Prognosis by cancer type and incidence of zoledronic acid–related osteonecrosis of the jaw: a single-center retrospective study

Abstract

Survival time after bisphosphonate use has been increasingly recognized to be associated with the incidence of medication-related osteonecrosis of the jaw (MRONJ); however, this has not been elucidated su ciently in the literature. This study aimed to clarify the incidence of MRONJ and the corresponding survival rate of patients treated with zoledronic acid (ZA) for each type of cancer and obtain useful information for the oral management of cancer. MethodsWe evaluated 988 patients who were administered ZA at our hospital; among them, 862 patients with metastatic bone tumors or myeloma were included. ResultsThe median survival time (MST) after ZA initiation was 35,34, 8,41,12, and 6 months for patients with breast, prostrate, lung, myeloma, renal, and other cancers, respectively. Patients with cancers that had a short survival time (lung and other cancers [MST = 8 and 6 months, respectively] and cancers with MST < 10 months) did not develop MRONJ; this could be attributed to the shorter duration of ZA administration.

Oral-Health-Related Quality of Life in Patients with Medication-Related Osteonecrosis of the Jaw: A Prospective Clinical Study

“…Bone-modifying agents such as bisphosphonates or monoclonal antibodies are commonly used to prevent or treat bone-related diseases such as osteoporosis, bone metastases of solid tumors, and cancerous bone lesions of multiple myeloma [ 1 , 2 ]. These agents influence bone remodeling by modifying the differentiation and function of osteoclasts in different ways [ 3 ].…”

MRONJ in breast cancer patients under bone modifying agents for cancer treatment-induced bone loss (CTIBL): a multi-hospital-based case series

“…The preventive measures in cancer patients with BM or multiple myeloma should be done strictly before the administration of MRONJ-related medications, and in osteo-metabolic patients within its first six months. Furthermore, the patients taking BMAs should undergo periodic dental visits for early diagnosis of MRONJ: every four months for patients assuming a high dose of BMAs with/without antiangiogenics medication intake; every six months for patients assuming a low dose of BMAs [ 3 , 9 ].…”

“…MRONJ is usually reported in two major groups of patients: (a) cancer patients with bone metastases (BM) or with multiple myeloma, usually receiving high doses of BMAs, and (b) osteo-metabolic patients under low doses of BMAs [ 2 , 6 – 8 ]. The risk of MRONJ is considerably higher in the malignancy group, ranging between 1% and more than 20%, than in the osteo-metabolic group, less than 1% [ 9 – 12 ].…”

Avaliação dos fatores de risco para o desenvolvimento de osteonecrose dos maxilares induzida por bisfosfonatos (ONMB) em pacientes oncológicos usuários de bisfosfonato intravenoso

“…A associação entre condição inflamatória/infecciosa em cavidade oral com desfechos sistêmicos como sepse, alteração do controle da glicemia, endocardite, doenças cardiovasculares e parto prematuro já foi descrita na literatura (Li et al, 2000;Reutemaa et al, 2008;Oppermann et al, 2012). Essa inter-relação é suportada pelas teorias de foco de infecção e infecção focal e tem como base a resposta inflamatória sistêmica e a translocação de microrganismos dos tecidos bucais por via hematogênica (Hata et al, 2022;Badros et al, 2021).…”

“…Nossa população foi prioritariamente composta por casos de próstata, mama e mieloma (85%), apenas 4% apresentavam doença em pulmão. A literatura tem apontado a menor sobrevida nos portadores de câncer de pulmão como provável causa da reduzida incidência de ONMB nesta população (Gadgaard et al, 2022;Hata et al, 2022).…”