoradiotherapy.

This is a randomized controlled prospective study of pentoxifylline and vitamin E given on daily basis throughout the period of concurrent chemoradiotherapy to patients with carcinoma of the head and neck. All patients will be followed up to 90 days since the first day of treatment. The incidence and severity of adverse events will be assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.

Inclusion Criteria:

• Adult patients
• Measurable disease
• Patients with squamous cell carcinoma of the head and neck eligible for treatment with concurrent chemo- radiotherapy
• Able to understand and willing to sign a written informed consent document

Exclusion Criteria:

• Pregnant or lactating women, since imaging cannot be done in this setting.
• Patients treated with vitamin E and/ or pentoxifylline for any other indication
• Patients with recent cerebral and/or retinal hemorrhage
• Patients who have previously exhibited intolerance to pentoxifylline or methylxanthines such as caffeine, theophylline, and theobromine.
• Patients treated with oral anticoagulants.
• Absolute neutrophil count ≤1.5×109/L
• Platelets ≤100×109/L
• AST ≥ 2.5 X institutional upper limit normal (ULN)
• Serum creatinine ≥ 1.5 mg% for males & 1.4 mg% for females
• Serum bilirubin ≥ 1.5X institutional upper limit normal (ULN)