AI Article Synopsis
- - This study investigates the link between survival time after bisphosphonate treatment and the occurrence of medication-related osteonecrosis of the jaw (MRONJ) in cancer patients treated with zoledronic acid (ZA).
- - Among 988 patients evaluated, those with shorter survival rates (lung and other cancers) rarely developed MRONJ, likely due to the limited duration of ZA use.
- - The findings suggest that dental management for cancer patients should consider individual prognosis and MRONJ risk, especially in those with cancers that have better survival outcomes.
Article Abstract
Purpose: 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 sufficiently 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/dental supportive care of cancer patients.
Methods: We evaluated 988 patients who were administered ZA at our hospital; among them, 862 patients with metastatic bone tumors or myeloma were included.
Results: The 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. The cumulative incidence of MRONJ in breast cancer, prostate cancer, and multiple myeloma was related to the frequency of anti-resorptive drug use and the increased risk over time. In renal cancer, the cumulative incidence of MRONJ increased early, although the MST was 12 months.
Conclusion: For the dentists in charge of dental management, it is essential to be aware of prognosis-related factors, predict MRONJ risk for each cancer treatment, and use risk prediction in dental management planning, particularly for cancers with non-poor prognosis.
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| http://dx.doi.org/10.1007/s00520-022-06839-4 | DOI Listing |
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